Adrenal gland & paraganglia

Adrenal hyperfunction / hyperplasia

Macronodular hyperplasia

Topic Completed: 1 February 2013

Minor changes: 4 June 2019

Copyright: 2003-2019,, Inc.

PubMed Search: Macronodular hyperplasia

Nat Pernick, M.D.
Page views in 2020: 909
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Cite this page: Pernick N. Macronodular hyperplasia. website. Accessed December 3rd, 2021.
Definition / 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
  • 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
Microscopic (histologic) 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
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