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38 Cards in this Set
- Front
- Back
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Acidophils synthesize _______
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Prolactin, growth hormone (stain eosinophilic)
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Basocphils synthesize ______.
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ACTH, TSH (stain blue)
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Chromophobes synthesize_______
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Any of the hormones (do not take up any color)
(GH, PRL, ACTH, FSH, LH, TSH) |
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Majority of adenomas are _________.
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Prolactinomas
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Microadenoma vs Macroadenoma
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Micro is under 1 cm
Macro is over 1 cm |
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Adenoma vs Carcinoma on Frozen Section
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Adenoma has a homogenous cell type (acidophilic or basophilic), carcinoma does not
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T/F: Tumors causing compression symptoms are likely to secrete hormones.
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False
Microadenomas secreting hormones would present early (before growth into macroadenoma) |
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Gonadotroph adenomas:
Symptoms |
Neurologicla symptoms predominate (MASS effect)
LH and FASH Secrete hormones inefficiently |
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Null Cell Adenomas:
Symptoms |
Neurological symptoms predominate
NOT secreting hormones so it's a mass effect |
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TSH Adenomas:
Symptoms |
Hyperthyroidism
(1% of all adenomas) |
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Modified glial cells (known as ______) and axonal processes from nerve cells in _______ nuclei produce ______.
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modified glial cells known as pituicytes
axonal processes from nerve cells in supraoptic and paraventricular nuclei produce: ADH and oxytocin |
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Diabetes Insipidus:
Presentation Ion levels Causes |
Polyuria, low urinary specific gravity
Increased serum sodium Results from trauma, pit or hthal tumors; inflammn |
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Hypopituitarism occurs when _______
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75% of pituitary is destroyed
Tumors, mass lesions, Rathke cleft cyst Sheehan Syndrome (labor induced infarct) |
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Conglomerated epitheliod histiocytes in the pituitary describes _________.
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Granulomatous inflammation of pituitary gland
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Suprasellar disorders:
Associated with Causes |
Sleep disturbances, hunger, hypogonadism, precocious puberty
Causes: Craniopharyngioma***, dermoid cyst, ependymoma, meningioma, trauma, encephalitis |
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Craniopharyngiomas tend to recapitulate __________.
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Rathke's pouch
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This growth is usually cystic with calcifications.
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Craniopharyngioma
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This growth is thick walled epithelial and lined with proteinaceous material.
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Rathke's cleft cyst
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Rathke's Cleft Cyst vs Craniopharyngioma
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Rathke's Cleft Cyst is lined with proteinaceous material
Craniopharyngioma is lined with cholesterol |
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Central vein of adrenal gland is not well circumscribed and is located in the adrenal ________.
Why is it not well-circumscribed? |
In Medulla, not well-circumscribed to allow for quick release of catecholamines
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Most common cause of adrenocortical hypercortisolism?
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Exogenous glucocorticoids
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Common Causes of Cushing's Syndrome:
Children vs Adults |
Adults: Pituitary Based dz, ectopic ACTH/CRH, Adenoma, Carcinoma (5%)
Children: Carcinoma (50%!), Pit based dz, Adenoma |
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This growth typically has a yellow color.
Why? |
Cortical adenomas (fasciculata) typically is yellow bc of lipid content
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Adenomas tend to be ______ and composed of _______.
How does this composition differ by tumor functionality What is the affect of an adenoma on adjacent endocrine tissue? |
well circumscribed and composed of lipid RICH and lipid POOR cells
Fnal tumors would be more lipid poor (using up fat to produce hormones) Adjacent layers of adrenal gland (in case of adrenal adenoma) will atrophy |
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Adrenocortical carcinomas tend to have a heterogenous texture on imaging. Why?
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Areas of necrosis (growth rate greater than blood supply can handle), hemorrhage
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This growth has cells with enlarged and hyperchromatic nuclei with mitoses.
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Adrenal cortical carcinomas
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What tumpors contribute to ectopic ACTH production?
How does this affect the adrenal gland (grossly)? |
SCC
Pancreatic MTC Causes substantial adrenal hypertrophy |
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Primary hyperaldosteronism:
Clinical Features Adenoma Features |
HTN
Hypokalemia Low serum renin Less than 2 cm in diameter (early effects) Bright yellow/orange Small, round, regular nuclei |
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Autoimmune Adrenalitis:
Type 1 vs Type 2 |
Type 1: Chronic adrenal insufficiency
AKA APECED: autoimmune polyendocrinopathy-candidiasis-ectodermal dystrophy) Type 2: Chronic adrenal insufficiency, autoimmune thyroid dz, IDDM |
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In this disorder the adrenal cortex is almost completely atrophic and is infiltrated by lymphocytes.
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Autoimmune adrenalitis
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In infants with this syndrome, the adrenals can be larger than the kidneys because of intense stimulation of the glands by ACTH.
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Adrenogenital syndrome (21-OHase deficiency)
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Adrenal metastases tend to originate in the _______.
Would the metastases exhibit adrenal histology? |
Lungs
(can also come from breast/liver) Can be unilateral or bilateral (adrenal glands) Would exhibit primary tumor histology (lung) |
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This process exhibits caseous necrosis in the adrenals glands.
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Adrenal tuberculosis (CHALKY appearance)
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What is Waterhouse Friderichsen Syndrome?
Symptoms? Effects on adrenal gland? |
Overwhelming bacterial infection (typically N. meningitidis)
Rapidly progressive hypotn leads to schock Disseminated intravascular coagulation leads to widespread purpura Rapidly developing adrenal cortical insufficiency associated with massive bilateral adrenal hemorrhage |
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Pheochromocytoms vs Paraganglioma
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Pheo: within adrenal medulla
Paraganglioma: extra-adrenal pheochromocytoma; just above kidney |
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Defining presentation of pheochromocytoma.
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Paroxysmal symptoms (spells)
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Pheochromocytoma:
Most Common Cause |
Familial (25%)
No more rule of 10's! |
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This disorder can result in an adrenal gland with multiple pheochromocytomas and hyperplasia of the medulla.
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Multiple Endocrine Neoplasias?-->MEN2!
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