Inflammatory and Infectious Disorders in Endocrine Pathology

Abstract

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.

PD-L1 expression, tumor-infiltrating lymphocytes, and mismatch repair proteins status in digestive neuroendocrine neoplasms: exploring their potential role as theragnostic and prognostic biomarkers

“…The clinical efficacy of ICIs therapy reflects the immunomodulatory effect mediated by the binding with their specific antigens involved in the regulation of immune response, consequently increasing host response to tumor cells [16]. It clearly appears that ICIs performance depends on the correct selection of patients who can benefit from the therapy, excluding those potentially not responding for whom the cost/benefit of ICIs therapy, which is not free of adverse symptoms (including, but not limited to, hypophysitis, thyroiditis, and colitis), is not favorable [15].…”

“…In this complex scenario, the role of immune checkpoint inhibitors (ICIs) therapy in NENs management has been preliminarily explored with conflicting and partially non-conclusive results and it still remains to be elucidated [13]. It is worth noting that the proper identification of patients to treat with ICIs reduces the cost/benefit balance, also in terms of adverse effects of these drugs, which may cause severe and potentially lethal conditions [14,15]. Consequently, the evaluation of predictive biomarkers is needed to predict clinical benefit.…”

Molecular Classification of Gastrointestinal and Pancreatic Neuroendocrine Neoplasms: Are We Ready for That?

“…Based on this rationale, immunotherapy with immune check point inhibitors (ICI) has been employed in patients with NEC of the lung and is currently being tested in extra-pulmonary NEC, including digestive ones. Clinical trials with anti-PD1, anti PDL-1, and anti-CTLA4 drugs, in monotherapy or in combination, are ongoing with conflicting results [ 150 ], and the employment of these therapeutics should be judiciously evaluated since they may give serious adverse effects on vital organs and systems [ 151 ]. Importantly, immunogenicity of NEC may be increased or elicited using DNA-damaging drugs, such as antiblastic chemotherapeutics, and the association of ICI with standard chemotherapy has given good results in terms of overall survival [ 136 , 152 , 153 ].…”

Effect of Caffeine on the Inflammatory-Dependent Changes in the GnRH/LH Secretion in a Female Sheep Model

“…The endocrine glands may be directly involved in infectious and inflammatory processes in the course of systemic inflammation. Infectious and inflammatory disorders of endocrine tissues may lead in turn to a disturbance in hormone production and activity [ 1 ]. One of the endocrine systems sensitive to inflammation is the hypothalamic–pituitary–gonadal (HPG) axis, which controls the reproductive process in female mammals.…”