Adrenal glands (Pathology) Flashcards
3 layers of cortex and what they excrete
glomerulosa - mineralcorticoids “salt”
fasciculata - glucocorticoids “sugar”
reticularis - estrogens and androgens “sex”
adrenal medula excretes
Epi & NE
trunkal obesity, moon facies w/flushing, acne, buffalo hump
cushing syndrome
Cushing disease
pituitary cushing syndrome
characteristics of hyperaldosteronism
htn & hypokalemiaa
aldosterone-secreting cortical adenoma causes
Conn syndrome
hypertension & hypokalemia
usual significance of cortical adenomas?
often insignificant (insidentaloma)
21-hydroxylase or 11-beta-hydroxylase deficiency leads to
adrenogenital syndrome
adrenogenital syndrome
impaired synthesis of both cortisol and aldosterone
increased secretion of adrenocorticotropic hormone, resulting in adrenal hyperplasia and increased synth of testosterone
Most common cause of Waterhouse-Friderichsen Syndrome
N. meningitidis
typical appearance of adrenal glands in Waterhouse-Friderichsen syndrome
big bag of blood
3 causes of acute adrenal insufficiency and outcome
N. meningitidis in Waterhous-Friderichsen syndrome
Sudden withdrawal from corticosteroids
patients with chronic insufficiency with sudden stress
Often fatal
chronic adrenal insufficiency
addison’s disease
addison’s disease characteristics
weakness, nausea, weight loss, hypotensive. pigmented skin.
hyponatremia, hyperkalemia, metabolic acidosis, hypoglycemia, low cortisol,
failure to respond to stimulation tests by increasing cortisol output
failure to respond to stimulation tests by increasing cortisol output
addison’s disease
Other causes of chronic adrenal insufficiency
TB, autoimmune, hemochromatosis
also tumors or suppresion of hypothalamus
adrenal cortex neoplasms
adenoma
carcinoma
adrenal medulla neoplasms
neuroblastoma
pheochromocytoma
adrenal cortical adenoma
most are silent
well circumscribed, 2.5 cm
if functional, opposite gland atrophic
if nonfunctional, opposite gland normal
yellow adrenal adenoma
cortical
adrenal cortical carcinoma
very uncommon children or adults >90% functioning big ones are malignant no mitoses, no anaplasia - bland
neuroblastoma
most common extracranial solid tumor in children
650/yr in US
adrenals and paraaortic ganglia are most common sites
red tumor, surrounded by a ring in adrenal medulla
pheochromocytoma
red tumor surrounded by ring in adrenal medulla
10% neoplasm
episodic htn
histology nonpredictive
pheochromocytoma “10% neoplasm” items (5)
familial extra-adrenal bilateral malignant in childhood
paraganglion system
sites of paraganglion cell nests where neoplasms may form. cervical, mediastinum, along aorta, down to iliacs & bladder
most common types of adrenal neoplasms
metastatic (lung, breast, many others)
multifocal = usually mets
