- Indications for cytology examination
- Procuring the specimen
- Test platforms/specimen processing and triage
- Report
Basic cytomorphology
Normal adrenal cells – N13-6084
- Variable Cellularity
- Cortex:
- Bare nuclei with foamy lipid from stripped cytoplasm background
- Single cells with round nuclei, inapparent nucleoli
- In intact cells, abundant vacuolated cytoplasm with frayed edges
- Medulla
- Rarely sampled, cells have basophilic cytoplasm
- Large eccentric nucleus with fine chromatin
- Conspicuous nucleoli
Adrenal cortical nodules (hyperplastic, adenomas)
- Usually indistinguishable from benign cortical cells
Pheochromocytoma – C91-C20757
- Loosely cohesive round/plasmacytoid to spindled cells
- Fibrillary cytoplasm, oval hyperchromatic nuclei - may show anisonucleosis/pleomorphism/binucleation
- Melanin pigment in some cells
- Red cytoplasmic granularity on air dried material
- Synaptophysin, chromogranin positive; S-100 positive in spindle cells
- MIMICS: Adrenal cortical carcinoma, other poorly differentiated malignancies
Adrenal cortical carcinoma – C99-T12804
- May not be able to diagnose on cytology alone, but may suspect if mitoses, necrosis or marked pleomorphism is present
Histological assessment required to distinguish larger adenomas from carcinomas
Metastases –N13-6638, C95-N3969 and C97-R25603
- cell population resembling primary tumor
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