Difference between revisions of "Adrenal gland"

Jump to navigation Jump to search
(create)
 
(format, cut paraganglioma)
Line 19: Line 19:


==Benign==
==Benign==
*Spironolactone bodies<ref>{{cite journal |author=Kovacs K, Horvath E, Singer W |title=Fine structure and morphogenesis of spironolactone bodies in the zona glomerulosa of the human adrenal cortex |journal=J. Clin. Pathol. |volume=26 |issue=12 |pages=949–57 |year=1973 |month=December |pmid=4131694 |pmc=477936 |doi= |url=http://jcp.bmj.com/cgi/pmidlookup?view=long&pmid=4131694}}</ref>
*Spironolactone bodies<ref>{{cite journal |author=Kovacs K, Horvath E, Singer W |title=Fine structure and morphogenesis of spironolactone bodies in the zona glomerulosa of the human adrenal cortex |journal=J. Clin. Pathol. |volume=26 |issue=12 |pages=949-57 |year=1973 |month=December |pmid=4131694 |pmc=477936 |doi= |url=http://jcp.bmj.com/cgi/pmidlookup?view=long&pmid=4131694}}</ref>
**location: zona glomerulosa (where aldosterone is produced)
**location: zona glomerulosa (where aldosterone is produced)
**appearance: eosinophilic spherical laminated whorls.
**appearance: eosinophilic spherical laminated whorls.
Line 25: Line 25:


==Adenomas==
==Adenomas==
Radiology<ref>[http://emedicine.medscape.com/article/376240-overview]</ref>
Radiology<ref>URL: [http://emedicine.medscape.com/article/376240-overview http://emedicine.medscape.com/article/376240-overview].</ref>
*radiologists are good at identifying adenomas, as they are usually lipid rich and have a characteristic low HU signal.
*radiologists are good at identifying adenomas, as they are usually lipid rich and have a characteristic low HU signal.


Treatment is excision if...<ref>[http://www.ncbi.nlm.nih.gov/pubmed/10870039]</ref><ref>[http://www.ncbi.nlm.nih.gov/pubmed/19035218]</ref>
Treatment is excision if...<ref name=pmid10870039>PMID 10870039.</ref><ref name=pmid19035218>PMID 19035218.</ref>
*lesions >30 mm
*Lesions >30 mm.
*hormonally active
*Hormonally active.
*non-incidental finding (?)
*Non-incidental finding. (???)


===Hyperplasia vs. adenoma===
===Hyperplasia vs. adenoma===
*Hyperplasia is multifocal.<ref>IAV 18 Feb 09.</ref>
*Hyperplasia is multifocal.<ref>IAV. 18 February 09.</ref>




Line 100: Line 100:
==Adrenocortical carcinoma (ACC)==
==Adrenocortical carcinoma (ACC)==
Epi.
Epi.
*prognosis sucks
*Prognosis sucks.


Histology
===Microscopic===
*very pleomorphic nuclei
Features:
*high mitotic rate
*Very pleomorphic nuclei.
*atypical mitoses
*High mitotic rate.
*eosinophilic cytoplasm
*Atypical mitoses.
*Eosinophilic cytoplasm.


==Malignant pheochromoctyoma==
==Malignant pheochromoctyoma==
*like the description in ''benign neoplasms''
*Like the description in ''benign neoplasms''.
*differentiated from benign pheochromocytoma by mets - often aided by radiologic report
*Differentiated from benign pheochromocytoma by mets - often aided by radiologic report.
*features useful for differentiating benign from malignant:<ref>[EP P.259]</ref>
*Features useful for differentiating benign from malignant:<ref>EP P.259.</ref>
**marked nuclear atypia
**Marked nuclear atypia.
**invasion
**Invasion:
***capsular
***Capsular.
***vascular
***Vascular.
**necrosis
**Necrosis.
**cellular monotony
**Cellular monotony.
**mitoses
**Mitoses:
***rate
***Rate.
***atypical mitosis
***Atypical mitosis.


==Neuroblastoma==
==Neuroblastoma==
Epi:  
Epi:  
*usually paediatric population
*Usually paediatric population.


Histology
===Microscopic===
*small blue cells
*Small round cell tumour.




Line 134: Line 135:


==References==
==References==
<references/>
{{reflist|2}}


[[Category:Endocrine pathology]]
[[Category:Endocrine pathology]]
[[Category:Genitourinary pathology]]
[[Category:Genitourinary pathology]]
----------------------------------------------------------------
'''Paraganglioma'''
General
*def'n: tumour of paraganglion (can be sympathetic or parasympathetic)
**most common paraganglioma - pheochromocytoma<ref>[EP P.327]</ref>
*head & neck most common site - after abdomen
**carotid body tumour
Epi.
*very rare
*rarely malignant
*familial syndromes assoc. with paragangliomas<ref>[EP. P.328]</ref>
**[[von Hippel Lindau]]
**Hereditary paragangliomatosis
**Neurofibromatosis type 1 (von Recklinghausen disease)
**MEN 2A
**MEN 2B
Clinical
*10% bilateral, multiple, familial, pediatric and malignant<ref>[EP P.327]</ref>
Micro.<ref>[EP PP.329-332]</ref>
*resembles pheochromocytoma
**Zellballen (literally: "cell balls") - nests of cells
**fibrovascular septae
**finely granular cytoplasm (salt-and-pepper nuclei)
IHC<ref>EP P.335</ref>
*chromogranin +ve
*synaptophysin +ve
*S100 +/-
*cytokeratin -ve
*EMA -ve
**+ve in RCC
==See also==
*[[Pheochromocytoma]]
==References==
<references/>
[[Category:Rare stuff]]
Retrieved from "https://librepathology.org/wiki/Adrenal_gland"