Difference between revisions of "Adrenal gland"

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Adrenal gland (view source)

Revision as of 20:59, 19 March 2011

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===General===
===General===
*Considered to be a [[paraganglioma]].<ref name=Ref_EP327>{{Ref EP|327}}</ref>
*Considered to be a [[paraganglioma]].<ref name=Ref_EP327>{{Ref EP|327}}</ref>
*Literally means "dusky" (pheo) "colour" (chromo) - dull appearance on gross.
*Tumour arises from medulla
Clinical:
*Classic finding: hypertension.
*Paroxysms (i.e. episodes) of tachycardia, headache, anxiety, hypertension.
Laboratory findings (urine):
*Vanillylmandelic acid (VMA).
*Metanephrines.
Epidemiology:
*May be associated with [[multiple endocrine neoplasia]] 2a and 2b.


===Clinical===
===Microscopic===
*Paroxysms (i.e. episodic) tachycardia, headache, anxiety.
Features:<ref>{{Ref PBoD8|1161}}</ref>
*Usu. polygonal cells, may be spindled.
*Arranged in cell nests - "Zellballen" (literally ''cell balls'') - '''key feature'''.
*Stippled chromatin ([[AKA]] salt and pepper chromatin) - coarsely granular chromatin.
*Granular cytoplasm, often basophilic - '''important'''.
*Often haemorrhagic - highly vascular.
*+/-Nuclear pleomorphism.


===Epidemiology===
Notes:
*Tumour arises from medulla
*The nested architecture (Zellballen) is useful for differentiating from [[ACC]].
*Literally means "dusky" (pheo) "colour" (chromo) - dull appearance on gross
 
===IHC===
*Chromogranin +ve.
*Synaptophysin +ve.
*S100 +ve (sustentacular cells).


===Histology===
===[[EM]]===
Features:
*Membrane-bound secretory granules.
*Architecture:
**Cell nests, ''auf deutsch'': Zellballen (literally ''Cell balls'').
***Useful for differentiating from ACC.
*Nuclei.
**+/-Pleomorphism.
**Nucleoli may be prominent (not signif. prognostically).
*Cellular morphology.
**Polygonal cells.
*Cytoplasm.
**Basophilic, granular.
*Other.
**Haemorrhagic.


==Ganglioneuroma==
==Ganglioneuroma==
Michael
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