Pathology Of Adrenal Gland

Front 1

adrenal myelolipomas occur in ___ (age group)

Back 1

- postpubertal adults!

Front 2

Ectopic adrenal cortex lacks a __

Back 2

medulla

Front 3

In Cushing's syndrome, the zona ___ and __ are thickened bilaterally

Back 3

zona fasciculata and zone reticularis
- note: in some cases the hyperplastic adrenal glands may only weigh slightly more than normal

Front 4

congenital adrenal hyperplasia is due to a partial or complete enzyme deficiencies resulting in a lack of __ and resultant __

Back 4

- lack of cortisol
- inceased ACTH and cortical hyperplasia

Front 5

the principle deficiencies seen in congenital adrenal hyperplasia are:

Back 5

- 21-alpha hydroxylase deficiency (95% cases)

- 11-beta hydroxylase deficiency (3%)

- 17-alpha hydroxylase deficiency

Front 6

In CAH, the adrenal cortex appears brown due to __

Back 6

lipofuscin pigment

Front 7

In males with CAH, bilateral benign testicular or paratesticular masses histologically resembling __ may be produced

Back 7

- resemble Leydig cell tumors
- these masses are ACTH-sensitive and often regress with steroid therapy
- this finding usually does NOT require surgical excision!!

Front 8

primary pigmented nodular adrenocortical disease, what the heck is this?

Back 8

- Essentials, p 661
- aka: microadenomatous hyperplasia
- more common in young women
- S/Sx of hypercortisolism
- osteoporosis is a prominent
- familial cases: part of Carney's complex:
- myxomas (cardiac, cutaneous, and mammary)
- pigmented skin lesios (ephelides, lentigines, blue nevi)
- endocrine overactivity (acromegaly due to pituitary adenoma, precocious puberty due to large cell calcifying Sertoli cell tumor of testes)
- Schwannomas

- multiple pigmented cortical nodules (1-3 mm) in an otherwise atrohic cortex
- glands usually nml size! or smaller

- nodules composed of large granular eosinophilic cells, some with large hyperchromatic nuclei
- lipofuscin pigment

DDX:
- pigmented cortical adenoma: larger, solitary, 3-6 cm