Korean J Pathol.  2011 Jun;45(3):306-310. 10.4132/KoreanJPathol.2011.45.3.306.

Composite Pheochromocytoma or Paraganglioma of Adrenal Gland: A Case Report with Immunohistochemical Studies and Electron Microscopic Examination

• Chang H
• Jeong H
• Kim Y
• Park SH
• Kim A

• KMID: 1443738
• DOI: http://doi.org/10.4132/KoreanJPathol.2011.45.3.306

Abstract

Composite pheochromocytoma or paraganglioma of the adrenal gland is a well-recognized, yet extremely rare tumor with only one case reported in Korea. We report a case of incidentally found composite pheochromocytoma and ganglioneuroma of the adrenal gland in a 44-year-old female composed of intermingled components of pheochromocytom, ganglioneuroma, and cells with intermediate features. On immunohistochemical staining, the pheochromocytoma component was positive for synaptophysin and chromogranin, but negative for S-100 protein. Staining for the S-100 protein revealed sustentacular cells which formed a peripheral coat around the "Zellballen" and Schwann cells. The Fontana-Masson stain defined neuromelanin granules of ganglion cells and the ganglion cells expressed neural markers such as neurofilament proteins. Ultrastructural findings revealed pheochromocytes with a round or ovoid nucleus and occasionally prominent nucleolus containing numerous adrenaline and noradrenaline granules.

Keyword

Composite pheochromocytoma and ganglioneuroma, Pheochromocytoma; Paraganglioma; Adrenal glands

MeSH Terms

Adrenal Glands
Adult
Electrons
Epinephrine
Female
Ganglion Cysts
Ganglioneuroma
Humans
Korea
Melanins
Neurofilament Proteins
Norepinephrine
Paraganglioma
Pheochromocytoma
S100 Proteins
Schwann Cells
Silver Nitrate
Synaptophysin
Epinephrine
Melanins
Neurofilament Proteins
Norepinephrine
S100 Proteins
Silver Nitrate
Synaptophysin