Adrenal tumors: Difference between revisions

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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: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.

Revision as of 08:34, 14 April 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]
  • 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.

Image sources

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