National Journal of Laboratory Medicine (Feb 2021)
A Histopathological Study on Adrenal Tumours in a Tertiary Care Centre in Chenna
Abstract
Introduction: The lesions of the adrenal gland are quite rarely encountered in surgical pathology. Primary adrenal neoplasms have a varied clinical presentation, being functional or nonfunctional, symptomatic or asymptomatic, or detected as incidentalomas in radiological evaluation. Histomorphological examination aided by Immunohistochemistry (IHC) when needed, constitutes the mainstay in the diagnosis of adrenal neoplasms. Aim: To document and analyse the clinicopathological features of the tumours of adrenal gland encountered in the surgical pathology laboratory of a tertiary care hospital. Materials and Methods: This was a retrospective observational study including the tissue samples of adrenal gland submitted for histopathological evaluation in the Institute of Pathology, Madras Medical College, Chennai, a tertiary referral centre over a period of seven and half years from January 2010 to June 2017. The various neoplastic and non-neoplastic conditions encountered were analysed with reference to age, gender, clinical characteristics (functional status, radiological findings, biochemical investigations), gross and histopathological features including IHC based on the data retrieved from the registers in the surgical pathology section of the institute. Also, Haematoxylin and Eosin stained Formalin Fixed Paraffin Embedded (FFPE) tissue sections of the study sample were reviewed microscopically to study the histopathological features. Results: The study group which included only adults showed that primary adrenal neoplasms were the most frequently encountered lesions with majority of the cases (82%, 60/73 cases) in 20-50 years age group and with a female preponderance (66%, 48/73 cases). Pheochromocytoma, the commonest tumour observed was generally functional (64.7%, 22/34 cases). Weiss system had a score of more than three in all the Adrenal Cortical Carcinomas (ACC) studied. Conclusion: The spectrum of primary adrenal neoplasms studied showed a varied clinical presentation. They were generally unilateral and solitary. Pheochromocytoma, followed by ACC and adenoma were the frequent tumours encountered. Weiss system has an invaluable role in the diagnosis of ACCs. IHC plays a key role in diagnosing metastatic tumours.
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