Adrenal cortical adenoma

ADRENAL CORTICAL ADENOMA
  • Gross:  sharply well circumscribed appearing encapsulated
  • Cut section : yellow or golden yellow with areas of dark discolouration due to hemorrhage
  • Microscopy
    •  Appear encapsulated with pushing border having compressed fibrous capsule.
    •   Tumor cells have pale staining lipid rich cells with uniform round nuclei.
    •  Architectural pattern of cells: nesting, alveolar, trabecular and short cords. Spindle cell pattern can also be present
  •  Other type of cells which can be seen
    • Cells with eosinophilic cytoplasm
    •  Lipochrome pigment can be seen in cells
    • Balloon cells ( cells 10 folds larger than normal cells)
    • Vesicular nuclei with small nucleoli / Hyperchromatic nuclei with nuclear enlargement/ nuclear pseudoinclusions.
    •  Lipomatous / myelolipomatous metaplasia 

 

Adrenal cortical adenoma : Tumor cells arranged in small clusters and trabecular pattern. Cells have lipid rich cytoplasm (H&E,X100)

 

Adrenal cortical adenoma : Tumor cells arranged in small clusters . Cells have lipid rich cytoplasm (H&E,X200)

 

Adrenal cortical adenoma : Tumor cells arranged in small clusters and trabecular pattern. Cells have lipid rich cytoplasm (H&E,X100)

 

Adrenal cortical adenoma : Tumor cells arranged in small clusters separated by highly vascular fibrous septa with congested blood vessels (H&E,X100)

 

Adrenal cortical adenoma :Tumor is separated by fibrous septa from normal adrenal tissue (top)(H&E,X100)

 

Adrenal cortical adenoma : Tumor cells having finely vesicular pale staining lipid rich cytoplasm (H&E,X400)

 

Adrenal cortical adenoma : Tumor cells have lipid rich clear cytoplasm (right) and compact eosinophilic cytoplasm (left) (H&E,X100)

 

Adrenal cortical adenoma : Tumor cells are arranged in cords and have compact eosinophilic cytoplasm (H&E,X100)

 

Adrenal cortical adenoma : Tumor cells are arranged in cords and have compact eosinophilic cytoplasm. Few cells are showing lipofuscin pigment (H&E,X400)