St Adrenals and Paragangliomas Flashcards

Fetal adrenal with primitive sympathetic cells forming neuroblastic nodules

Newborn adrenal with focal cytomegaly of fetal cortex

Newborn adrenal of Beckwith-Wiedemann syndrome with widespread cytomegaly

Atrophic adrenal gland:
- fibrotic capsule and cortical layer is atrophic but medulla unaffected.
DDx adrenal hypofuntion:
- _atrophic:_autoimmune (lymphocytes and plasma cells, abs sto P450 enzyme), Type I polyglandular autoimmune sydrnome (APECED, AR), Type II polyglandular autoimmune syndrome (AD), previous Waterhouse-Friderichsen (fibrosis), exogenous corticosteroid, Cushing syndrome
- necrotic: CMV
- replacement: TB (caseous), fungus (caseous), Amyloidosis, tumour, Waterhouse-Friderichsen (blood), anticoagulatn tx (blood)

Adrenocortical hyperplasia
- vacuolated fasciculata

Primary hyperaldosteronism
- Hyperplasia of zona glomerulosa

Primary pigmented nodular adrenocortical disease - microadenomatous hyperplasia:
- Nodules of large, granular eosinophilic cells with enlargec hyperchromatic nuclei with prominent nucleoli
- filled with lipochrome
- associated with Carney complex (PRKAR1A)

Pigmented (black) adrenocortical adenoma
- associated with Cushing syndrome
- compact cells with lipochrome pigment

Adrenocortical adenoma with stromal fibrosis
- associated with Cushing syndrome

Adrenocortical adenoma, myelolipomatous change
- Associated with Cushing syndrome

Adrenocortical carcinoma
- areas of necrosis

Adrenocortical carcinoma
- marked nuclear pleomorphism
- intranuclear pseudoinclusions

Adrenal cyst, endothelial type (+ Factor VIII)
- other types: epithelial, parasitic, endothelial and psuedocysts

Adrenal myelolipoma
- hematopoeitic tissue scattered among fat

Metastatic pulmonary adenocarcinoma

Adrenal gland with metastatic bronchogenic adenocarcinoma, FNA

Adrenocortical hemangioma

Adenomatoid tumour
- glands and tubules
- +: calretinin and CK

Ganglioneuroma

Pheochromocytoma

Pheochromocytoma
- +: Chromogranin A

Diffuse hyperplasia of adrenal medulla
- anisonucleosis of cells expected

Pheochromocytoma, S100+ sustentacular cells