Fat Chief cells Normal parathyroid Oxyphil cells

Parathyroid adenoma capsule Normal parathyroid Incidental cyst (not important) Tumor behavior is much more important than morphology The neoplasm

Parathyroid carcinoma Tumor invasion in the capsule

Parathyroid hyperplasia Same as normal tissue but expanded …and somehow, adipose tissue is diminished

Normal pancreas Islet of Langerhans Exocrine pancreas (acini with zymogenic color of the cells)

Inflamed islet Insulitis DM type 1 Lymphocytes

Amyloid Advanced stage of DM2 Islet of Langerhans

Islet cell tumor Islet Trabeculae of tumor cells …they can grow in many patterns …here: trabecular pattern Islet cell tumor (= pancreatic neuroendocrine tumor) Normal pancreas Islet May be benign May be malignant The tumor behavior is the most important

Islet cell tumor also a trabecular pattern is seen here …resembling trabecular bone This is a neuroendocrine tumor (like carcinoid) So when you look at the nuclei:

Normal adrenal gland Cortex Medulla Cells with Zona reticularis Zona fasciculata Zona glomerulosa Cells with good amount of basophilic cytoplasm (chromaffin cells)

Atrophic adrenals e.g., exogenous steroids (low ACTH) or Addison Golden cortex Normal adrenals Dark medulla Hypertrophic glands e.g., ACTH oversecretion

Neuroblastoma Neuroblastoma that have grown to the degree of displacing the liver to the left Liver

An adrenal medullary tumor …mainly in children

*It is a small round blue cell tumor *High mitotic and apoptotic activity and necrosis mitoses

Adrenocortical adenoma A well-circumscribed adrenocortical tumor

Adrenocortical adenoma Resembling adrenocortical cells

Adrenocortical carcinoma Discovered at an advanced stage because the retroperitoneal space permits this degree of enlargement

Pheochromocytoma An adrenal medullary tumor After staining with dichromate...due to the oxidation of catecholamines

Pheochromocytoma Cortex Part of pheochromocytoma tumor May be benign May be malignant The most important is behavior Part of pheochromocytoma tumor …the cells have good amount of basophilic cytoplasm Cortex

Pheochromocytoma Capillary network Nests of polygonal to spindle-shaped chromaffin cells (zellballen pattern) that are supplied by a rich vascular network Pheochromocytoma

Pheochromocytoma Nest Nest Nest Capillary network This nested pattern is called: Zellballen pattern Nest Nest Sustentacular cells

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