Adrenal Pathology Flashcards
Describe how adrenal morphology changes with diseases of hypo function.
morphology looks different depending on the cause- in automimmune disease the cortex thins out, in TB the adrenal becomes nodular and granulomatous on appearance, hemorrhage can cause pressor atrophy on adjacent tissue (cortex thins and dies)
What are the 3 major causes of hyperfunciton?
hyperplasia
adenoma
carcinoma
Describe the histopathalogical features of adrenocortical diffuse hyperplasia and adrenocortical adenoma.
excess of cortical cells, layers of cells can be difficult to distinguish
primary lesions tend be small and non-functional (often a silent, incidental finding)
in both histology can be bland or more pleomorphic with “endocrine atypia” (common and not-specific to disease)
What are the typical characteristics of adrenocortical carcinoma?
usually big, advanced tumors when diagnosed, usually who invasion into surround tissues, are not distinct from adenoma until they metastasize to other tissue
Contrast the histopathology of adrenocortical carcinoma and adrenocortical adenoma.
cannot be distinguished but generally has more pleomorphism and more mitoses
Describe the gross appearance and histology of the adrenal medulla.
medulla: gray tan color, surrounded by the cortex
histologically is composed of neuroendocrine cells of neural crest origin
What is the rule of 10s regarding pheochromocytoma?
10% are extra adrenal (para ganglioma- same cell line)
10% sporadic cases are bilateral (up to 50% if familial)
10% are malignant
10% are not associated with hypertension
Describe the histological appearance of a pheochormocytoma.
nests of cells surrounded by vascular and supporting cells (zallballen) granules within the cytoplasm contain catecholamines
Pheochromocytomas are common in which familial tumor syndromes?
MEN 2A
MEN 2B
NF type 1 (neurofibromatosis)
VHL syndrome
