#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

#Gross


A
#Diagnosis 👉🏻  Atrophy adrenal gland
DUE TO Addison’s disease or Long term using of Corticosteroids and stop using it suddenly not gradually

B
#Diagnosis 👉🏻 Normal adrenal gland
• The cortex is yellow in color
• The medulla is red in color

C
#Diagnosis 👉🏻 adrenal hyperplasia
DUE TO Cushing's disease

#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

#Gross

#Diagnosis 👉🏻  Adrenocortical adenoma


#The_white_arrow
Adenoma

#The_features
- Circumscribed , Unilateral, solitary
- yellow tan in color
- Hemorrhage
- Functional adenoma may result in atrophy of contralateral adrenal cortex

NOTE
Cause hypertension and hypokalemia

#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

#Gross

#Diagnosis 👉🏻  Phenochromocytoma


#The_black_arrow
Small remnant of remaining adrenal

#The_white_star
adrenal neoplasm

#The_blue_arrow
Hemorrhage

#The_white_arrows
Cortex

#The_features
- Well circumscribed and unencapsulated
- Solid , gray tan
- hemorrhagic in cut surface

#Gross

#Diagnosis 👉🏻  Phenochromocytoma
"chromaffin reaction"


#The_red_arrow
tumor which has not been placed in dichromate fixative

#The_white_arrow
tumor at the bottom has been placed into a dichromate fixative
والذي يظهر لنا باللون البني الغامق وذلك عشان انه catecholamines حصلها oxidized

#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

سلايد اوضح

Microscopic

#Diagnosis 👉🏻   Phenochromocytoma


#The_yellow_arrows
intervening capillaries

#The_black_arrows
sustentacular cells

#The_blue_area
Zellballen ( nest )

#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)

THE FIRST & SECOND LAB DONE  ✓✓

Q1)

Q2)

Q3)