Pituitary neuroendocrine tumors (PitNETs), also known as pituitary adenomas, are rare tumors that are usually benign. At present, the WHO PitNET classification based on transcription factors is in force. A problem is caused by invasive tumors and silent tumors which, despite a lack of obvious clinical symptoms, tend to behave aggressively. Factors influencing the clinical course of these tumors are currently being sought. The aim of our study was to assess the expression of programmed death-ligand 1 (PD-L1) and proliferation biomarkers (Ki-67, cyclin D1, and P53) in PitNETs depending on the transcription factor and adenoma subtype. The analysis was performed in seventy-four patients operated on in a single neurosurgical center for pituitary tumors. Immunohistochemistry was performed for transcription factors and biomarkers—PD-L1, Ki-67, P53, and cyclin D1—in tissue microarray format. Membranous expression of PD-L1 was scored as 0 (no expression) and ≥1%. Nuclear expression of Ki-67 was scored at <3% and ≥3%, and the expression of P53 and cyclin D1 was scored at <10% and ≥10%. The following tumors expressed PD-L1 at ≥1%: gonadotroph, 21 (28.4%); corticotroph, 5 (6.7%); gonadotroph/lactotroph, 2 (2.7%); null cell adenoma, 3 (4.0%); multiple synchronous PitNET, 2 (2.7%); immature PIT-1 tumor, 1 (1.3%); mature PIT-1 tumor, 1 (1.5%). Ki-67 ≥ 3% was found in the following PitNETs: gonadotroph, 3 (4.0%); corticotroph, 2 (2.7%); lactotroph, 1 (1.3%); multiple synchronous PitNET, 1 (1.3%); immature PIT-1 tumor, 1 (1.3%); and mature PIT-1 tumor, 1 (1.3%). Patients with Ki-67 ≥ 3% were statistically significantly younger (p = 0.03). All tumors (100%) with a combination of cyclin D1 ≥ 10% and P53 < 10% were invasive on the Hardy scale. Of the four factors, PD-L1 increased the odds of invasiveness the most (adjusted OR = 2.35; 95% CI: 0.56–9.90). PD-L1 expression was present in some types of PitNETs. PD-L1 expression may help in identifying null cell adenomas. High cyclin D1 with low P53 may indicate greater tumor invasiveness.

Background: An accurate diagnosis of thyroid nodules is crucial for avoiding unnecessary surgical procedures and making timely treatment possible. The objective of the present study was to evaluate the diagnostic accuracy of fine-needle aspiration biopsy (FNAB) using histopathological findings as the reference standard. Patients with the diagnostic categories (DCs) III, IV, and V were subjected to special analysis. In addition, the authors assessed whether other factors, including age, gender, body mass index (BMI), obesity, and histopathologically confirmed lymphocytic thyroiditis, had an impact on the occurrence of malignant tumors. Methods: We performed a retrospective analysis of 535 patients (with a mean age of 52.3) who underwent thyroid surgery between October 2022 and September 2023 at the Department of Endocrine Surgery at the University Hospital in Krakow. To assess the reliability of FNAB, the results obtained using the Bethesda classification were compared with the histopathological results. Results: The risk of malignancy (ROM) values for DCs I–VI were 38.1%, 15.6%, 29.8%, 18.6%, 91.0%, and 93.2%, respectively. DC V (OR 62.34, p < 0.0001) and an age ≤ 50 (OR = 2.31, p < 0.006) had statistically significant effects on the risk of thyroid cancer. DCs III and IV were not statistically significantly associated with the risk of malignancy (OR = 1.68, p = 0.16; OR = 1.51, p = 0.3, respectively). There were no statistically significant differences in sex, BMI, or obesity between the patients with benign and malignant lesions. Conclusions: DC V is associated with a high likelihood of malignancy, especially in patients under 50 years of age, and, therefore, surgery is indicated in this category of subjects. In DCs III and IV, the risk of malignancy is lower, and conservative management with active clinical and ultrasound surveillance can be considered. In patients < 50 years of age, with Bethesda categories III and IV, surgical treatment should be considered.

Objective: This study assessed the relationship between serum calcium (Ca) and parathyroid hormone (PTH) levels, the size and weight of the enlarged parathyroid gland (PG), and the results of technetium-99m-metoxyisobutylisonitrile (MIBI) parathyroid scintigraphy with single-photon emission computed tomography/computed tomography. Methods: Among 252 patients who underwent surgery for hyperparathyroidism between October 2022 and March 2025 at the Department of Endocrine Surgery of the University Hospital in Krakow, 212 patients with primary hyperparathyroidism (PHPT) were selected and divided into the MIBI(−) (n = 49) and MIBI(+) (n = 163) groups. Results: MIBI was positive in 76.9% and negative in 23.1% patients with PHPT. Mean PTH in the MIBI(+) and MIBI(−) groups was 177.3 ± 144.7 and 127.7 ± 59.4 pg/mL, respectively. Significant differences were found in PTH (p < 0.01), maximum excised PG size (p < 0.01), and weight (p < 0.01). PTH predicted positive scintigraphy in univariate analysis (OR = 2.65; 95% CI: 1.19–5.89; p = 0.02) and showed a borderline association in the multivariate model (OR = 2.47; 95% CI: 0.95–6.41; p = 0.06). Optimal cut-offs for predicting MIBI positivity were 135.0 pg/mL for PTH (AUC = 0.64), 0.73 g for PG weight (AUC = 0.81), and 18.0 mm for PG maximum size (AUC = 0.78). The Wisconsin index (Ca × PTH) was associated with positive MIBI (OR = 2.58; 95% CI: 1.15–5.78; p = 0.02), with an optimal cut-off of 256.0. Serum total Ca levels showed no significant association with positive MIBI (p = 0.60). Conclusions: Serum PTH levels, Wisconsin index, and enlarged PG size and weight may help predict parathyroid scintigraphy outcomes.

The human pituitary is a gland located within a small bony box, the sella turcica, under the base of the brain

Background: Our study investigated the association between chronic lymphocytic thyroiditis (CLT) and thyroid cancer (TC). Methods: A retrospective review of 1670 patients who underwent thyroid surgery between October 2022 to February 2025 was performed. The clinicopathological characteristics of patients with TC and CLT were collected. CLT was diagnosed histopathologically. Results: Patients with a positive CLT result (60.39%) compared to a negative CLT result (34.12%) had more frequently TC (p < 0.001), predominantly PTC. In univariate analysis, patients with malignancy + CLT-positive compared to malignancy + CLT-negative were found to be younger in age (p < 0.001), female gender (p < 0.001), smaller tumours focus (p = 0. 013), smaller mass of thyroid removed (p < 0.001) and more often Bethesda category V and VI (p = 0.019), true positive fine needle aspiration biopsy (FNAB) for PTC (p = 0.009), and microcarcinoma (p = 0.021). There were no differences in multifocality, the presence of LNM, or the number of LNMs. The location of metastases at neck lymph nodes was at the borderline of significance (p = 0.065). In multivariate analysis, after accounting for Bethesda and age, CLT+ was found to increase the risk of TC by 73% (OR = 1.73; 95%CI, 1.15-2.29), while the risk of PTC increased more than 2-fold (OR = 2.12; 95% CI, 1.45–3.11). CLT had no statistically significant effect on the presence of LNM. Conclusions: We found that CLT is a risk factor for TC. One should be vigilant concerning the coexistence of these two diseases. We suggest that total thyroidectomy should be considered in patients referred for thyroid nodules and suspected CLT. However, this issue requires further research.

Background: An accurate diagnosis of thyroid nodules is crucial for avoiding unnecessary surgical procedures and making timely treatment possible. The objective of the present study was to evaluate the diagnostic accuracy of FNAB (fine-needle aspiration biopsy) using histopathological findings as the reference standards. Patients with the diagnostic categories (DCs) III, IV, V were subjected to a special analysis. In addition, the authors assessed whether other factors, i.e. age, gender, BMI (body mass index), obesity and histopathologically confirmed lymphocytic thyroiditis had an impact on the occurrence of malignant tumors. Methods: A retrospective analysis was conducted on 535 patients who underwent thyroid surgery between October 2022 and September 2023. To assess the FNAB reliability, the result obtained using the Bethesda classification was compared with the histopathological result. Results: The ROM (risk of malignancy) values for DCs I-VI were 38.1%, 15.6%, 29.8%, 18.6%, 91.0%, 93.2%, respectively. DC V (OR 62.34, p< 0.0001) and age≤50 (OR=2.31, p<0.006) had a statistically significant effect on the risk of thyroid cancer. DCs III and IV were not statistically significantly associated with the risk of malignancy (OR=1.68,p=0.16; OR=1.51,p=0.3,respectively). There were no statistically significant differences in sex, BMI and obesity between the patients with benign and malignant lesions. Conclusion: DC V is associated with a high likelihood of malignancy, especially in patients under 50 years of age, and therefore surgery is indicated in this category of subjects. In the DCs III and IV categories, the risk of malignancy is lower and conservative management with active clinical and ultrasound surveillance can be considered. In patients < 50 years of age, with the Bethesda categories III and IV, surgical treatment should be considered.