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Difference between revisions of "Adrenal gland"
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==Clinical== | ==Clinical== | ||
Patients getting a bilat. adrenalectomy get pre-treatment with steroids. | Patients getting a bilat. adrenalectomy get pre-treatment with steroids.<ref>URL: | ||
http://www3.interscience.wiley.com/cgi-bin/fulltext/119909358/PDFSTART | [http://www3.interscience.wiley.com/cgi-bin/fulltext/119909358/PDFSTART http://www3.interscience.wiley.com/cgi-bin/fulltext/119909358/PDFSTART]. Accessed on: 21 August 2010.</ref> | ||
Adrenal insuff. may be immediately post-op. | Adrenal insuff. may be immediately post-op.<ref>URL: [http://ats.ctsnetjournals.org/cgi/content/full/62/5/1516 http://ats.ctsnetjournals.org/cgi/content/full/62/5/1516]. Accessed on: 21 August 2010.</ref> | ||
http://ats.ctsnetjournals.org/cgi/content/full/62/5/1516 | |||
==Benign== | ==Benign== | ||
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*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 name=pmid10870039>PMID 10870039 | Treatment is excision if...<ref name=pmid10870039>{{Cite journal | last1 = Luton | first1 = JP. | last2 = Martinez | first2 = M. | last3 = Coste | first3 = J. | last4 = Bertherat | first4 = J. | title = Outcome in patients with adrenal incidentaloma selected for surgery: an analysis of 88 cases investigated in a single clinical center. | journal = Eur J Endocrinol | volume = 143 | issue = 1 | pages = 111-7 | month = Jul | year = 2000 | doi = | PMID = 10870039 }} | ||
</ref><ref name=pmid19035218>{{Cite journal | last1 = Liu | first1 = XK. | last2 = Liu | first2 = XJ. | last3 = Dong | first3 = X. | last4 = Kong | first4 = CZ. | title = [Clinical research about treatment for adrenal incidentalomas] | journal = Zhonghua Wai Ke Za Zhi | volume = 46 | issue = 11 | pages = 832-4 | month = Jun | year = 2008 | doi = | PMID = 19035218 }}</ref> | |||
*Lesions >30 mm. | *Lesions >30 mm. | ||
*Hormonally active. | *Hormonally active. | ||
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===Hyperplasia vs. adenoma=== | ===Hyperplasia vs. adenoma=== | ||
*Hyperplasia is multifocal.<ref>IAV. 18 February | *Hyperplasia is multifocal.<ref>IAV. 18 February 2009.</ref> | ||
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==Pheochromocytoma== | ==Pheochromocytoma== | ||
===General=== | ===General=== | ||
*Considered to be a [[paraganglioma]].<ref>EP | *Considered to be a [[paraganglioma]].<ref name=Ref_EP327>{{Ref EP|327}}</ref> | ||
===Clinical=== | ===Clinical=== | ||
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==Ganglioneuroma== | ==Ganglioneuroma== | ||
===Microscopic=== | |||
Features: | |||
*Ganglion cells. | *Ganglion cells - '''key feature'''. | ||
**Large cells with large nucleus. | **Large cells with large nucleus. | ||
***Prominent nucleolus. | ***Prominent nucleolus. | ||
*Disordered fibrinous material. | |||
==Myelolipoma== | ==Myelolipoma== | ||
==Adenomatoid tumour== | ==Adenomatoid tumour== | ||
See: ''[[Uterine_tumours#Adenomatoid_tumour|Adenomatoid tumours (uterine tumours)]]''. | |||
===Malignant neoplasms=== | ===Malignant neoplasms=== | ||
==Adrenocortical carcinoma (ACC)== | ==Adrenocortical carcinoma (ACC)== | ||
Epidemiology: | |||
*Prognosis sucks. | *Prognosis sucks. | ||
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*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 | *Features useful for differentiating benign from malignant:<ref name=Ref_EP259>{{Ref EP|259}}</ref> | ||
**Marked nuclear atypia. | **Marked nuclear atypia. | ||
**Invasion: | **Invasion: | ||
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===Microscopic=== | ===Microscopic=== | ||
*Small round cell | Features: | ||
*See: ''[[Small round cell tumours]]''. | |||
==References== | ==References== | ||