adrenal pathology

Question 1

solitary, well-circumscribed, yellow-orange lesions within adrenal cortex or protrude into medulla

Answer 1

adrenal cortical adenoma

Question 2

functional adenomas are____

Answer 2

atrophied

Question 3

non-functional adenoma are____

Answer 3

normal thickness

Question 4

vacuolated, lipid rich tumor cella, mild pleomorphism

Answer 4

adrenal cortical adenoma

Question 5

lesions that are yellow on cut surface, but usu contain areas of hemorrhage, cystic change, and necrosis

Answer 5

adrenal cortical carcinomas

Question 6

carcinoma or adenoma: invade vascular channel, with metastases

Answer 6

carcinoma

Question 7

where do adrenal cortical carcinomas like to metastasize to?

Answer 7

lungs

Question 8

if you see anaplasia on histo of adrenal cortex, it is likely_____

Answer 8

carcinoma

Question 9

define anaplasia

Answer 9

lack of differentiation

Question 10

how to differentiate adrenal cortical carcinoma from adenoma? (5)

Answer 10

1. metastases
2. large size
3. necrosis
4. mitotic figures
5. vascular invasion

Question 11

adrenal cortex that is yellow, thickened and multinodular

Answer 11

adrenal cortical hyperplasia

Question 12

caused by elevation in glucocorticoid/cortisol levels

Answer 12

cushings

Question 13

a solitary, small, encapsulated aldosterone secreting adenoma

Answer 13

Conn syndrome

Question 14

what accounts for 65% of primary hyperaldosteronism?

Answer 14

conn syndrome

Question 15

clinical signs of hyperaldosteronism (4)

Answer 15

1. HTN
2. hypokalemia
3. high aldosterone
4. low blood renin

Question 16

addison disease is primary acute OR chronic adrenocortical insufficiency

Answer 16

primary chronic adrenocortical insufficiency

Question 17

septicemic infxn caused by N. meningitidis infxn that results in massive adrenal hemorrhage in children

Answer 17

waterhouse-friderichsen syndrome

Question 18

waterhouse-friderichsen syndrome is more common in ____ vs addison disease which is more common in _____

Answer 18

children; adults

Question 19

causes of addisons (3)

Answer 19

1. TB
2. fungi
3. metastatic neoplasms

Question 20

morphology with small glands, lipid depletion, lymphocytic infiltrate in cortex

Answer 20

addison disease

Question 21

presentation: fatigue, hyperpigmentation, N/V, hypotension, high potassium, low Na, elevated ACTH

Answer 21

addison disease

Question 22

morphologically, sedonary adrenocortical insufficiency spares the ____ and _____

Answer 22

zona glomerulosa and medulla

Question 23

uncommon neoplasms assc’d with incr catecholamine production and HTN

Answer 23

pheochromocytomas

Question 24

the cut surface is pale gray/brown, assc’d with hemorrhage, necrosis, cystic change, highly vascular tumors

Answer 24

pheochromocytoma

Question 25

neuroendocrine markers for pheochromocytoma (2)

Answer 25

1. synaptophysin

2. chromogranin

Question 26

clinical presentation: abrupt HTN, sweating, tremor, HA, tachycardia, palpitations

Answer 26

pheochromocytoma

Question 27

dx of pheochromocytoma (2)

Answer 27

1. urinary & serum catecholamines

2. MIBG scan

Question 28

amplification of N-Myc oncogene

Answer 28

neuroblastoma

Question 29

neuroblastoma is characerized by ___HTN, incr urine ____

Answer 29

diastolic; VMA/HNA

Question 30

homer-wrigth rosettes

Answer 30

neuroblastoma