Neoplasms Of The Adrenal Cortex

Neoplasms of adrenal cortex: growth disorders are the most important lesions in the adrenal cortex…

Hyperplasia: (diffuse or macro/micro-nodular) - Often-minimal enlargement.

Adenoma:

• Usually small, solitary, poorly encapsulated, yellow nodules

• Larger lesions may contain areas of haemorrhage, cystic change and calcification

• Lipid laden cells, sometimes more pleomorphic, diagnosis difficult

• Many non-functional

Carcinoma:

• Usually large, unencapsulated, highly anaplastic and malignant

• Lymphatic and or haematogenous metastasis to lungs  other organs

• Some are small and difficult to distinguish from adenoma

• Tumours commonly invade vascular channels and metastasis to lung is common

These lesions may result in:

• Hypofunction: acute or chronic adrenal insufficiency; the result of massive destruction of adrenal glands (e.g. Waterhouse-Friderichsen syndrome, meningococcal septicaemia)

• Hyperfunction: e.g. Cushing (excess glucocorticoid), Conn (excess mineralocorticoid) or adrenogenital syndromes (ACTH secretion)

• Normal function

Note: secondary tumours are more common than primary (esp. lung & breast)

Category: Pathology Notes