#Microscopic

#Diagnosis 👉🏻  Normal adrenal gland


#The_red_star
Periadrenal fat

#The_black_star
Capsule

#The_blue_star
Zona glomerulosa
THE CELLS
- well defined cells
- Rounded
- acidophilic cytoplasm
- lipid droplets
- secretes mineralocorticoids

#The_yellow_star
Zona fasiculata
THE CELLS
- Broad band of large cells with distinct membranes arranged in cords
- Cytoplasm has numerous small lipid vacuoles
- secretes glucocorticoids

#The_green_star
Zona reticularis
THE CELLS
- Granular and eosinophilic cytoplasm with minimal lipid
- Richly vascularized, capsular blood vessels, nerves and lymphatics penetrate along connective tissue septae
- secretes androgens

#The_brown_star
Medulla

#Microscopic

#Diagnosis 👉🏻  Adrenal nodular hyperplasia


#The_black_arrows
Nodules

#The_blue_arrows
Lipid poor pink cells like reticulari

#The_red_arrows
Lipid-rich clear cells like fasciculata

NOTES
- The Nodules larger than 3mm ( macronodular )
- metaplasia or atrophic cortex between nodules

#Microscopic

#Diagnosis 👉🏻  Adrenocortecal adenoma


#The_red_arrow
Adenoma

#The_black_star
Capsule of adenoma

#The_blue_arrow
Normal adrenal

#The_blue_star
Capsule of adrenal

#The_features
• adenoma cells are larger with different cytoplasm
• increased variation in nuclear size
• cells have abundant foamy cytoplasm like of zona fasciculata

#Microscopic

#Diagnosis 👉🏻   Adrenocortecal carcinoma


#The_black_star
Invasion (Metastases to vein)

#The_blue_arrow
Hemorrhage

#The_features
- Encapsulated tumor 
- Invasion of thick fibrous capsule
- Lymphovascular invasion
- hemorrhage
- hyperchromic nuclei

NOTES
Often are functional and can lead to
- Cushing diseas
- Masculinization in females
- Feminization in male

#Microscopic

#Diagnosis 👉🏻   Phenochromocytoma


#The_black_star
Neoplasm

#The_black_arrows
intervening capillaries

#The_blue_arrow
sustentacular cells

#The_red_area
Zellballen ( nest )

#The_yellow_arrows
Vacuoles

#The_blue_star
Normal adrenal


#The_features
- Nested (zellballen) with adjacent smaller sustentacular cells surrounded by abundant intervening capillaries
- Cells: large, polygonal to spindle , uniform or extensively vacuolated
- Cytoplasm: abundant fine, granular red-purple cytoplasm
- Nuclei: central round to oval, nucleoli prominent

#Microscopic

#Diagnosis 👉🏻  Phenochromocytoma


#The_black_arrow
Phenochromocytoma
والتي تظهر باللون البني عند صبغها بصبغة S100 لانه ذي الصبغة تصبغ الادرينالين و النورادرينالين ويلي يكونوا في حاله افراز بشكل كبير

#The_blue_arrow
Adrenal cortex (negative)

#Microscopic

#Diagnosis 👉🏻  Phenochromocytoma


#The_black_arrow
Phenochromocytoma
والتي تظهر باللون البني عند صبغها بصبغة Chromogranin
وتظهر الانوية باللون الازرق

#The_blue_arrow
Adrenal cortex (negative)

#MICROSCOPIC

#Diagnosis 👉🏻 Cerebral infarct (Acute hypoxic-ischemic injury)
In first day


#The_black_arrows
Glial cells

#The_blue_arrows
Neurons
- Eosinphilic cytoplasm
- Shrinkage of the nucleus (pyknosis)

#Type_of_stain
HE
In ischemia the cells cytoplasm ➪ eosinphilic due to protein denaturation

#MICROSCOPIC

#Diagnosis 👉🏻 Cerebral infarct
1-3 days


#The_black_arrows
Neutrophils attack red neurons

#The_white_arrows
Neutrophils infiltration

#The_red_arrows
clusters of erythrocytes

#The_blue_arrows
Neurons without nucleus

#The_black_star
Cuff of neutrophils around and within Blood vessels

#MICROSCOPIC

#Diagnosis 👉🏻  Cerebral infarct
6-7 days


#The_black_arrows
Foamy macrophages