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Adrenal oncocytic pheochromocytoma
1Department of Pathology, Albert Einstein College of Medicine/Montefiore Medical Center, Bronx, New York 10461, USA. maomili@pol.net
The American Journal of Surgical Pathology
|November 15, 2000
Summary
This study details a rare adrenal oncocytic pheochromocytoma in a woman. The tumor exhibited unique ultrastructural and immunohistochemical features, expanding the known spectrum of pheochromocytoma.
Area of Science:
- Endocrinology
- Oncology
- Pathology
Background:
- Pheochromocytomas are rare neuroendocrine tumors arising from chromaffin cells of the adrenal medulla.
- Oncocytic change in pheochromocytoma is exceptionally rare, with limited ultrastructural and immunohistochemical data.
Observation:
- A 37-year-old woman presented with a large left adrenal mass causing increased abdominal girth.
- Surgical excision revealed a 1,150g tumor with histological features of oncocytic pheochromocytoma.
- Electron microscopy showed abundant mitochondria and dense-core granules in tumor cells.
Findings:
- Immunohistochemistry revealed positivity for neuroendocrine markers (chromogranin, synaptophysin) and cytokeratins (AE1/3, CAM 5.2, CK7, CK20).
- The tumor cells also expressed serotonin, bombesin, ACTH, vimentin, desmin, and S-100 protein.
- This case represents the first ultrastructurally confirmed adrenal oncocytic pheochromocytoma with extensive immunohistochemical findings.
Implications:
- This case expands the immunohistochemical and ultrastructural spectrum of pheochromocytoma.
- Understanding these diverse features is crucial for accurate diagnosis and classification of adrenal tumors.
- Further research may elucidate the pathogenesis and clinical behavior of oncocytic pheochromocytomas.