Along with hypertension,
hemorrhage and necrosis is the story of this tumor. Understanding that
will help aid with knowing why we see episodic swings in blood pressure in
patients with this condition. Parts of the tumor die and and suddenly
release a large amount of epinephrine; up goes the blood pressure.
It will be tough to find much viable tumor in this specimen, but it's there.
This is a hard slide
to understand. There is a lot of necrosis, so don't bother with the central
portion of the tissue. Also, I am not so sure there is much in the line of
normal adrenal gland to get your "bearings" from. The necrosis is the hallmark
of this lesion. Look around the edges for viable tumor cells. They will be
large and have bizarre nuclear features. There will be lots of pigment, representing
old hemorrhage with hemosiderin deposits. Read about this lesion before trying
to tackle the slide.
