153 - adrenal cortex path

Question 1

what is the general shape of right and left adrenal glands?

Answer 1

right is triangular and left is semilunar shape

Question 2

describe emryologic development of adrenal cortex

Answer 2

it derives from mesoderm. it arises with gonads and testes before splitting off around week 6.

Question 3

describe fetal development of adrenal gland

Answer 3

adrenals are very large at birth. the outer portion is the definitive zone and the inner portion is the fetal zone and will dissapear by age 1

Question 4

what does heterotropic mean and how does this relate to adrenal cortex

Answer 4

normal adrenal cortical tissue in an abnormal location. generally occurs due to abnormalities in development and migration. most common locations are celiac artery, testis and ovaries

Question 5

what do the zones of adrenal cortex look like in normal histology?

Answer 5

zona glomerulosa takes up 15% and cells are arranged in clusters with high nuclear to cytoplasm ratio and pink color. zona fasiculata makes up 70-80% and the cells are arranged in a column. zona reticularis has 5-15% of cortex and the cells are haphazardly arranged and pink

Question 6

what will autoimmune hypofunction look like on histology?

Answer 6

chronic inflammation with dark blue lymphocytes

Question 7

describe waterhouse friderichsenn syndrome

Answer 7

acute adrenal failure due to hemorrhage and necrosis of adrenal glands. due to sepsis. causes petechial purpuric rash and bags of blood adrenals

Question 8

define adrenal cortex hyperplasia

Answer 8

bilateral increase in adrenal mass (>12 g combined) due to a documented endocrine abnormality

Question 9

describe the three basic patterns of hyperplasia…

Answer 9

1) diffuse pattern is bilateral and occurs commonly in congenital adrenal hyperplasia and cushing syndrome.
2) micronodular pattern is bilateral but the glands have multiple nodules which measure < 1 cm. the nodules lack a capsule and is seen in some cases of cushings
3) macronodular has nodules > 1 cm. uncommon pattern.

Question 10

describe idiopathic adrenal cortical nodules

Answer 10

benign, nonfunctional. frequently bilateral with most nodules < 1 cm. common after age of 50.

Question 11

are most adenomas functional or not? can you tell microscopically? what is an exception?

Answer 11

not functional; no; ones that will produce aldosterone will have bullseye spironolactone bodies with treatment

Question 12

what is the distribution of adrenal cortical carcinoma?

Answer 12

bimodal age distribution. same in men and women. more common in girls than boys

Question 13

what are size and weights for carcinomas?

Answer 13

> 100 g and 6.5 cm in adults. >400g and 10.5 cm in children

Question 14

how do carcinomas and adenomas function differently?

Answer 14

adenomas commonly produce aldosterone while carcinomas rarely do. glucocorticoids are most common in carcinomas.

Question 15

which tumors are mitoses common in?

Answer 15

carcinomas