J Pathol Transl Med.  2024 Jul;58(4):201-204. 10.4132/jptm.2024.06.07.

What’s new in adrenal gland pathology: WHO 5th edition for adrenal cortex

• Rizkalla CN
• Tretiakova M

• KMID: 2557761
• DOI: http://doi.org/10.4132/jptm.2024.06.07

Abstract

The 5th edition of WHO Classification of Endocrine and Neuroendocrine Tumors (2022) introduced many significant changes relevant to endocrine daily practice. In this newsletter, we summarize the notable changes to the adrenal cortex based on the 5th edition of the WHO classification [1].

Figure

• 

  Fig. 1. Adrenal ectopia: benign adrenocortical tissue within the spermatic cord.

• 

  Fig. 2. Adrenal pseudocyst: adrenal cyst without a discrete lining.

• 

  Fig. 3. Adrenal vascular cyst: adrenal cyst with lymphangitic endothelial lining (D2-40 positive).

• 

  Fig. 4. Myelolipoma coexisting with adrenal cortical carcinoma (oncocytic variant).

• 

  Fig. 5. Bilateral macronodular (>10 mm) adrenocortical disease: representative gross sections.

• 

  Fig. 6. Functional aldosterone-producing adrenal cortical adenoma with predominantly vacuolated cells and scattered pleomorphism.

• 

  Fig. 7. Adrenal cortical carcinoma (myxoid variant) with lymphovascular invasion.

• 

  Fig. 8. A: Adrenal cortical carcinoma with tumor necrosis (right of image). B: Adrenal cortical carcinoma with a disrupted reticulin framework.

• 

  Fig. 9. Adrenal cortical carcinoma with high mitotic activity (2 mitoses in a 60× HPF).

Reference

References

1. Mete O, Erickson LA, Juhlin CC, et al. Overview of the 2022 WHO classification of adrenal cortical tumors. Endocr Pathol. 2022; 33:155–96.