#Endo_Patho
Lecture 3 ( Written )
- Types of adrenocortical hyperfunction ?
Cushing syndrome: increased levels of glucocorticoids.
Hyperaldosteronism: increase mineralocorticoid
Adrenogenital syndromes: increase androgens
- Symptoms of Cushing Syndrome ?
Hypertension, Hyperglycemia, Truncal obesity, Buffalo hump , Moon facies Cutaneous striae, Hirsutism and Mental disturbances.
- Causes of Cushing Syndrome ?
If 1ry Hyper function : Adrenal Adenoma , Adrenal Carcinoma
If 2nd Hyper function : Cushing disease , para neoplastic Cushing , Iatrogenic Medication .
- Causes of Hyperaldosteronism ?
If 1ry Hyper function : Adrenocortical Neoplasm as adenoma at Zona glomerulosa , Bilateral nodular hyperplasia
If 2nd Hyper function :
Renin secreting tumor , Renal artery stenosis . Edematous state , Diuretics
- Clinical Presentation of Hyperaldosteronism ?
Sever hypokalemia , Muscle weakness , parasethia and arrhythmia (ECG changes) , Hypertension, Metabolic alkalosis .
- Causes of Adrenogenital Syndrome ?
Adrenocortical neoplasms
Adrenocortical carcinomas
Adrenocortical adenomas.
- Addison disease Patients present with ?
. Deficiency of aldosterone results in sodium and water loss in urine leads to
. Dehydration and hypotension.& shock
. Deficiency of glucocorticoids leads to hypoglycemia.
. Deficiency of androgens leads to muscular atrophy and weakness
. Loss of hormonal control of the adrenal cortex on the activity of pituitary
. Melanocyte hormone leads to pigmentation in the skin (face, breast axilla and scrotum)
. High ACTH
- Causes of Addison Disease ?
Autoimmune destruction of the adrenal gland (the most common cause)
Other causes include: Infection as: Tuberculosis, Cytomegalovirus, Histoplasmosis , Metastatic carcinoma , Sarcoidosis , Amyloidosis,Drugs as rifampin .
- Classification of adrenal tumors ?
Adrenocortical tumors:
. Adrenocotical adenoma
. Adrenocortical carcinoma
. Mesenchymal tumors: as myelolipoma , Shwannoma
. Secondary tumors
Adrenal medullary tumors :
. Pheochromocytoma
. Neuroblastic tumors as :
Ganglioneuroma , Neuroblastoma
- Microscopic Pic of Pheochromocytoma ?
polygonal to spindle-shaped cells arranged into small nests (Zellbalen) surrounded by a rich vascular network .
The cytoplasm of the neoplastic cells often has a finely granular appearance, because of the presence of granules containing catecholamines that can be highlighted by a silver stain.
- Microscopic pic of Neuroplastoma ?
Composed of small round blue cells aggregate separated by delicate fibrovascular septa ,
Prominent Homer Wright pseudorosette (round spaces surrounded by peripheral nuclei and filled with a faintly esinophilic fibrillay matrix) Haemorrhage and microcalcification may be prominent.
- Microscopic Pic of Ganglioneuroma
Admixture of ganglion cells and Schwann cells , Ganglion cells Eosinophilic cytoplasm with distinct cell borders, single eccentric nucleus, prominent nucleolus , Schwann cells May be arranged in small intersecting fascicles,
