Adrenal gland and paraganglia
Other benign cortical lesions
Adenomatoid tumor of adrenal gland

Author: Nat Pernick, M.D. (see Authors page)

Revised: 15 January 2016, last major update February 2005

Copyright: (c) 2002-2016,, Inc.

Definition / General
Case Reports
Gross Description
  • 1-4 cm, originates within adrenal gland, well-circumscribed, white-tan-gray and may have cystic structures
Micro Description
  • Adenoid, angiomatoid, cystic and solid patterns of anastomosing glands and tubules of variable size lined by epithelioid and flattened cells
  • Cells have low nuclear / cytoplasmic ratio, no mitotic activity
  • Involves adrenal cortex, often medulla and often extends into adjacent adipose tissue with signet-ring like cells
Micro Images

    Fig A: CT shows small adrenal gland mass;
    Fig B: tumor composed of variably sized cystic spaces, focally infiltrative into adrenal tissue;
    Fig C: calretinin+;
    Fig D: EM shows numerous long, bushy microvilli on luminal surfaces, desmosomes (arrows) and cytoplasmic fibrillar networks
    Positive Stains
    • Calretinin, AE1 / AE3, CAM 5.2, CK7, vimentin and CK5/6 (weak)
    Negative Stains
    • CK20, CD15, CD31, CD34, MOC31, CEA and MIB1 (low activity)
      Molecular / Cytogenetics Description
      • Diploid or tetraploid
        Electron Microscopy Description
        • Well-formed desmosomes, extensively developed microvilli
          Differential Diagnosis