Department of Biomedical Sciences, Humanitas University, Via Rita Levi Montalcini 4, 20072 Pieve Emanule, Milan, Italy.
Pathology Service IRCCS Humanitas Research Hospital, Via Manzoni 56, 20089, Rozzano, Milan, Italy.
Endocr Pathol. 2023 Dec;34(4):406-436. doi: 10.1007/s12022-023-09771-3. Epub 2023 May 20.
A variety of inflammatory conditions may directly involve the endocrine glands, leading to endocrine dysfunction that can cause severe consequences on patients' health, if left untreated. Inflammation of the endocrine system may be caused by either infectious agents or other mechanisms, including autoimmune and other immune-mediated processes. Not infrequently, inflammatory and infectious diseases may appear as tumor-like lesions of endocrine organs and simulate neoplastic processes. These diseases may be clinically under-recognized and not infrequently the diagnosis is suggested on pathological samples. Thus, the pathologist should be aware of the basic principles of their pathogenesis, as well as of their morphological features, clinicopathological correlates, and differential diagnosis. Interestingly, several systemic inflammatory conditions show a peculiar tropism to the endocrine system as a whole. In turn, organ-specific inflammatory disorders are observed in endocrine glands. This review will focus on the morphological aspects and clinicopathological features of infectious diseases, autoimmune disorders, drug-induced inflammatory reactions, IgG4-related disease, and other inflammatory disorders involving the endocrine system. A mixed entity-based and organ-based approach will be used, with the aim to provide the practicing pathologist with a comprehensive and practical guide to the diagnosis of infectious and inflammatory disorders of the endocrine system.
多种炎症性疾病可能直接累及内分泌腺体,导致内分泌功能障碍,如果不加以治疗,可能会对患者的健康造成严重后果。内分泌系统的炎症可能由感染因子或其他机制引起,包括自身免疫和其他免疫介导的过程。炎症和传染性疾病经常表现为内分泌器官的肿瘤样病变,并模拟肿瘤过程。这些疾病可能在临床上被低估,而且诊断通常是基于病理样本得出的。因此,病理学家应该了解其发病机制的基本原则,以及它们的形态特征、临床病理相关性和鉴别诊断。有趣的是,几种全身性炎症性疾病表现出对整个内分泌系统的特殊趋向性。相反,在特定的内分泌腺体中观察到器官特异性炎症性疾病。本综述将重点关注感染性疾病、自身免疫性疾病、药物诱导的炎症反应、IgG4 相关疾病和其他涉及内分泌系统的炎症性疾病的形态学方面和临床病理特征。将采用基于实体和基于器官的混合方法,旨在为临床病理医生提供有关内分泌系统感染和炎症性疾病诊断的综合实用指南。