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Pathology Unit X
Endocrine System: Adrenals
19
Pathology
Graduate
04/19/2013

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Term
Disorders associated with hypofunction of the adrenal cortex
Definition
anatomic or metabolic lesion of the cortex
Term
Clinical significance with hypofunction of the adrenal cortex
Definition
impairs output of cortical steroids or secondary to a deficiency of ACTH
Term
Primary chronic adrenocortical insufficiency/Addison's disease
Definition
rare condition caused by any chronic
destructive process (for example idiopathic, TB, autoimmune) in the adrenal cortex.
Term
Primary acute adrenocortical insufficiency (adrenal crisis)
Definition
can occur in patients with Addison disease
under conditions of stress; in association with improper steroid use; in association with hemorrhagic
destruction of adrenal (most often related to bacteremic infection, esp. TB).
Term
Secondary adrenocortical insufficiency
Definition
any disorder of hypothalamus and pituitary that reduces the output of ACTH.
Term
Disorders associated with hyperfunction of the adrenal cortex
Definition
Cushings syndrome, aldosteronism, and congenital adrenal hyperplasia
Term
Clinical significance of hyperfunction of the adrenal cortex
Definition
abnormal production of hormones
Term
Cushing syndrome
Definition
caused by any condition producing elevated glucocorticoid levels. Most common cause is administration of exogenous glucocorticoids;
Term
Aldosteronism
Definition
excess production of aldosterone - results in hypertension and hypokalemia
Term
Congenital adrenal hyperplasia
Definition
group of autosomal recessive disorders , characterized by a hereditary
defect in an enzyme involved in cortisol biosynthesis. Decreased cortisol production results in
compensatory increase in ACTH secretion, adrenal hyperplasia and increased production of steriods -
often resulting in virulization.
Term
Morphologic features of adenomas and carcinomas of the Adrenal cortex
Definition
single nodules, small are benign and large are malignant
Term
Clinical significance of adenomas and carcinomas of the Adrenal cortex
Definition
cortical carcinoma is rare and highly malignant, carcinomas are more likely to be functional
Term
Incidence of pheochromocytoma
Definition
uncommon
Term
Gross features of pheochromocytoma
Definition
yellow-tan, well-defined lesions, larger lesions are hemorrhagic, necrotic and cystic
Term
Clinical course of pheochromocytoma
Definition
sustained/episodic hypertension due to production of catecholamines (epi and norepi), 10% become malignant
Term
Incidence of neuroblastoma
Definition
80% found in children, < 5 years, genetic association, most common childhood tumor
Term
Gross features of neuroblastoma
Definition
arise in adrenal medulla or in retroperitoneal sympathetic ganglia, sharply demaracated with a fibrous pseudocapsule, can be infiltrating and invade surround structures, soft, gray-tan, brainlike tissue, larger have areas of necrosis, cystic softening, and hemorrhage
Term
Clinical course of neuroblastoma
Definition
aggressive tumor, spreads rapidly to liver, lungs and bones
Term
Most common metastasis of adrenal gland
Definition
lung carcinoa
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