adrenocortical hyperplasia ICD-10: E27.0
Mann, 79 J., metastasierendes Kolonkarzinom. Autopsiepräparat
- Architektur der Nebennierenrinde erhalten (infolge der Autolyse
teilweise schwierig zu erkennen)
- Verbreiterung der Zona fasciculata,
weniger stark der Zona reticularis
- Zellen gross (Hypertrophie), Zellzahl deutlich vermehrt (Hyperplasie)
Pathogenese:
Inadäquate, zu intensive Stimulation durch ACTH
Makroskopie:
- Vergrösserte Nebenniere
- Verbreiterte Nebennierenrinde
- Normale Nebennierenrinde: Breite ca. 1 mm (umfasst gelbe und braune
Zona fasciculata und reticularis).
- Bei Hyperplasie oft beide Zonen verbreitert.
79-year-old male suffered from metastasized carcinoma of the colon (specimen from autopsy).
- The architecture of the adrenal cortex is maintained, the zona glomerulosa, fasciculata and reticularis can readily be distinguished.
- In hyperplasia both, the zona fasciculata and to a lesser degree, the
zona reticularis are widened.
- The cells are larger than usual (hypertrophy) and the absolute number of cells is increased (hyperplasia).
Pathogenesis: Acquired hyperplasia of the adrenal cortex is always bilateral. A diffuse and a nodular form are distinguished. The first is caused by
inadequate ACTH production and is thus referred to as the ACTH-dependent form. In contrast, nodular hyperplasia usually arises independent of an increased
ACTH-production, and is therefore referred to as the ACTH-independent form.
Macroscopy: The adrenal glands are enlarged. In adults, an adrenal gland weighing above 6 g is considered hyperplastic. The adrenal cortex is diffusely
thickened and yellow. Normally, the width of the adrenal cortex is around 1mm and exhibits a yellow and brown color (zona fasciculata and reticucularis).