Srp Ark Celok Lek
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Adrenal incidentalomas are a heterogeneous group of pathological entities, including benign or malignant adrenocortical or medullary tumors, hormonally active or inactive lesions, which are identified incidentally during the examination of nonadrenal-related abdominal complaints. About 1.5% to 23% of adrenal incidentalomas are pheochromocytomas. Composite pheochromocytoma is a rare tumour of adrenal medulla with divergente clinical course. ⋯ Immunoreactivity of this tumour added several features to the wide immunohistochemical spectrum. This case demonstrates the indolent behavior of sporadic-type CP and retroperitoneal paraganglioma in an adult patient. Unusual morphological features of CP occur in a substantial number of cases and may cause diagnostic problems.
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Arterial occlusive disease is a systemic phenomenon frequently coexisting in more than one arterial system. Often in one arterial bed disease is manifested with symptoms, in another is asymptomatic. There are only several reports indicating the prevalence of carotid stenosis in patients with peripheral vascular disease. Asymptomatic carotid stenosis is defined as the presence of internal carotid/carotid bifurcation stenotic or occlusive lesions in patients with no signs or symptoms of cerebrovascular disease. Lesions are important causative factors in unheralded stroke. Two factors are particularly important: severity of stenosis and morphologic characteristics of the stenotic plaque. The recent largest completed clinical trial concerning asymptomatic carotid artery stenosis (completed 1995) ACAS (Asymptomatic Carotid Artery Study) established the benefit of surgical treatment vs. best medical treatment. The reduction in relative risk of stroke was 55% in favor of surgery. Population screening for carotid stenosis is inefficient and expensive. The current interest is focused on the efficacy of screening population at risk. ⋯ Prevalence of asymptomatic carotid artery stenosis in patients with lower extremities atherosclerosis is relatively high. Limiting screening of specific subgroups for any demographic or medical characteristics is ineffective. Screening for asymptomatic carotid artery stenosis is indicated in all patients with lower extremities atherosclerosis except in whom prophylactic carotid endarterectomy is not recommended because of comorbid disease or extreme age.