Adrenal gland and paraganglia
Adrenal hyperfunction / hyperplasia
Macronodular hyperplasia

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

Revised: 14 January 2016, last major update February 2013

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PubMed Search: Macronodular hyperplasia
General
  • Large (0.5 cm or more), bilateral nodules of histologically unremarkable adrenocortical tissue in adrenal cortex or protruding into adjacent adipose tissue
  • Rare (< 100 cases reported)
  • Mean age 45-55 years
  • Laboratory: elevated plasma cortisol not suppressed by dexamethasone, low serum ACTH
Treatment
  • Bilateral adrenalectomy, does not appear to recur
Gross Description
  • Enlarged adrenal glands, up to 200 g
  • May be “massive”
  • Nodules from 0.2 to 4.0 cm, yellow-tan and not encapsulated
Micro Description
  • Nodules composed of clear and compact cells with variable lipid
  • Variable myelolipomatous change, osseous metaplasia or atrophic cortex between nodules
  • No / rare mitotic figures or atypia