Adrenal Gland Pathology

A variety of neoplastic and non-neoplastic lesions arise in the adrenal gland, including both cortex and medulla. Congenital anomaly and hyperplasia are rarely encountered in the surgical pathology laboratories. Neoplastic specimens account for the vast majority of adrenal specimens a surgical pathologist signs out. In this chapter, we discuss the diagnostic challenges of common adrenal cortical and medullary lesions as well as rare entities with a focus on pathologic features and differential diagnoses. Salient clinical features associated with these lesions are highlighted. The applications of immunohistochemical, cytogenetic, and molecular tests in the pathologic diagnosis are also discussed. Emphasis is placed on the integration of clinical, imaging, laboratory, and pathological findings to arrive at a correct diagnosis.