Adrenal gland and paraganglia
Other benign cortical lesions
Ovarian thecal metaplasia

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

Revised: 15 January 2016, last major update February 2005

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

Definition / General
  • Also called stromal spindle nodules
  • Present in 5% of women (usually postmenopausal) undergoing adrenalectomy for metastatic breast carcinoma; rare in men
  • May be due to metaplasia from adrenal capsule mesenchymal cells due to unopposed pituitary gonadotropin during menopause
  • Usually no clinical significance
Case Reports
Gross Description
  • Multiple bilateral nodules in adrenal cortex, grossly visible (up to 2 cm) or microscopic
Micro Description
  • Proliferation of spindle cells in capsule, surrounding small nests of cortical cells
Micro Images

Fig 1: pancreatic ductuloinsular complexes;
2A: somatostatin+; 2B: pancreatic polypeptide+;
3: adrenal gland with nodules composed of nests of oval/spindle cells with bland nuclei, surrounded by eosinophilic hyalinized stroma; inset-cells are progesterone receptor+;
4: adrenal gland lesion has individual cells surrounded by reticulin fibers; arrows-reticulin surrounds nests, not individual cells, of entrapped normal cortical cells