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Pathology - Adrenal cortical adenoma
A nonmalignant epithelial tumor of the adrenal cortex. Epidemiology: The majority of instances manifest in adults, exhibiting no gender preference. The actual incidence figures remain unknown, mostly due to the difficulty in differentiating nodular adrenal hyperplasia from genuine neoplastic adenomas.
Aetiology • Predominantly unidentified in the majority of instances. Genetics • No consistent genetic anomalies have been identified. Presentation • The majority of non-functional tumors are identified accidentally during abdominal imaging conducted for unrelated purposes. Aldosterone-producing adenomas manifest as primary hyperaldosteronism (Conn’s syndrome), which is characterized by hypertension and, in certain patients, hypokalaemia. Cortisol-secreting adenomas manifest as Cushing's syndrome.
Macroscopy • The adrenal gland exhibits a well-defined tumor that may be encapsulated. The median tumor weight is 40 grams. Aldosterone-producing adenomas may exhibit a brilliant yellow coloration, whereas those linked to Cushing’s syndrome may range from yellow to tan. A limited quantity of adenomas exhibit a black coloration, referred to as 'black adenoma.'
Histopathology: The tumors consist of massive polygonal cells organized in nests and trabeculae, interspersed with a delicate vascular network. The cells have cytoplasm that is either transparent and microvesicular or dense and eosinophilic. The nuclei are typically spherical to oval in shape and generally have a bland appearance. • At times, pronounced nuclear pleomorphism may be observed; nevertheless, this does not imply malignant behavior. A compressed ring of normal adrenal cortex may be observed at the periphery.
Prognosis: Adrenal cortical adenomas are benign tumors that lack the potential for malignant behavior. The prognosis is mostly influenced by the severity of the endocrine effects of functional tumors.
Pathological staging of adrenal cortical carcinoma Primary tumour (T)
pT1: tumour 5cm or less in size, localized.
pT2: tumour > 5cm, localized.
pT3: tumour of any size, locally invasive, but not involving adjacent organs.
pT4: tumour of any size, involving adjacent organs.
Regional lymph nodes (N)
N0: no regional lymph node metastasis.
N1: regional lymph node metastasis
A nonmalignant epithelial tumor of the adrenal cortex. Epidemiology: The majority of instances manifest in adults, exhibiting no gender preference. The actual incidence figures remain unknown, mostly due to the difficulty in differentiating nodular adrenal hyperplasia from genuine neoplastic adenomas.
Aetiology • Predominantly unidentified in the majority of instances. Genetics • No consistent genetic anomalies have been identified. Presentation • The majority of non-functional tumors are identified accidentally during abdominal imaging conducted for unrelated purposes. Aldosterone-producing adenomas manifest as primary hyperaldosteronism (Conn’s syndrome), which is characterized by hypertension and, in certain patients, hypokalaemia. Cortisol-secreting adenomas manifest as Cushing's syndrome.
Macroscopy • The adrenal gland exhibits a well-defined tumor that may be encapsulated. The median tumor weight is 40 grams. Aldosterone-producing adenomas may exhibit a brilliant yellow coloration, whereas those linked to Cushing’s syndrome may range from yellow to tan. A limited quantity of adenomas exhibit a black coloration, referred to as 'black adenoma.'
Histopathology: The tumors consist of massive polygonal cells organized in nests and trabeculae, interspersed with a delicate vascular network. The cells have cytoplasm that is either transparent and microvesicular or dense and eosinophilic. The nuclei are typically spherical to oval in shape and generally have a bland appearance. • At times, pronounced nuclear pleomorphism may be observed; nevertheless, this does not imply malignant behavior. A compressed ring of normal adrenal cortex may be observed at the periphery.
Prognosis: Adrenal cortical adenomas are benign tumors that lack the potential for malignant behavior. The prognosis is mostly influenced by the severity of the endocrine effects of functional tumors.
Pathological staging of adrenal cortical carcinoma Primary tumour (T)
pT1: tumour 5cm or less in size, localized.
pT2: tumour > 5cm, localized.
pT3: tumour of any size, locally invasive, but not involving adjacent organs.
pT4: tumour of any size, involving adjacent organs.
Regional lymph nodes (N)
N0: no regional lymph node metastasis.
N1: regional lymph node metastasis
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