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Presented by Pedram Argani, M.D. and prepared by ChanJuan Shi, M.D., PhD.
Case 3: These are products of conception from a 26-year-old female.
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1. Question
Week 383: Case 3
These are products of conception from a 26-year-old female. The fetus was estimated to be at 17 weeks gestation.images/030209-argani-3a.jpg
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images/030209-argani-3d.jpgCorrect
Answer: Neuroblast clusters in fetal adrenal (normal histology)
Histology: Within the normally expanded oncocytic provisional zone of the fetal adrenal cortex are clusters of primitive neuroblastic cells. These cells focally form rosettes. Mitotic figures and apoptotic bodies are evident. This is the normal developmental histology of the adrenal gland.
Discussion: Neuroblastoma and neuroblastoma in situ would be composed of cytologically similar cells. However, these would form a mass legion, in the case of neuroblastoma, or would be a microscopic lesion present in an infant in the case of neuroblastoma in situ. Chronic inflammatory cells would lack the fine dispersed chromatin and rosette formation of the neuroblastic nodules.
Neuroblastic nodules are a normal finding and peak at 17- to 20-weeks gestation. An excellent illustration of these cells is found in the AFIP Fascicle on Tumors of the Adrenal Gland and Extraadrenal Paraganglia, third series, Fascicle 19, page 6.
Incorrect
Answer: Neuroblast clusters in fetal adrenal (normal histology)
Histology: Within the normally expanded oncocytic provisional zone of the fetal adrenal cortex are clusters of primitive neuroblastic cells. These cells focally form rosettes. Mitotic figures and apoptotic bodies are evident. This is the normal developmental histology of the adrenal gland.
Discussion: Neuroblastoma and neuroblastoma in situ would be composed of cytologically similar cells. However, these would form a mass legion, in the case of neuroblastoma, or would be a microscopic lesion present in an infant in the case of neuroblastoma in situ. Chronic inflammatory cells would lack the fine dispersed chromatin and rosette formation of the neuroblastic nodules.
Neuroblastic nodules are a normal finding and peak at 17- to 20-weeks gestation. An excellent illustration of these cells is found in the AFIP Fascicle on Tumors of the Adrenal Gland and Extraadrenal Paraganglia, third series, Fascicle 19, page 6.
