Pathology of the adrenal glands Flashcards
what disease is excessive secretion of cortisone
cushing’s
what are the features of cushings
excessive cortisone secretion muscle wasting fat around waist abnormal collagen hypertension osteoporosis impaired glucose tolerance hirsutism depression and psychosis emotional disturbance enlarged sella turcica moon face cardiac hypertrophy buffalo hump obesity think, wrinkled skin abdominal striae amenorrhea purpura skin ulcers, poor wound healing
what causes cushing’s
pituitary adenoma producing ACTH > adrenal hyperplasia
primary adrenal neoplasm (benign or malignant)
ectopic ACTH or related peptides (paraneoplastic syndrome)
iatrogenic adrenal hypertrophy
what cancers can cause paraneoplastic syndrome with increased ACTH
carcinoid lung tumour
small cell carcinoma of lung
What is Conn’s disease
primary hyperaldosteronism
what are the symptoms of Conn’s disease
hypokalaemia muscle weakness and cramps metabolic alkalosis high aldosterone low renin
what is aldosterone
hormone produced in the zona glomerulosa of the adrenal cortex
regulates sodium, potassium and blood pressure
what causes Conn’s disease
adrenal adenoma
or idiopathic bilateral hyperplasia of ZG
what is congenital adrenal hyperplasia
uncommon
hydroxylase deficiency- genetic
causes sex steroid excess or deficiency and may cause intersex conditions
where can metastases in the adrenal glands metastasize from
lung breast kidney colon melanoma lymphoma
describe adrenal adenomas
may be subclinical
low malignant potential
what are the features of adrenal carcinomas
rare
poor prognosis
secretes sex steroids
what is a pheochromocytoma
chromaffin cell tumour
intermittent production of catecholamines
- Hypertension
- Sweating
- collapse
- Glycosuria
may be part of MEN
may be familial
spectrum of benign to malignant
what is a neuroblastoma
very rare
found in young children
develops from neuroblasts
what can cause adrenal hypofunction
meningococcal septicaemia
Addison’s disease
amyloid, TB, mets
