Adrenal gland & paraganglia

Other nonneoplastic

Focal adrenalitis



Last author update: 1 May 2017
Last staff update: 17 November 2022

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PubMed Search: focal adrenalitis

Lan L. Gellert, M.D., Ph.D.
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Cite this page: Gellert LL. Focal adrenalitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/adrenalfocaladrenalitis.html. Accessed June 2nd, 2023.
Definition / general
  • Aggregates of lymphocytes and plasma cells in adrenal gland
  • Usually incidental finding
  • Common in elderly
Epidemiology
Etiology
  • Uncertain, possibly immune mediated
Clinical features
  • Clinically apparent only after more than 90% of the adrenal cortex destroyed
Microscopic (histologic) description
  • Aggregates of lymphocytes and plasma cells, often perivascular, in adrenal cortex and medulla‚Ä®
Microscopic (histologic) images

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Various images

Positive staining - disease
  • Most infiltrating cells are CD3+ T cells, which primarily express CD4; CD8+ T cells are fewer
  • A considerable proportion of CD4+ T cells were considered activated based on interleukin 2 receptor expression (Clin Exp Immunol 1989;77:101)
Differential diagnosis
  • Autoimmune adrenalitis: Inflammation more diffuse, sometimes with follicle formation; often associated with marked cortical atrophy
  • Adrenal tuberculosis: granulomatous inflammation in adrenal gland
  • Viral infection in adrenal gland: CMV, EBV infection, usually in patients with immunodeficiency disorders
  • Xanthogranulomatous adrenalitis: diffuse histiocytic inflammation in adrenal gland, with occasional lipofuscin crystals and focal necrosis (Endocr Pathol 2015;26:229)
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