Adrenal tumors: Difference between revisions

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[[File:Incidences and prognoses of adrenal tumors.png|thumb|280px|Incidences and prognoses of adrenal tumors.<ref>Data and references for pie chart are located at [https://commons.wikimedia.org/wiki/File:Incidences_and_prognoses_of_adrenal_tumors.png file description page in Wikimedia Commons.]</ref>]]
[[File:Incidences and prognoses of adrenal tumors.png|thumb|280px|Incidences and prognoses of adrenal tumors.<ref>Data and references for pie chart are located at [https://commons.wikimedia.org/wiki/File:Incidences_and_prognoses_of_adrenal_tumors.png file description page in Wikimedia Commons.]</ref>]]


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<gallery mode=packed heights=200>
<gallery mode=packed heights=200>
File:Adrenal gland Conn syndrome4.jpg|Gross pathology of '''adrenocortical adenoma'''.
File:Adrenal gland Conn syndrome4.jpg|Gross pathology of '''adrenocortical adenoma'''.
File:Histopathology of adrenocortical adenoma.jpg|Histopathology of '''adrenocortical adenoma''', most commonly showing clear cells with high lipid contents.<ref>{{cite journal|last1=Mete|first1=Ozgur|last2=Duan|first2=Kai|title=The Many Faces of Primary Aldosteronism and Cushing Syndrome: A Reflection of Adrenocortical Tumor Heterogeneity|journal=Frontiers in Medicine|volume=5|year=2018|issn=2296-858X|doi=10.3389/fmed.2018.00054}}<br>Attribution 4.0 International (CC BY 4.0) license</ref>
File:Zona fasciculata versus adrenocortical adenoma.jpg|Zona fasciculata versus '''adrenocortical adenoma'''. An adrenocortical adenoma typically has mild changes in comparison, including larger cells with larger and more pleomorphic nuclei with more coarse chromatin. H&E stain. {{MH}}
File:Adrenocortical adenoma with focal high grade nuclear atypia.jpg|'''Adrenocortical adenoma''' with focal high grade nuclear atypia.<ref name=Gupta2010/>
File:Adrenocortical adenoma with focal necrosis.jpg|'''Adrenocortical adenoma''' with focal necrosis<ref name=Gupta2010>{{cite journal| author=Gupta S, Melendez J, Khanna A| title=Deoxycorticosterone producing tumor as a cause of resistant hypertension. | journal=Case Rep Med | year= 2010 | volume= 2010 | issue= | pages= 372719 | pmid=20671982 | doi=10.1155/2010/372719 | pmc=2909735 | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20671982  }}<br>- "This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited."</ref>
File:Adrenal cortical carcinoma.JPG|Gross pathology of '''adrenocortical carcinoma'''. They are generally large, with a tan-yellow cut surface, and often have areas of hemorrhage and necrosis.
File:Adrenal cortical carcinoma.JPG|Gross pathology of '''adrenocortical carcinoma'''. They are generally large, with a tan-yellow cut surface, and often have areas of hemorrhage and necrosis.
File:Histopathology of adrenocortical carcinoma.jpg|Histopathology of '''adrenocortical carcinoma''', with marked mitotic activity.
File:Histopathology of adrenocortical carcinoma.jpg|Histopathology of '''adrenocortical carcinoma''', with marked mitotic activity.
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===Other adrenal tumors===
===Other adrenal tumors===
<gallery mode=packed heights=220>
<gallery mode=packed heights=220>
File:Histopathology of a pheochromocytoma with coagulative necrosis, annotated.jpg|Histopathology of a '''pheochromocytoma''' with coagulative necrosis, displayed at gross pathology (upper left) and light microscopy at low (upper right), medium (lower left) and high magnification (lower right).
File:Histopathology of pheochromocytoma.jpg|thumb|250px|'''[[Pheochromocytoma]]''', with typical features shown.
</gallery>
</gallery>


==Reporting==
==Reporting==
{{CAP}}
{{CAP}}<noinclude>
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{{Bottom}}
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Latest revision as of 13:51, 17 November 2022

Author: Mikael Häggström [note 1]

Incidences and prognoses of adrenal tumors.[1]

Adenoma versus carcinoma

The most common adrenal tumors are adrenocortical adenomas and carcinomas. These are most commonly distinguished by the Weiss system,[2] as follows:[3]

Characteristic[3] Score
High nuclear grade (enlarged, oval to lobated, with coarsely granular to hyperchromatic chromatin and easily discernible, prominent nucleoli)[4] 1
More mitoses than 5/50 high power fields 1
Atypical mitoses 1
Eosinophilic cytoplasm in >75% of tumor cells 1
Diffuse architecture of >33% of tumor 1
Necrosis 1
Venous invasion 1
Sinusoidal invasion (no smooth muscle in wall) 1
Capsular invasion 1

Total score indicates:[3]

  • 0-2: Adrenocortical adenoma
  • 3: Undetermined
  • 4-9: Adrenocortical carcinoma
  • Gross pathology of adrenocortical adenoma.
    Gross pathology of adrenocortical adenoma.
  • Zona fasciculata versus adrenocortical adenoma. An adrenocortical adenoma typically has mild changes in comparison, including larger cells with larger and more pleomorphic nuclei with more coarse chromatin. H&E stain. [image 1]
    Zona fasciculata versus adrenocortical adenoma. An adrenocortical adenoma typically has mild changes in comparison, including larger cells with larger and more pleomorphic nuclei with more coarse chromatin. H&E stain. [image 1]
  • Adrenocortical adenoma with focal high grade nuclear atypia.[5]
    Adrenocortical adenoma with focal high grade nuclear atypia.[5]
  • Adrenocortical adenoma with focal necrosis[5]
    Adrenocortical adenoma with focal necrosis[5]
  • Gross pathology of adrenocortical carcinoma. They are generally large, with a tan-yellow cut surface, and often have areas of hemorrhage and necrosis.
    Gross pathology of adrenocortical carcinoma. They are generally large, with a tan-yellow cut surface, and often have areas of hemorrhage and necrosis.
  • Histopathology of adrenocortical carcinoma, with marked mitotic activity.
    Histopathology of adrenocortical carcinoma, with marked mitotic activity.

Other adrenal tumors

Reporting

For cancers, generally include a synoptic report, such as per College of American Pathologists (CAP) protocols at cap.org/protocols-and-guidelines.

Notes

  1. ↑ For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

Main page

References

  1. ↑ Data and references for pie chart are located at file description page in Wikimedia Commons.
  2. ↑ Wang, Cuiping; Sun, Yang; Wu, Huanwen; Zhao, Dachun; Chen, Jie (2014). "Distinguishing adrenal cortical carcinomas and adenomas: a study of clinicopathological features and biomarkers ". Histopathology 64 (4): 567–576. doi:10.1111/his.12283. ISSN 03090167. 
  3. ↑ 3.0 3.1 3.2 Aye, Than Than; Myint, Phone; Myint, Kyar Nyo Soe (2015). "Adrenocortical Oncocytoma Presenting with Gynaecomastia ". Journal of the ASEAN Federation of Endocrine Societies 30 (1): 27–30. doi:10.15605/jafes.030.01.08. ISSN 08571074. 
  4. ↑ Tito Fojo. Adrenocortical Cancer. Retrieved on 2020-07-02.
  5. ↑ 5.0 5.1 Gupta S, Melendez J, Khanna A (2010). "Deoxycorticosterone producing tumor as a cause of resistant hypertension. ". Case Rep Med 2010: 372719. doi:10.1155/2010/372719. PMID 20671982. PMC: 2909735. Archived from the original. . 
    - "This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited."

Image sources

  1. ↑ Image(s) by: Mikael Häggström, M.D. Public Domain
    - Author info
    - Reusing images
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