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Presented by Pedram Argani, M.D. and prepared by Matthew Olson, M.D.
Case 2: This is a 63 year old female with incidental adrenal mass.
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Question 1 of 1
1. Question
Week 479: Case 2
This is a 63 year old female with incidental adrenal mass.images/1Alex/04252011case2image1.jpg
images/1Alex/04252011case2image2.jpgCorrect
Answer: Adrenal cortical carcinoma
Histology: This is a sheet like proliferation of eosinophilic polygonal cells. The cells demonstrate high grade nuclear atypia, atypical mitosis, a diffuse growth pattern, and venous invasion. There are less than 25% clear cells. These are 5 of the 9 Weiss histological criteria which support the diagnosis of adrenal cortical carcinoma.
Discussion: Adrenal cortical adenoma would lack the malignant features described above. Pheochromocytoma would feature nested cells with clear to amphophilic cytoplasm in a highly vascularized stroma. Myelolipoma would contain myeloid elements along with fat.
Incorrect
Answer: Adrenal cortical carcinoma
Histology: This is a sheet like proliferation of eosinophilic polygonal cells. The cells demonstrate high grade nuclear atypia, atypical mitosis, a diffuse growth pattern, and venous invasion. There are less than 25% clear cells. These are 5 of the 9 Weiss histological criteria which support the diagnosis of adrenal cortical carcinoma.
Discussion: Adrenal cortical adenoma would lack the malignant features described above. Pheochromocytoma would feature nested cells with clear to amphophilic cytoplasm in a highly vascularized stroma. Myelolipoma would contain myeloid elements along with fat.
