Black adenoma and pigmented nodules of the adrenal cortex. A case report of functioning black adenoma and a study of pigmented nodules in autopsy materials

K. K. Lui, K. Shikata, T. Amano

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Abstract

A 26-yr-old woman had complained of obesity and hypertension, and was found having a moon face, acne, and livid striae in the hypogastrium. Adrenal function tests yielded high urine 17-OHCS and high blood cortisol values, and adrenal venography revealed a round tumor at the left supra-renal region. She underwent an operation for extirpation of the tumor. At the operation, the round tumor measured 1.8 X 2.8 cm, and had a characteristic dark brown color. The adjacent adrenal gland was notably atrophic. Microscopically, the tumor was partly encapsulated by thin fibrous tissue, and consisted mostly of compact cells and partly of clear cells, both being intermingled with rich vascular channels. The compact cells contained abundant intracytoplasmic granules which were stained golden brown with H & E stain, and were positive with PAS, Fontana and Sudan III stains, the staining characteristics being almost the same as of lipofuscins in the myocardium. Electron microscopy revealed the compact cells containing abundant mitochondria, numerous smooth endoplasmic reticulum and electron-dense granules which were partly electronlucent and were surrounded by membraneous whorls. Bilateral adrenal glands from 100 consecutive autopsies, exclusing the perinatal deaths and such cases as with adrenal infiltration by malignant neoplasms, were sectioned at 2 mm intervals and examined grossly for incidence of black-pigmented nodules. Microscopically, 10 cases (10 %) were found having a black-pigmented nodule located at the corticomedullary junction. The nodules consisted of aggregations of compact cells which contained the golden brown intracytoplasmic pigment histochemically similar to that of the black adenoma. Both the black adenoma and the pigmented nodules in this series arose from the zona reticularis and consisted of compact cells, though the latter lacked evidence of neoplasia. We prefer to call them 'nodules' instead of 'adenoma', as Robinson et al. did.

Original languageEnglish
Pages (from-to)583-591
Number of pages9
JournalFukuoka Acta Medica
Volume71
Issue number10
Publication statusPublished - Dec 1 1980
Externally publishedYes

ASJC Scopus subject areas

  • Medicine(all)

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