Adrenal tumors: Difference between revisions
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===Other adrenal tumors=== | ===Other adrenal tumors=== | ||
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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 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) showing ghost cells. | ||
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Revision as of 17:40, 1 March 2022
Author:
Mikael Häggström [note 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. -
![Histopathology of adrenocortical adenoma, most commonly showing clear cells with high lipid contents.[5]](https://upload.wikimedia.org/wikipedia/commons/thumb/a/af/Histopathology_of_adrenocortical_adenoma.jpg/500px-Histopathology_of_adrenocortical_adenoma.jpg?utm_source=commons.wikimedia.org&utm_campaign=imageinfo&utm_content=thumbnail)
Histopathology of adrenocortical adenoma, most commonly showing clear cells with high lipid contents.[5] -
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 adenoma, most commonly showing clear cells with high lipid contents.[5]](/File:Histopathology_of_adrenocortical_adenoma.jpg)
Other adrenal tumors
-
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) showing ghost cells.
Reporting
For cancers, generally include a synoptic report, such as per College of American Pathologists (CAP) protocols at cap.org/protocols-and-guidelines.
Notes
- ↑ 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
- ↑ Data and references for pie chart are located at file description page in Wikimedia Commons.
- ↑ 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:. ISSN 03090167.
- ↑ 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:. ISSN 08571074.
- ↑ Tito Fojo. Adrenocortical Cancer. Retrieved on 2020-07-02.
- ↑ Mete, Ozgur; Duan, Kai (2018). "The Many Faces of Primary Aldosteronism and Cushing Syndrome: A Reflection of Adrenocortical Tumor Heterogeneity
". Frontiers in Medicine 5. doi:. ISSN 2296-858X.
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Image sources