1. Fat
Chief cells
Normal parathyroid
Oxyphil cells

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

3. Parathyroid carcinoma
Tumor invasion in the capsule

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

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

6. Inflamed islet
Insulitis
DM type 1
Lymphocytes

7. Amyloid
Advanced stage
of DM2
Islet of Langerhans

8. 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

9. 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:

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

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

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

13. An adrenal medullary tumor
…mainly in children

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

15. Adrenocortical adenoma
A well-circumscribed adrenocortical tumor

16. Adrenocortical adenoma
Resembling
adrenocortical
cells

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

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

19. 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

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

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

22. Thank You