Open AccessMultiple pigmented adrenal cortical nodules associated with cushing's syndrome
Author(s) -
Kawai Kioko,
Shigematsu Kazuto,
Matsuo Kenji,
Tsuchiyama Hideo,
Saito Yasushi
Publication year - 1984
Publication title -
acta patholigica japonica
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.73
H-Index - 74
ISSN - 0001-6632
DOI - 10.1111/j.1440-1827.1984.tb07611.x
Subject(s) - lipofuscin , endoplasmic reticulum , adrenal cortex , ultrastructure , adrenocorticotropic hormone , pathology , lipid droplet , mitochondrion , cushing syndrome , hyperplasia , biology , adenoma , endocrinology , medicine , hormone , microbiology and biotechnology
Multiple pigmented adrenocortical nodules were found in a 25−year‐old woman associated with Cushing's syndrome, whose laboratory data indicated that the adrenal cortex had been functioning autonomously and adrenocorticotropic hormone (ACTH) from the pituitary gland as suppressed. The surgically removed left adrenal gland disclosed multiple black nodules measuring up to 3 mm in diameter and histologically consisting of large “compact cells” which contained numerous yellow‐brown pigments, but adjacent cortical cells were not atrophied. This kind of adrenal lesion is generally regarded as nodular hyperplasia of the cortex. The present case revealed scanty lipid and markedly increased activity of 3β‐hydroxysteroid dehydrogenase (3β‐HSD) and glucose−6−phosphate‐dehydrogenase (G6PD). Ultrastructural study showed abundant cytoplasm with a large number of mitochondria, well‐developed smooth‐surfaced endoplasmic reticulum (SER), less rough‐surfaced endoplasmic reticulum (RER), lysosomes, and numerous granules in cells of the nodules. Mitochondria varied in size and shape up to occasional giant mitochondria. SER was vesicular or tubular forming a network of anastomosing tubules. Granules varied greatly in size from 400 mm̈ to 6 m̈ in diameter, with diverse electron densities, mostly exhibiting the structural features of lipofuscin. The ultrastructural features resembled those in black adenoma associated with Cushing's syndrome ever reported. Concentration of cortisol was increased in the tissue where numerous black nodules were contained. Acta pathol. jpn. 34: 827 ∼ 837, 1984.