Describe what the following cell of the adenohypophysis produces: 1. somatotrophs 2. lactotrophs 3. corticotrophins 4. thyrotrophs 5. gonadotrophs

1. growth hormone (GH) 2. prolactin 3. adrenocorticotrophic hormone (ACTH) 4. thyroid stimulating hormone (TSH) 5. follicle stimulating hormone (FSH) and luteinizing hormone (LH)

Endocrine Pathology- Exam II Flashcards by Abagayle Moody

Functions of the endocrine system include: (4)

maintain metabolic equilibrium (homestasis)
secrete chemical messengers (hormones)
regulate activities of various organs
process of feedback inhibition

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Maintaining metabolic equilibrium:

homeostasis

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Chemical messengers:

hormones

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In the process of feedback inhibition, increased activity of target tissue, typically ____ the activate of the gland secreted the stimulating hormone

down regulates

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Diseases of under/over production of hormones:

endocrine diseases

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Endocrine diseases are associated with development of:

mass lesions

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What are the 3 classifications of endocrine diseases?

too little
too much
others: tumors

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Tumors of endocrine glands whether benign or malignant, may secrete the hormone native to the gland. These tumors are said to be:

functional tumors

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With functional tumors of endocrine glands, it may be the ___ or the _____ that calls attention to the tumor

mass effect; or metabolic effect of the excessive hormone

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List the endocrine organs: (6) -
excluding testicles, ovaries, pineal gland, hypothalamus

anterior pituitary
posterior pituitary
thyroid
parathyroid
pancreas
adrenal gland

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Where is the pituitary gland located?

base of brain- sella turcica

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The pituitary gland is connected to the:

hypothalamus

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The pituitary gland is connected to the hypothalamus by:

stalk composed of axons
venous plexus

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What is the function of the pituitary gland:

central role in regulation of other endocrine glands

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What are the two components of the pituitary gland?

anterior lobe (adenohypophysis)
posterior lobe (neurohypophysis)

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What part of the pituitary gland is the adenohypophysis?

anterior lobe

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What part of the pituitary gland is the neurohypophysis?

posterior lobe

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How are the diseases of the pituitary gland categorized?

based on what lobe is mainly affected

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Label the following image:

A: pons
B: midbrain
C: hypothalamus
D: pituitary gland

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What can be seen in the following image?

pituitary gland

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Label the following image:

A: hypothalamus
B: anterior pituitary (adenohypophysis)
C: posterior pituitary (neurohypophysis)

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What are the different types of cells in the anterior pituitary?

somatotrophs
lactotrophs
corticotrophs
thyrotrophs
gonadotrophs

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Describe what the following cell of the adenohypophysis produces:

somatotrophs
lactotrophs
corticotrophins
thyrotrophs
gonadotrophs

growth hormone (GH)
prolactin
adrenocorticotrophic hormone (ACTH)
thyroid stimulating hormone (TSH)
follicle stimulating hormone (FSH) and luteinizing hormone (LH)

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The following hormones are produced in the:

growth hormone (GH)
prolactin
adrenocorticotrophic hormone (ACTH)
thyroid stimulating hormone (TSH)
follicle stimulating hormone (FSH) and luteinizing hormone (LH)

anterior pituitary (adenohypophysis)

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What hormones are produced in the posterior pituitary? (2)

1. Antidiuretic Hormone (ADH/Vasopressin) 2. Oxytocin

The following hormones are produced in the: 1. Antidiuretic Hormone (AHD/Vasopressin) 2. Oxytocin

posterior pituitary (neurohypophysis)

What is the function of the following hormone? Growth hormone (GH)

tissue growth

What is the function of the following hormone? TSH

Stimules thyroid to produce thyroid hormones

What is the function of the following hormone? ACTH

Acts on the adrenal gland to produce cortical hormones

What is the function of the following hormones? FSH and LH

Act on the testes to produce testorone and sperm Act on the ovaries to produce the ova, estrogen, and progesterone

What is the function of the following hormone? Prolactin (PRL)

Acts on breast glandular tissue

What is the function of the following hormone? Oxytocin

Acts on uterus for uterine contraction; functions in lactation

What is the function of the following hormone? ADH

Acts on kidney to stimulate water reabsorption

Diseases of the anterior pituitary include:

1. Hypopituitarism (decrease secretion of trophic hormones) 2. Hyperpituitarism (increased secretion of trophic hormones)

Disease of the anterior pituitary in which there is a decreased secretion of trophic hormones:

hypopituitarism

Disease of the anterior pituitary in which there is an increased secretion of trophic hormones:

hyperpituitarism

What are the characteristics of hypopituitarism?

destructive lesions/processes

Give some examples of what might cause hypopituitarism:

- ischemia - radiation - inflammation - neoplasms

What are the characteristics of hyperpituitarism?

functional adenoma within the anterior lobe with local mass effects

What are some of the local mass effects involved in hyperpituitarism?

- enlargement of sella turcica - visual field abnormalites - increased intracranial pressure

- pituitary adenomas - radiation treatment - neurosurgery - Sheehan syndrome These are all potential causes of:

hypopituitarism

Ischemic necrosis of the pituitary gland:

Sheehan syndrome (may cause hypopituitarism)

What are the clinical manifestations of hypopituitarism? (6)

1. pituitary dwarfism 2. amenorrhea & infertility 3. low libido & impotence 4. postpartum lactation failure 5. hypothyroidism 6. hypoadrenalism

1. pituitary dwarfism 2. amenorrhea & infertility 3. low libido & impotence 4. postpartum lactation failure 5. hypothyroidism 6. hypoadrenalism These are all clinical manifestations of:

hypopituitarism

- pituitary adenomas - pituitary hyperplasia - pituitary carcinomas - hypothalamic disorders These are all potential causes of:

hyperpituitarism

What are the clinical manifestations of hyperpituitarism?

1. gigantism 2. acromegaly 3. Cushing disease

- condition of hyperpituitarism - excess growth hormone (GH)

gigantism

Gigantism is caused by ____ which produces excess growth hormone

primary tumor

The primary tumor in gigantism is an:

adenoma of the AP

what is the second most common anterior pituitary syndrome?

gigantism

What type of tissues are affected in gigantism?

all growing tissues

Gigantism occurs:

before growth plate closure

List the symptoms associated with gigantism: (7)

1. generalized overgrowth (3 standard deviations) 2. headaches 3. chronic fatigue 4. arthritis & osteoporosis 5. muscler weakness 6. hypertension 7. CHF

- condition of anterior pituitary with excess growth hormone - late diagnosis - poor vision - enlarged skull, hands, feet, & ribs - soft tissue, viscera - enlarged maxilla, mandible, nasal & frontal bones, & maxillary sinus - intraoral manifestations

acromegaly

Describe the intraoral manifestations of acromegaly: (5)

1. diastemas 2. malocclusion 3. macroglossia 4. enlarged lips 5. sleep apnea

Diabetes insipidus (central) is a condition involving the:

posterior pituitary

What are two symptoms associated with diabetes insipidus (central)?

1. polyuria (dilute urine) 2. polydipsia

Diabetes insipidus (central) is due to irregularities in what hormone?

Secretion of innapropriotely high levels of ADH (SIADH) from the posterior pituitary

The secretion of inappropriately high levels of ADH (SIADH) seen in diabetes insipidus (central) may cause:

1. hyponatremia 2. cerebral edema 3. neurologic dysfunction 4. increased total body water

Describe the increased total body water seen in diabetes insipidus? (2)

- blood volume normal - no peripheral edema

Iodide from a normal diet is stored in the ____ (bound to ____) and used for production of ___ and ___

thyroid gland (bound to thyroglobulin); T3 and T4

T3 and T4 have identical chemical compositions except for:

addition of one iodide (in T4)

___ is produced exclusively by the thyroid while majority of ___ is the result of ___ conversion

T4; T3; T4

____ is the activator for synthesis of TSH

TRH (thyrotropin releasing hormone)

TRH is the activator for synthesis of:

TSH

____ is the activator for T3 and T4 production

TSH (Thyroid Stimulating hormone)

- T3/T4 levels are low - Elevation in ____ levels - Increase in T3/T4 production

TSH

TRH controls ___ production

TSH

TSH controls ___ production

T3/T4

The 3 glands that are responsible for thyroid function include:

1. hypothalamus 2. pituitary 3. thyroid

A very small percentage of T3 and T4 is not bound to ____ and remains ___

thyroxine binding proteins; free in circulation

What form of T3 and T4 are metabolically active?

the small percentages of each that are free in circulation

What is the effect on basal metabolic rate with: 1. decreased T3 and T4 2. increased T3 and T4

1. decreased BMR 2. increased BMR

Low levels on T3 and T4 have what effect on gluconeogenesis and glycogenolysis?

decreased gluconeogenesis & decreased glycogenolysis

High levels of T3 and Tr have what effect on gluconeogeneis and glycogenolysis

increased gluconeogenesis & increased glycogenolysis

Low levels of T3 and T4 have what effect on protein metabolism?

decreased protein synthesis & decreased proteolysis

High levels of T3 and T4 have what effect on protein metabolism?

increased protein synthesis, increased proteolysis and muscle wasting

Low levels of T3 and T4 have what effect on lipid metabolism?

decreased lipogenesis & decreased lipolysis & increased serum cholesterol

High levels of T3 and T4 have what effect on lipid metabolism?

increased lipogenesis & increased lipolysis & decreased serum cholesterol

Low levels of T3 and T4 have what effect on thermogenesis?

Decreased thermogenesis

High levels of T3 and T4 have what effect on thermogenesis?

increased thermogenesis

Low levels of T3 and T4 have what effect on the autonomic nervous system?

normal levels of serum catecholamines

High levels of T3 and T4 have what effect on the autonomic nervous system?

Increased expression of beta adrenoreceptors (increased sensitivity to catecholamines, which remain at normal levels)

Discuss causes of primary hypothyroidism:

1. intrinsic abnormality in the thyroid 2. surgery 3. radiotherapy 4. autoimmune

Discuss the causes of secondary hypothyroidism:

pituitary failure

If hypothyroidism is caused by pituitary failure, this results in:

secondary hypothyroidism

- Hypothyroidism - Adult - Generalized fatigue - Apathy - Mental sluggishness - Listless - Cold intolerance - Overweight This describes:

myxedema

- Hypothyroidism - Childhood - Impaired skeletal development - Severe mental retardation - Short stature - Course facial features - Delayed tooth eruption These describe:

cretinism

The adult form of hypothyroidism:

myxedema

The childhood form of hypothyroidism:

cretinism

Symptoms of hypothyroidism include: (5)

1. cold intolerance 2. fatigue/lethargy 3. weight gain 4. constipation 5. bradycardia

Despite elevated TSH levels, in the condition of ____ the thyroid continues to produce reduced levels of T3/T4. This malfunction is permanent:

hypothyroidism

How is hypothyroidism treated? What is the outcome?

treated with replacement therapy, TSH values return to normal

In hypothyroidism, if TSH is increased this is describing what form?

primary hypothyroidism

In hypothyroidism, if TSH is decreased, this is describing what form?

secondary hypothyroidism

In both primary and secondary hypothyroidism, ____ hormone is low

What is the treatment of both primary and secondary hypothyroidism?

supplement

Hashimoto Thyroiditis is a ____ disease

autoimmune

Describe the thyroid in Hashimoto thyroiditis

painless enlargement; symmetric & diffuse

What is a risk associated with Hashimoto thyroiditis?

Risk of B-cell non-hodgkins lymphomas

Clinical signs and symptoms of hyperthyroidism include: (7)

1. goiter (small) 2. exophthalmus (frequent) 3. heat intolerance 4. weight loss & muscle waisting 5. malabsorption and diarrhea 6. tachycardia 7. irritability and anxiety

The most common cause of hyperthyroidism is:

autoimmune - graves disease

Discuss the following laboratory levels associated with hyperthyroidism: 1. T4 & free T4= 2. T3 & free T3 3. TSH = 4. TRH =

1. elevated 2. elevated 3. suppressed 4. suppressed

In hyperthyroidism despite low ____ levels, the thyroid continues producing elevated ____ levels.

TSH; T3&T4

In hyperthyroidism despite low TSH levels, the thyroid continues producing elevated T3 & T4 levels. This is possible because of ____ which stimulate the thyroid hormone production. This thyroid hyper function is permanent.

autoantibodies (TSI= thyroid stimulating immunoglobulins)

In hyperthyroidism, because of feedback from thyroid hormones T3 and T4 , TSH production and release is:

reduced

What is seen in this image? What is this characteristic of?

exopthalmos; hyperthyroidism

Describe some symptoms associated with graves disease: (5)

(Hyperthyroidism) - tachycardia - increased appetite - weight loss - exopthalmos - heat intolerance

In graves disease, autoantibodies are created against the:

TSH receptors

In primary graves disease, TSH levels are:

low

In secondary graves disease, TSH levels are:

normal to high

In both primary and secondary graves disease, describe the levels of T3 and T4:

Increased

What is the treatment for graves disease?

ablation

What is one major concern with graves disease?

thyroid storm

In graves disease, thyroid storm may be caused by:

1. infection 2. stress 3. trauma

Describe what may occur with a thyroid storm?

- elevated body temp - tachycardia - 20-40% mortality

Diffuse and multi-nodular goiter can be described by:

1. thyroid enlargement 2. impaired synthesis of thyroid hormone 3. euthyroid

In diffuse and multi nodular goiter, impaired synthesis of thyroid hormone is due to:

1. iodine deficiency (endemic) 2. hyperplasia of follicles (pituitary stimulation)

In diffuse and multi nodular goiter, the maintenance of minimal function of the thyroid is called:

euthyroid

List the sequence of events in endemic goiter:

1. diet deficient in iodine 2. decreased output of T3 and T4 by thyroid 3. pituitary responds by secreting TSH 4. thyroid hyperplasia

What can be seen in these images?

endemic goiter

What type of thyroid neoplasm is being described? - solitary - males - younger - warm/cold nodules

adenoma

What type of thyroid neoplasm is being described? - 75-85% - all ages - radiation - 10 year survival = 95% - worse outcome in elderly

papillary carcinoma

What type of thyroid neoplasm is being described? - 10-20% - older - iodine deficiency - cold nodules

follicular carcinoma

What type of thyroid neoplasm is being described? - 5% - neuroendocrine - calcitonin (C cells) - amyloid - MEN 2 A/B (20%

medullary carcinoma

Usually presents as solitary, non-functioning nodule:

papillary carcinoma

The parathyroid glands are derived from:

developing pharyngeal pouches

Lie in close proximity to upper and lower poles of each thyroid lobe:

parathyroid glands

May be found on a path of descent of pharyngeal pouches- carotid sheath, thymus, anterior mediastinum:

parathyroid glands

What do the parathyroid glands secrete?

PTH

The parathyroid glands secrete PTH which, with ___ regulates ____

calcitonin; calcium homeostasis

The parathyroid glands secrete PTH which, with calcitonin regulates calcium homeostasis - controlled by the level of:

free (ionized) calcium

PTH: 1. activates ___ activity 2. Increases ____ resorption 3. Increases ___ into the active ___ form in the kidneys 4. Increases urinary excretion of ___ 5. Increases ___ absorption by the GI tract

1. osteoclast 2. Ca renal tubular 3. conversion of vitamin D; dihydroxy 4. phosphates 5. calcium

What is an iatrogenic cause of hypoPARAthyroidism?

surgically induced

The congenital abscence of the parathyroid glands resulting in hypoPARAthyroidism:

DiGeorge syndrome

What is an autoimmune cause of hypoPARAthyroidism?

APECED

What are the three characteristic signs of hypoparathyroidism?

1. hypocalcemia 2. Chvostek sign 3. Trousseau sign

Hypocalcemia from hypoPARAthyroidism may result in:

tetany

Describe Chvostek sign associated with hypoPARAthyroidism:

When tapping CN 7, muscle contraction of the eye, mouth, and nose

Describe Trousseau sign associated with hypoPARAthyroidism:

when occluding circulation of forearm, carpal spasms occurs

What can be seen in the following image?

trousseau's sign caused by tetany in patient with hypoPARAthyroidism

What condition is associated with the following images?

hypoparathyroidism

Primary hyperPARAthyroidism is caused by: (include percentages)

1. Adenoma (75-80%) 2. Hyperplasia (10-15%) 3. Carcinoma (<5%)

Secondary hyperPARAthyroidism is caused by:

renal failure

Primary hyperPARAthyroidism caused by adenoma is associated with:

one gland

Primary hyperPARAthyroidism caused by hyperplasia is associated with: (2)

1. multiglandular 2. MEN 1 & 2a,b

Adenoma (one gland), Hyperplasia (multi glandular and MEN 1,& 2a, b) and Carcinoma are all causes of:

primary hyperPARAthyroidism

What are some outcomes of renal failure that are responsible for contributing to secondary hyperPARAthyroidism?

1. hyperphosphatemia 2. chronic hypocalcemia 3. vitamin D deficiency

- adenoma, hyperplasia, and carcinoma are all responsible for:

primary hyperPARAthyroidism

What morphologic changes are associated with primary hyperPARAthyroidism?

1. skeletal changes 2. serum calcium level changes

What are the skeletal changes seen in primary hyperPARAthyroidism?

1. bone resorption 2. formation of bone cysts & hemorrhages (osteitis fibrosa- cystic) 3. brown tumors 4. urinary tract stones (nephrolithiasis) 5. metastatic calcification

1. bone resorption 2. formation of bone cysts & hemorrhages (osteitis fibrosa- cystic) 3. brown tumors 4. urinary tract stones (nephrolithiasis) 5. metastatic calcification These are all skeletal changes seen in:

primary and secondary hyperPARAthyroidism

In primary hyperPARAthyroidism serum calcium levels are high, especially:

ionized calcium levels

- Hypercalcemia - Hypophosphateima - Increased urinary excretion of both calcium and phosphate These all accompany:

primary hyperPARAthyroidism

In this condition, calcium is chronically depressed and low serum calcium levels lead to compensatory hyperactivity of the parathyroids. Serum phosphate levels are elevated

secondary hyperPARAthyroidism

Describe the serum calcium levels and serum phosphate levels associated with secondary hyperPARAthyroidism:

LOW serum calcium HIGH serum phosphate

Describe the serum calcium levels and serum phosphate levels associated with primary hyperPARAthyroidism:

HIGH serum calcium (especially ionized) LOW serum phosphate

What are the causes of secondary hyperPARAthyroidism? (4)

1. Chronic renal failure 2. Vitamin D deficinecy 3. Inadequate dietary calcium 4. Steatorreha

Describe the morphologic changes associated with secondary hyperPARAthyroidism: (3)

1. hyperplastic parathyroid glands 2. bone changes 3. metastatic calcification

What has more severe clinical features, primary or secondary hyperPARAthyroidism?

primary

The clinical features of secondary hyperPARAthyroidism are related to symptoms secondary to:

chronic renal failure

Describe the bone abnormalities associated with secondary hyperPARAthyroidism:

renal osteodystrophy

seen with secondary hyperPARAthyroidism, elevated calcium & phosphate products; causes blood clots and painful skin ulcers:

calciphylaxis

occurs when excess parathyroid hormone is secreted by the parathyroid glands, usually after long-standing secondary hyperparathyroidism:

tertiary hyperparathryoidism

- osteomalacia & loss of lamina dura - brown tumor - nephrolithiasis - peptic/duodenal ulcers - mental changes These are all related to:

hyperparathryoidism

What saying is used to describe the symptoms of hyperPARAthyroidism?

stones, bones, moans, & groans

PTH functions to: 1. ____ serum calcium 2. ____ osteoclasts 3. ____ renal tubular absorption of calcium 4. ____ renal conversion of vitamin D 5. ____ urinary excretion of phosphate 6. ____ gastric absorption of calcium

1. increases 2. activates 3. increases 4. increases 5. increases 6. increases

What are shown in the following images?

adrenal glands

Little beanies on top of the kidneys:

adrenal glands

From outermost to innermost layer in a transverse section of the adrenal gland, the layers include:

capsule, cortex, medulla

Label the following image of the adrenal gland:

A: Capsule B: Zona glomerulosa C: Zona fasiculata D: Zona reticularis E: medulla

The outermost layer of the adrenal cortex is the ____.

zona glomerulosa

The zona glomerulosa produces ____ which is regulated by ____.

aldosterone; angiotensin II

The middle layer of the adrenal cortex is the ____.

zona fasiculata

The zona fasiculata produces ____ which is regulated by _____.

glucocorticoids (cortisol); ACTH (biofeedback)

The innermost layer of the adrenal cortex (right outside the medulla) is the ___

zona reticularis

The zona reticularis produces ____ and has no feedback with ____.

androgens; ACTH

What is produced by the medulla of the adrenal gland?

epinephrine and norepinephrine (catecholamines)

Adrenal cortex pathology associated with too little:

adrenal insufficiency

Acute adrenal insufficiency:

waterhouse-friderichsen

Primary chronic adrenal insufficiency:

Addisons disease

Adrenal cortex pathology associated with too much: (3)

1. hyperaldosterism 2. hypercorticolism (Cushing syndrome) 3. Adrenogenital syndrome

Destruction of the adrenal cortex resulting in DECREASED production of adrenal corticosteroid hormones:

Addisons disease

Addisons disease is categorized as a ____ disease:

autoimmune

What type of cancer is associated with Addisons disease?

metastatic carcinoma

What infections are associated with Addisons disease?

1. deep fungal infections 2. TB (both are involved with AIDS)

Addisons disease is a ____ hypoadrenocorticism involving destruction of the adrenal cortex. Secondary hypoadrenocorticism is a disorder of the ____ or ____.

primary hypothalamus or pituitary

In Addisons disease (primary hypoadrenocorticism involving destruction in the adrenal cortex) the clinical symptoms appear:

late

Describe some symptoms with Addisons disease (primary hypoadrenocorticism involving destruction of the adrenal cortex): (5)

1. weakness & fatigue 2. postural hypotension 3. GI disturbances 4. hyperpigmentations (bronzing) 5. adrenal crisis

Describe the GI disturbances that may occur with Addisons disease (primary hypoadrenocorticism involving destruction of the adrenal cortex): (5)

- nausea and vomiting (N/V) - anorexia - diarrhea - weight loss - salt cravings ( increased K+ and decreased Na+)

Describe the hyperpigmentation (bronzing) involved in Addison's disease (primary hypoadrenocorticism involving destruction of the adrenal cortex):

- ACTH precursor stimulates melanocytes - frictional areas

Describe the acute adrenal crisis that occurs with Addisons disease (primary hypoadrenocorticism involving destruction of the adrenal cortex): (3)

- abdominal pain - hypotension - vascular collapse

Primary hypercortisolism is considered:

endogenous

Secondary hypercortisolism is considered:

exogenous

Is primary (endogenous) or secondary (exogenous) hypercortisolism more common?

secondary (exogenous)

What is the cause of primary (endogenous) hypercortisolism?

too much endogenous steroid

Primary (endogenous) hypercortisolism occurs in females at ___x more common rate as well as in the ___ decade of life

5x; 3rd decade

Too much endogenous steroid is the cause of primary hypercortisolism. The large amount of the endogenous steroid may be due to: (include percentages)

1. pituitary adenomas (that produce ACTH) 50%- involved in Cushing disease 2. Adrenal hyperplasia & neoplasm (10-20%) 3. Neuroendocrine tumors (that produce ACTH) -involved in small cell lung carcinoma

What rule applies to secondary hypercortisolism?

rule of 2s

Secondary hypercortisolism can become:

hypocortisol without taper

What disease is being described? Tumor in the anterior pituitary that releases excess ACTH causing adrenal hyperplasia. The adrenal hyperplasia produces excess amounts of cortisol:

Pituitary chasing syndrome

What disease is being described? Tumor in the adrenal gland producing excess cortisol. OR Nodular hyperplasia of the adrenal gland producing excess cortisol .

adrenal cushing syndrome

What disease is being described? Lung cancer or other non-endocrine cancer causing an increased production of ACTH. The increased ACTH acts on the adrenal gland to produce excess cortisol

paraneoplastic Cushing syndrome

What disease is being described? Patient takes an increased amount of steroids which causes adrenal atrophy

Cushing syndrome?? this one is weird I know

What disease is being described? - Central obesity - Peripheral wasting - Buffalo hump - Moon facies - Abdominal striae - Hirsutism - Poor wound healing - Diabetes - Hyperglycemia - Osteoporosis - Hypertension

Hypercortisolism (Cushing syndrome)

What disease does this man have? What are some key features in this image that leads you to the diagnosis?

Cushing syndrome (hypercortisolism) - red cheeks - moon face

What disease can be seen in this image? What are some key features in this image that leads you to the diagnosis?

Cushing syndrome (hypercortisolism) - pendulous abdomen - abdominal striae - moon face - red cheeks

What is seen in this image? What disease is this characteristic of?

buffalo hump; Cushing syndrome (hypercortisolism)

Adrenal neoplasms can occur in the:

cortex or medulla

Adrenal neoplasms that occur in the cortex include:

adenomas & carcinomas

Adrenal neoplasms that occur in the medulla include:

pheochromocytoma & neuroblastoma

- Cushing disease - hyperaldosteronism - "incidentalomas" These area all due to:

adenomas of the adrenal cortex

Carcinomas of the adrenal cortex are considered:

rare

- Viralizing adenoma - Li-Fraumeni & Beckwith-Wiedemann These are both results of:

adrenal cortex carcinoma

Pheochromocytoma and neuroblastoma are both:

adrenal neoplasms of the medulla