title: [Analysis of adrenocortical tumors morphology as regards their structure and potential malignancy].
abstract: BACKGROUND
  A consequence of diagnosis of adrenocortical carcinoma (ACC) is introduction of pharmacological therapy, precise monitoring of the patients and in some cases re-operation. The aim of the study is to analyse morphology of adrenocortical tumours as regards their malignancy by use of criteria proposed by Weiss.
  
  
  METHODS
  110 adrenocortical tumours in 107 patients were analysed (M 27.1%, F 72.9%; age 32 to 77 years, mean 55.2 +/- 9.7). Conn syndrome was diagnosed in 16 patients (14.9%), Cushing syndrome in 12 (11.2%), and virilisation in 3 (2.8%). In 76 patients (71.0%) biochemical tests did not reveal hormonal hyperactivity of the tumour.
  
  
  RESULTS
  In routine histopatological examination ACC was diagnosed in 6 tumours (5.4%), adrenocortical adenoma (ACA) in 92 (83.6%) and adrenocortical hyperplasia in 12 (10.9%). Nuclear grade III or IV was observed in 8 tumours (7.3%), mitotic rate > 5/50 high power fields in 6 (5.4%), atypical mitoses in 5 (4.5%), clear cells constituting < 25% of the tumour in 10 (9.1%), diffuse architecture in 8 (7.3%), necrosis in 16 (14.5%), veins infiltration in 4 (3.6%), sinusoids infiltration in 7 (6.3%), and tumour capsule infiltration in 5 (4.5%). Among ACC tumours 4-9 features of malignancy were present, among ACA--0-3 features. Statistical analysis revealed correlation between number of criteria proposed by Weiss and maximal tumour size (p < 0.05).
  
  
  CONCLUSIONS
  The structure and cell arrangement in adrenocortical adenoma are heterogeneous. Application of criteria proposed by Weiss in histopathological examination of adrenocortical tumours can be useful in differentiating adrenocortical adenoma from carcinoma.
authors.affiliation: Department of Pathology, Medical University of Silesia, Katowice.
authors.forename: Maciej
authors.initials: M
authors.lastname: Kajor
authors.forename: Jacek
authors.initials: J
authors.lastname: Ziaja
authors.forename: Robert
authors.initials: R
authors.lastname: Król
authors.forename: Monika
authors.initials: M
authors.lastname: Ciupińska-Kajor
authors.forename: Zuzanna
authors.initials: Z
authors.lastname: Dobrosz
authors.forename: Marek
authors.initials: M
authors.lastname: Heitzman
authors.forename: Lech
authors.initials: L
authors.lastname: Cierpka
mesh_terms: D000306:Adrenal Cortex Neoplasms / Q000473:pathology / Q000648:ultrastructure*; D018246:Adrenocortical Adenoma / Q000473:pathology / Q000648:ultrastructure*; D018268:Adrenocortical Carcinoma / Q000473:pathology / Q000648:ultrastructure*; D000328:Adult; D000368:Aged; D014408:Biomarkers, Tumor / Q000032:analysis*; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009361:Neoplasm Invasiveness / Q000473:pathology* / Q000648:ultrastructure*; D011379:Prognosis; D012189:Retrospective Studies; D018709:Statistics, Nonparametric
chemical_list: D014408:Biomarkers, Tumor