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Anatomic pathology > Adrenal > Flashcards

Flashcards in Adrenal Deck (131)
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90

Neuroblastoma: Histologic architecture.

Cells are arranged in vague lobules and may form Homer Wright rosettes (filled with pink fibrillary matter).

91

Pheochromocytoma: Prognosis.

Five-year survival rate

− Benign: 95%.
− Malignant: 44%.

92

Neuroblastoma: Subtypes.

Undifferentiated.

Undifferentiated and pleomorphic.

Poorly differentiated.

Differentiating.

93

Neuroblastoma: Undifferentiated (2).

Neuroblasts show no differentiation toward ganglion cells.

No neuropil.

94

Neuroblastoma: Undifferentiated and pleomorphic.

Same as undifferentiated neuroblastoma, except that neuroblasts are larger and more pleomorphic and have more cytoplasm.

95

Neuroblastoma: Poorly differentiated.

Fewer than 5% of neuroblasts show differentiation toward ganglion cells.

96

Neuroblastoma: Differentiating.

More than 5% of neuroblasts show differentiation toward ganglion cells.

97

Mitosis-karyorrhexis index: Number of cells to be counted.

5000.

98

Mitosis-karyorrhexis index: Ranges.

Low: Less than 2%.

Intermediate: 2-4%.

High: More than 4%.

99

Neuroblastoma: Mutation that confers poor outcome.

Amplification of MYCN (more than 10 copies).

100

Prognosis of neuroblastoma: Patient over 5 years of age.

Any neuroblastoma is considered to have unfavorable histology.

101

Prognosis of neuroblastoma: Patient between 18 months and 5 years of age, inclusive (3).

Undifferentiated or poorly differentiated: Unfavorable histology.

Differentiating: Favorable as long as the MKI is low (i.e. not intermediate or high).

102

Prognosis of neuroblastoma: Patient under 18 months of age (3).

Undifferentiated: Unfavorable histology.

Poorly differentiated or differentiating: Favorable as long as the MKI is low or intermediate.

Any tumor with a high MKI: Unfavorable.

103

Prognosis of neuroblastoma: DNA index.

A. Use.
B. Interpretation.

A. Used in patients under 1 year of age.

B. Hyperdiploidy or near-triploidy is better than near-diploidy or near-tetraploidy.

104

Prognosis of neuroblastoma: Expression of TRK.

TRK A, B, and C: Low or absent expression imparts poorer prognosis.

105

Neuroblastoma: Extracellular components (2).

Fibrillar matrix resembling neuropil.

Delicate fibrovascular septa separating the lobules.

106

Neuroblastoma: Definition of stage 4S.

Small, localized primary tumor with metastases to liver, skin, or bone marrow that nearly always spontaneously regress.

107

Neuroblastoma: Immunohistochemistry of tumor cells (5,2).

Positive: NSE, synaptophysin, chromogranin, neurofilament, Neu-N.

Negative: Cytokeratins and other non-neural markers.

108

Neuroblastoma: Associated hereditary syndromes (4).

Hirschsprung's disease.

Congenital central hypoventilation.

Neurofibromatosis-1.

109

Neuroblastoma: Electron microscopy (3).

Cytoplasmic filaments.

Dense-core granules.

Microtubules.

110

Primary melanoma of the adrenal gland: Criteria (4).

Unilateral.

No previous melanoma.

No endocrine disorder.

No doubt about histology.

111

Primary melanoma of the adrenal gland: Gross pathology.

Often locally advanced at presentation, with renal adhesions.

112

Primary melanoma of the adrenal gland: Prognosis.

Death within 2 years.

113

Primary melanoma of the adrenal gland vs. pigmented adrenal cortical adenoma: Immunohistochemistry (3).

Both are positive for Melan-A.

Adenoma is negative for S100, HMB-45.

114

Primary melanoma of the adrenal gland vs. pheochromocytoma: Immunohistochemistry.

Both are positive for HMB-45.

The sustentacular cells of pheochromocytoma are positive for S-100.

115

Myelolipoma: Age group.

Middle-aged.

116

Myelolipoma: Presentation (2).

Usually asymptomatic.

Rarely causes Cushing's syndrome or Conn's syndrome.

117

Myelolipoma:

A. Gross pathology.
B. Histopathology.

A. Red and yellow cut surface.

B. Mature bone marrow and mature fat.

118

Myelolipoma: Variant.

Adenolipoma combines myelolipoma and adrenal cortical adenoma.

119

Myelolipoma: Extraadrenal sites (3).

Liver.

Retroperitoneum.

Stomach.