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. 2010 Oct;23(4):426-8.
doi: 10.1080/08998280.2010.11928663.

Ectopic adrenocorticotropic hormone syndrome: a diagnostic challenge and review of the literature

Yanjun Ma  1 , Cristi Aitelli, Robin W Dobson, Kartik Konduri
Affiliations

Ectopic adrenocorticotropic hormone syndrome: a diagnostic challenge and review of the literature

Yanjun Ma et al. Proc (Bayl Univ Med Cent). 2010 Oct.

Abstract

We present a case of a 60-year-old woman who initially presented with pneumonia and abdominal pain and was diagnosed with ectopic adrenocorticotropic hormone (ACTH) syndrome secondary to small cell lung cancer. We review published literature and summarize the typical challenges in the diagnosis and treatment of ectopic ACTH syndrome. Recent research has shed new light on the mechanism of ectopic ACTH production and provided a potential new target for treatment.

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Figures

Figure 1
Figure 1
CT scans of the chest demonstrating (a) a 4.1 × 3.8–cm mass invading the right middle lobe bronchus (arrow) and (b) a 2.1 × 4.1–cm subcarinal lymph node (arrow) that subsequently underwent fine-needle biopsy.
Figure 2
Figure 2
Fine-needle biopsy of the subcarinal lymph node with (a) hematoxylin and eosin staining and (b) Papanicolaou staining demonstrating metastatic small cell carcinoma with prominent nucleoli. Adjacent bronchial mucosa is visible on the left portion of panel a. (c) Bone marrow core biopsy revealing a bone marrow almost completely replaced by metastatic small cell carcinoma cells. (d) 1000× amplification of the bone marrow aspirate demonstrating a close-up view of the metastatic small cell carcinoma with scattered nucleoli and finely speckled chromatin.
See this image and copyright information in PMC

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