Adrenal cortical tumors, pheochromocytomas and paragangliomas. Mod Pathol 24:S58-S65

Department of Pathology, University of Wisconsin School of Medicine and Public Health, Madison, WI 53792, USA.
Modern Pathology (Impact Factor: 6.19). 04/2011; 24 Suppl 2(2):S58-65. DOI: 10.1038/modpathol.2010.126
Source: PubMed


Distinguishing adrenal cortical adenomas from carcinomas may be a difficult diagnostic problem. The criteria of Weiss are very useful because of their reliance on histologic features. From a practical perspective, the most useful criteria to separate adenomas from carcinomas include tumor size, presence of necrosis and mitotic activity including atypical mitoses. Adrenal cortical neoplasms in pediatric patients are more difficult to diagnose and to separate adenomas from carcinomas. The diagnosis of pediatric adrenal cortical carcinoma requires a higher tumor weight, larger tumor size and more mitoses compared with carcinomas in adults. Pheochromocytomas are chromaffin-derived tumors that develop in the adrenal gland. Paragangliomas are tumors arising from paraganglia that are distributed along the parasympathetic nerves and sympathetic chain. Positive staining for chromogranin and synaptophysin is present in the chief cells, whereas the sustentacular cells are positive for S100 protein. Hereditary conditions associated with pheochromocytomas include multiple endocrine neoplasia 2A and 2B, Von Hippel-Lindau disease and neurofibromatosis I. Hereditary paraganglioma syndromes with mutations of SDHB, SDHC and SDHD are associated with paragangliomas and some pheochromocytomas.

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    • "It is reported that the absolute organ weight and organ-to-body weight ratio of the adrenal glands in F344 female rats were significantly higher than those in male rats from weeks 4 to 104, while a similar trend was observed from weeks 13 to 104 in B6C3F1 mice8, and this was consistent with our results. The change in adrenal gland weight might suggest the appearance of hypertrophy, hyperplasia, tumor or test item effects9. Some studies have reported that the adrenal cortex was thicker in female F344 rats and B6C3F1 mice compared with males, in particular, the reticular zone thickness increased significantly in the area that was mainly responsible for the secretion of androgen and a small amount of estrogen10. "
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