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Adrenal tumors.

Adenomas of the adrenal cortex. Classify depending on hormonal activity and cytogenesis (Table 35.3).

Aldosteroma. It develops from the glomerular cells, produces minerolocorticoids, is clinically characterized by development

Table 35.3 Clinical and morphological features of adrenal adenomas



Adenoma name Source of growth Clinical characteristic
Aldosteroma Glomerular bark zone Conn syndrome
Corticosteroma Bunch of bark Cushing's syndrome
Androsteroma Mesh area of ​​the cortex Men: premature puberty, mild symptoms; Women: —complicated germaphroditism —vilism
Incidentaloma Any area of ​​the cortex More often asymptomatic
Conn syndrome (arterial hypertension; neuromuscular changes - muscle weakness, paresthesia, convulsions; nephropathy - polyriemia, polydipsia, etc.).

Corticosteroma develops from the cells of the beam zone, producing glucocordicoids. Clinically manifested by Cushing's syndrome with a pronounced violation of fat metabolism.

Androsteroma comes from the reticular zone, secretes androgens (testosterone). Clinically manifested:

1) in men:

a) before puberty - premature puberty, macrogenitomy; short stature;

b) in the postpuberte - the symptoms are hardly noticeable (increased libido, hypertrichosis, etc.);

2) in women:

a) before puberty - heterosexual sexual development (false female hermaphroditism);

b) in postpuberty - virilism.

Hormone-inactive adenoma of the upper arm (incidental).

It develops from different layers of the cortex, does not synthesize physiologically active hormones.

Regardless of the production of hormones, adrenal cortex adenomas may have a different histological structure.
In light-cell adenoma, the tumor is constructed from cells with light (rich in lipids) cytoplasm, forming alveolar structures. In case of dark-cell adenoma, the tumor is formed by cords and trabeculae from cells with homogeneous eosinophilic, dense cytoplasm.

Cancer of the adrenal cortex. Usually larger than adenomas, has no clear boundaries, secondary changes are expressed (foci of necrosis, hemorrhages, etc.) Microscopically characterized in varying degrees by pronounced cellular atypism and infiltrating growth. Metastasize rarely. Clinically or hormonally inactive, or plurihormonal. For example, adrenal carcinoma tissue produces glucocorticoids and androgens. In this case, there is a combination of Cushing and hyperandrogenism syndromes.

The adrenal hromaffinoma develops from medulla cells, producing catecholamines. A tumor may be benign (pheochromocytoma) or malignant (pheochromoblastoma). Histologically, pheochromocytoma is usually represented by process cells of different sizes with dark cytoplasm. The electron diffraction pattern shows the presence of characteristic catecholamine granules in the tumor cells - with an electron-dense core and a light rim. Cellular polymorphism and infiltrating growth are indicative of the malignant nature of tumor growth.

The main clinical manifestation of chromaffinoma is symptomatic arterial hypertension.

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Adrenal tumors.

  1. DIAGNOSTIC AND TREATMENT OF THE ADAPTER TUMORS
    DIAGNOSTICS AND TREATMENT OF TUMORS
  2. TUMOR GROWTH. PROGRESSION OF TUMORS. MORPHOGENESIS OF TUMORS. INVASION AND METASTASIS OF MALIGNANT TUMORS. BIOMOLECULAR MARKERS OF TUMORS. ANTI-TUMOR IMMUNITY. PARANOPLASTIC SYNDROM. BASIC PRINCIPLES OF CLASSIFICATION OF TUMORS. MORPHOLOGICAL FEATURES OF TUMORS FROM EPITHELIUM AND TUMORS FROM TISSUES - DERIVATIVE MESENCHYMS
    TUMOR GROWTH. PROGRESSION OF TUMORS. MORPHOGENESIS OF TUMORS. INVASION AND METASTASIS OF MALIGNANT TUMORS. BIOMOLECULAR MARKERS OF TUMORS. ANTI-TUMOR IMMUNITY. PARANOPLASTIC SYNDROM. BASIC PRINCIPLES OF CLASSIFICATION OF TUMORS. MORPHOLOGICAL CHARACTERISTICS OF TUMORS FROM EPITHELIUM AND TUMORS FROM TISSUES - DERIVATIVES
  3. MESENCHYMAL TUMORS. TUMORS MELANE-FORMING I TISSUE. TUMORS OF THE CENTRAL NERVOUS SYSTEM, BRAIN SHELL AND PERIPHERAL NERVES
    MESENCHYMAL TUMORS. TUMORS MELANE-FORMING I TISSUE. TUMOR CENTRAL NERVOUS SYSTEM, BRAIN SHELL AND PERIPHERAL
  4. Adrenal pathology
    Adrenal pathology is very diverse, but pheochromocytoma and Addison's disease are more common. Pheochromocytoma - a tumor of the medulla, leads to an increase in blood pressure (adrenaline and norepinephrine), patients die from bleeding in the brain. Addison's disease is caused by the hypofunction of the adrenal cortex, more often with its tuberculous lesion, less often with amyloidosis, cancer metastases,
  5. Hyperfunction of the cortex of the adrenal glands
    Hyperfunction of the adrenal cortex is a disease that occurs rarely in cats. It is caused by increased synthesis of the hormone cortisone, which leads to metabolic disorders and various pathological processes. The cause may be a tumor of the adrenal glands or pituitary gland. Symptoms: hair loss, swelling, possible liver failure. Treatment usually
  6. Adrenal glands
    The adrenal glands are a paired organ and are located extraperitoneally at the upper poles of the kidney. Their weight is 4 g regardless of gender and body weight. The uniqueness of the blood supply to the adrenal glands is that each gland is supplied with the blood of three arteries - branches of the diaphragmatic artery with isolated veins one on each side (the right flows into the inferior hollow, the left into the renal). Cortical
  7. Adrenal glands
    As already mentioned, the adrenal glands in newborns are relatively larger than in adults. The adrenal medulla of the newborn is very poorly developed and is almost indistinguishable in macroscopic examination. The cortex consists of two layers - the inner one, the darker one, and the outer one, the lighter one. The adrenal medulla is formed from the inner layer over time (A. F.
  8. ADRENAL
    The adrenal gland (glandula suprarenalis) is a paired organ located in the retroperitoneal space directly above the upper end of the corresponding kidney. Its mass is 12–13 g, length 40–60 mm, width 2–8 mm. The adrenal gland has the form of a cone compressed from front to back, in which there are distinguished anterior, posterior and lower (renal) surfaces. Adrenal glands are located at the level of the XI — XII infants
  9. Tumors: definition, nomenclature, classification. Tumor growth and molecular basis of carcinogenesis. Tumors from the epithelium.
    1. The main theories of tumor growth 1. inflammatory 2. dystogenetic 3. viral-genetic 4. chemical carcinogens 5. physical carcinogens 2. Activation mechanisms of cellular oncogenes 1. alteration 2. regeneration 3. proliferation 4. amplification 5. point mutation 3. Stages chemical carcinogenesis 1. promotion 2. initiation 3. alteration 4. proliferation 5. tumor progression 4.
  10. Adrenal Diseases and Pregnancy
    Physiology of the adrenal glands The adrenal glands are paired organs of internal secretion, located above the upper poles of the kidneys at the level of the vertebrae from ThXI to L [. Have the appearance of vertically standing flat plates in the form of a pyramid or triangle. The average mass of both adrenal glands is 10–12 g. The dimensions are on average 4.5 x 2-3 cm, thickness 0.6–1 cm. The left adrenal gland is larger than the right. Rudiments
  11. Adrenal insufficiency
    1. Give a definition of adrenal insufficiency. Adrenal cortex insufficiency, or Addison's disease, is characterized by reduced production of glucocorticoids and mineralocorticoids by the adrenal glands. The cause of the disease is a pathological process that directly affects the adrenal glands (primary hypoadrenocorticism) or the formation and secretion
  12. Adrenal glands
    Physiology The adrenal glands secrete the cortex and medulla. The adrenal cortex is the source of three types of hormones: androgens, mineral-corticoids (for example, aldosterone) and glucocorticoids (for example, cortisol). In the medulla of the adrenal glands, catecholamines are produced (adrenaline, norepinephrine, dopamine). Adrenal androgens are not essential for anesthesia and
  13. ADAPTERS
    The adrenal glands are located in the form of oval or bean-shaped cells medially and somewhat cranial to the kidneys. They develop from two primordia. The adrenal cortex arises from the epithelium of the splanchnomotomes of the mesoderm near the mesentery root, that is, from the same material as the sex glands and kidneys. The brain substance is formed from the material from which the sympathetic develops.
  14. Anesthesia for adrenal surgery
    Anesthetic management during interventions on the adrenal glands is classified as rather complicated. This is due not only to the fact that the adrenal glands produce hormones important for the course of many processes (gluco - and mineralocorticoids, catecholamines). Adrenal hormones have a significant impact on the state of the main vital functions and, above all, on the blood circulation, are involved in
  15. Adrenal glands
    The adrenal cortex produces more than 60 biologically active substances and tissue hormones of a steroid nature, which by their effect on metabolic processes are divided into glucocorticoids (cortisone, cortisol), mineralocorticoids (aldosterone, 11 - deoxycorticosterone), sex hormones - androgens (17-ketosteroids) and testosterone) and trace concentrations of female sex hormones -
  16. Mesenchymal tumors. Tumors of melano-forming tissue
    Mesenchymal tumors are tumors that develop from mesenchymal derivatives - connective, vascular, muscle, fat, bone, cartilage tissue, synovial membranes, fasciae, tendons, aponeuroses. Among the benign mesenchymal tumors, there are: 1) fibrous tissue tumors — fibroma and dermatofibroma (histiocytoma); 2) adipose tissue tumors - lipoma, intramuscular
  17. Adrenal glands (problems)
    Physical blocking The adrenal glands are the paired endocrine glands, as the name implies, located above the kidneys. They perform several functions: if necessary, they release adrenaline, which activates the brain, accelerates heart rate and mobilizes sugar from the reserve, when the body needs additional energy. They secrete cortisone - a hormone that plays
  18. Hyperfunction of the adrenal medulla
    The function of the medulla is enhanced, as a rule, in extreme situations, by the action of nociceptive (from Lat. Possege - to harm) stimuli, when the sympathetic-adrenal system is activated. Sometimes, the basis of the hyperfunction of the adrenal medulla is the formation of a tumor from the cells of the medulla of the adrenal gland or extraadrenal chromaffin tissue - chromaffinoma. It happens more often
  19. Congenital adrenal hypoplasia
    Etiology The hereditary form associated with the X chromosome and caused by defects in the NR0B1 gene encoding a DAX1 transcription factor is most common. Pathogenesis DAX1 factor is necessary for laying the adrenal cortex and testicles, is involved in the regulation of the hypothalamogonadotrophic function. Clinical picture With a defect of factor DAX1 in boys, adrenal insufficiency occurs, clinically
  20. Diseases of the adrenal medulla
    The adrenal medulla consists of specialized nerve cells (neuroendocrine). It serves as the main source of catecholamines - epinephrine, norepinephrine, dopamine. Neurosecretory cells have a round or oval shape, developed cytoplasmic membrane and cytoplasm, containing catecholamine vesicles surrounded by a membrane. These cells are in well vascularized
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