HISTOPATHOLOGICAL CONSIDERATIONS IN THE DIAGNOSIS OF TUMOURS OF ADRENAL MEDULLA

BACKGROUND Tumours of the adrenal medulla can be heterogeneous in morphology and unpredictable in biological behaviour. Diagnosis of these tumours requires histopathological evaluation along with clinical and radiological correlation. These tumours are categorized into neuroblastoma and pheochromocytoma groups based on specific features. However, in some cases distinguishing malignancy becomes extremely difficult, especially in case of pheochromocytoma. Moreover, differential diagnosis of neuroblastoma and pheochromocytoma from adrenal cortical tumours and metastatic lesions poses many challenges to the pathologist. Careful gross and microscopic examination of these lesions is essential for an accurate diagnosis and immunohistochemistry is crucial for confirmation. AIM This work is taken up to study the incidence of adrenal medullary tumours and analyse the histopathological criteria for diagnosis and the utility of immunohistochemistry in differentiating them from cortical tumours and the metastatic lesions. MATERIAL AND METHODS This is a retrospective study of tumours of adrenal medulla that were reported in the Department of Pathology, Guntur Medical College. Gross examination of postoperative specimens and microscopic features on histological sections are analysed and supplemented by immunohistochemistry. RESULTS The clinical and morphological findings of tumours of adrenal medulla are tabulated and basing on the distinct features histological diagnosis of neuroblastoma and pheochromocytoma is made and confirmed by immunohistochemistry. CONCLUSION This study highlights the importance of thorough histopathological examination in diagnosis of tumours of adrenal medulla and specific criteria in grading neuroblastoma and identifying malignancy in pheochromocytoma and the role of immunohistochemistry in confirmation.