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PATOHISTOLOŠKA TIPIZACIJA I ANALIZA RAZLIČITIH LEZIJA NADBUBREŽNE ŽLEZDE NAKON TOTALNE ADRENEKTOMIJE /

PATHOHISTOLOGICAL TYPING AND ANALYSIS OF DIFFERENT LESION OF THE ADRENAL GLAND AFTER TOTAL ADRENALECTOMY

Authors

 

Sandra Trivunić Dajko1,2, Dunja Popović2, Željka Vrekić2, Milena Vasilijević1,2, Matilda Đolai2,3

1Katedra za patologiju, Medicinski fakultet, Univerzitet u Novom Sadu
2Centar za patologiju i histologiju, Klinički centar Vojvodine, Novi Sad, Srbija
3Katedra za histologiju i embriologiju, Medicinski fakultet, Univerzitet u Novom Sadu

 

UDK: 616.452-07


The paper was received / Rad primljen: 01.09.2020.

Accepted / Rad prihvaćen: 14.09.2020.

 


Correspondence to:


prof. dr Sandra Trivunić Dajko,
Centar za patologiju i histologiju,
Klinički centar Vojvodine
Hajduk Veljkova 1-3,
21 000 Novi Sad, Srbija
e-mail: sandra.trivunic-dajko@mf.uns.ac.rs

 

 

Abstract

 

Uvod: Nadbubrežna žlezda je ishodište različitih patoloških procesa, a definitivna dijagnoza lezije je moguća samo patohistološkom analizom. Morfološkom analizom materijala nakon totalne adrenektomije patolog najčešće postavlja dijagnozu adrenokortikalnog adenoma. Cilj: patohistološka tipizacija i analiza zastupljenosti različitih lezija nakon totalne adrenektomije. Materijal i metode: Studija je obuhvatila 170 nadbubrežnih žlezda, koje su totalno uklonjene laparoskopski ili otvorenim hirurškim pristupom i nakon toga patohistološki analizirane u Centru za patologiju i histologiju Kliničkog centra Vojvodine. Rezultati: Najveći broj slučajeva činili su tumori (82,36%), a netumorske lezije su imale značajno manju zastupljenost (16,48%), među kojima je hiperplazija najučestalija netumorska dijagnoza (8,82%). Od neoplazija najmnogobrojni su bili adrenokortikalni adenomi (37,65%) sa vrednostima Weissa 0-2, mahom kod ženskih ispitanika. Čak 10% tumora korteksa  klasifikovano je kao adrenokortikalni tumor, neoplazma nejasnog biološkog ponašanja, sa vrednostima Weiss skora 0-6. Feohromocitomi su bili najčešći tumor medule (13,53%) sa vrednostima PASS skora 0-3 kod 86,95% ispitanika. Metastatski tumori  su dijagnostikovani kod 12,35% pacijenata. Zaključak: najčešća patohistološka lezija nakon adrenektomije su adrenokortikalni adenomi. Kod izvesnog broja adrenokortikalnih tumora neophodna je upotreba “Weiss scoring” sistema u cilju predikcije biološkog ponašanja i smernica kliničaru za dalji tretman pacijenta, jer se ne može izvršiti precizna patohistološka tipizacija samo na osnovu morfologije tumora. Feohromocitom je najčešći medularni tumor sa vrednostima PASS skora koji bi ukazivali na benigno biološko ponašanje. Od netumorskih lezija najzastupljenije nakon totalne adrenektomije su hiperplazije.

 

 

 

Key words:

Nadbubreg, adenom, feohromocitom, Weiss skor, PASS skor

 

 

Sažetak

 

Introduction: Various pathological conditions originate from adrenal gland, so the definite diagnosis of the lesion is possible only by pathohistological analysis. By analyzing the morphological features of the material obtained after total adrenalectomy, the pathologist often gives the diagnose of adrenocortical adenoma. Aim: Pathohistological typing and analysis of the incidence of different adrenal lesions after total adrenalectomy. Material and Methods: This study included 170 cases of adrenal glands removed by laparoscopic approach or open surgical procedure. The material obtained after the surgical resection was analyzed in the Center for Pathology and Histology, Clinical Center of Vojvodina. Results: The majority of cases were tumors (82.36%). Non-tumor lesions had lower incidence (16.48%), with hyperplasia being the most common non-tumor diagnosis (8.82%). Among neoplasia, adrenocortical adenomas were diagnosed most often (37.65%) with the Weiss score values 0-2, mostly in women. Ten percent of cortical tumors were classified as adrenocortical tumor of unclear biological behavior, with the Weiss score values 0-6. Pheochromocytoma was the most frequent tumor of the adrenal medulla (13.53%), with the PASS score values 0-3 in 86.95% of patients. Metastatic tumors were diagnosed in 12.35% of all cases. Conclusion: The most frequent lesion diagnosed after total adrenalectomy is adrenocortical adenoma. In certain number of cases, the use of Weiss scoring system is necessary in predicting biological behavior of adrenocortical tumors and important for the further treatment of patients, as morphological features of tumors are not sufficient. Pheochromocytoma is the most common medullary tumor with the PASS score values indicative of benign biological behavior. Hyperplasia is the diagnosis most commonly given in the group of non-tumor lesions after total adrenalectomy.

 

 

Ključne reči:

Adrenal, adenoma, pheochromocytoma, Weiss score, PASS score

 

 

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PDF Trivunić Dajko S. et al • MD-Medical Data 2020;12(3):123-127

 

 

 

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