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Endocrine Sequence - LAB 2
Adrenal: Addison’s disease
The common denominator of Addison's disease is a chronic destructive process of the adrenal cortex. Clinical manifestations occur when about 90% of the cortex has been destroyed.
This slide shows an adrenal gland that is replaced by caseous material. Some residual cortical tissue may be present just underneath the capsule of the gland.
Adrenal: Cortical hyperplasia
Begin by examining the slide with the naked eye (this is a good habit to develop). Note that the adrenal gland appears larger than normal with vague nodularity. The section shows cortical hyperplasia consisting of lipid-rich fasciculata-type cells (cells with clear cytoplasm with many lipid droplets). Occasional lipid-poor reticularis-type cells are also present. Notice that no medullary tissue is identified.
This section contains a cellular neoplasm and may contain normal adrenal cortex at the periphery. The neoplasm consists of cells that resemble the normal adrenal medulla growing in nests separated by prominent blood vessels. See Figure 26-57 in Robbins for an example of this pattern if you cannot appreciate it on the slide.
Pancreas: Pancreatic endocrine neoplasm (islet cell tumor)
This section of pancreas contains an epithelial neoplasm. Compare the appearance of the neoplastic cells with those of the adjacent normal islets, if present. This is a classic pancreatic endocrine neoplasm in which the cells grow in islands and trabeculae. Notice the prominent vessels. The cells contain round nuclei with small nucleoli and abundant granular cytoplasm.
This slide contains two separate sections of pancreas, one from a patient with insulin-dependent diabetes mellitus (type I) and the other from a patient with non-insulin dependent diabetes mellitus (type II). Carefully examine the islets from the two sections looking for lymphocytic infiltrates (insulitis) and amyloid deposition.
The answers to the path lab questions will be posted approximately 48-72 hours after the lab sessions. These are abbreviated answers, not a full discussion of the topics. You can find them in the M2 CTools site resources. In the folder for each sequence the will be a folder called 'Path Lab Resources'