Adrenal tumors
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]
-
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]](/index.php?title=Special:Upload&wpDestFile=Histopathology_of_adrenocortical_adenoma.jpg){kind=link}
Other adrenal tumors
-
Pheochromocytoma, with typical features shown.
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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