adrenal 4

Question 1

adrenal medullar

Answer 1

most important lesions are neoplasms or neural and neuroendocrine type

mostly adnrela pheochromocytoma

Question 2

normal adrenal medulla

Answer 2

neural crest oorigin
neuroendocrine cells (phaeochromocytes)
produce adrenaline, noradrenaline
arranged in clusters, supported by a delicate fibrovascular stroma

Question 3

adrenal phaechromocytoma

Answer 3

neoplasm arising from adrenal demullary neuroendocrine cells (phaechromocytes)

Question 4

paraganglioma

Answer 4

is an adrenal phaeochromocytoma arising in extra adrenal neuroendocrine cells (paraganglionic tissue, related to autonomic nervous system in head and neck including caotid body, along vagus nerve, aorta and its branches

Question 5

familial phaeochromocytoma

Answer 5

may be bilateral but not necessarily synchronous

seen in MEN 2a or 2b, neurofibromatosis, von hippie Linda syndrome, familial paraganglioma syndrome

Question 6

behaviour of adrenal pheochromocytoma

Answer 6

10% are extra adrenal 
10% familial/syndrome associated 
10% sporadic type of bilateral 
10% biologically malignant 
10% asymptomatic 
10% in children

Question 7

diagnosis of adrenal phaeochromocytoma

Answer 7

may be secretory (functional) or non-secretory
functional tumours result in increased adrenaline/noradrenaline in the circulation, mimics fight or flight
associated with paroxysmal or persistent hypertension (often very high BP), headache, sweating, palpitation, fatigue, GI and cardiac symptoms, tremor
risk of complications over time eg. hypertensive vascular disease, stroke

Question 8

imagine of adrenal phaeochromocytoma

Answer 8

adrenal mass, variation in size (from size of a grape up to several kg)

Question 9

biochemistry of adrenal phaeochromocytoma

Answer 9

secretion of free catecholamines and their metabolites in urine