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Department of Pathology and Laboratory Medicine

Department of Pathology and Laboratory Medicine

Residency Program - Case of the Month

December 2011 - Presented by Meighan Tomic, M.D.

Clinical history:

The patient is a 64 year old female, with a past medical history significant for chronic obstructive pulmonary disease, diabetes mellitus, and hypertension, who was found to have a right adrenal mass on chest CT (during work-up for pneumonia). Follow up abdominal CT showed a well circumscribed, 6.6 x 7.2 x 7.5 cm, mass with areas of high tissue density, fat density and multiple dystrophic calcifications. She subsequently underwent a right adrenalectomy.

 

Abdominal MRI:

Abdominal MRI (Click to enlarge)

 

Gross description:

Received fresh was a 152 gram adrenal gland (10.3 x 6.8 x 5.2 cm) with scant attached fat. The yellow-orange surface was partially disrupted. Cut surfaces varied in appearance with solid, golden-orange areas and cystic areas (0.3 - 2.0 cm). The cysts were filled with gelatinous gray to hemorrhagic material. No definitive residual normal adrenal gland was identified.

 

Gross images:

Gross image 1 (Click to enlarge) Gross image 2 (Click to enlarge)

 

Microscopic photographs:

Microscopic image 1 (Click to enlarge) Microscopic image 2 (Click to enlarge)

 

ANSWER