Clinicopathologic characteristics and reticular fiber staining of adrenocortical carcinoma / 临床与实验病理学杂志

ABSTRACT

Purpose To analyse the clinicopathologic characteristics and reticular fiber staining of adrenocortical carcinoma (ACC).Methods The clinical,imaging,pathological data and reticular fiber staining of 20 cases with adrenocortical adenoma (ACA) and 16 cases with ACC were analyzed retrospectively.Results The median course of disease and maximum diameter of ACA were 21 months and 2.6 cm respectively,but ACC were 5 months and 9.5 cm respectively.9 cases with ACC were diagnosed with distant metastasis.Histologically,ACA cells arranged in nest-like and coarse trabecular forms with acidophilic or clear cytoplasm,unconspicuous nuclear atypia,and rare mitotic figures.The capsules,sinusoids and veins were uninvolved,and hemorrhage,necrosis and thick collagen fibers were infrequent.The Weiss score of all ACA was less than 2 (average =0.85 ± 0.81).ACC cells arranged in nest-like,coarse trabecular,cord-like,and diffuse structure with acidophilic cytoplasm,various nuclear atypia and atypical mitotic figures.The invasion of capsules,sinusoids and veins,hemorrhage and necrosis regions and thick collagen fibers were easily found.The Weiss score of all ACC was more than 3 (average =5.2 ±1.3).Immunohistochemical staining showed that vimentin,Syn,NSE,CK,CR,Melan-A and α-inhibin were expressed similarly between ACA and carcinoma (P ＞ 0.05).Reticular fiber staining revealed that the reticular fiber structures of ACA were unbroken,but ACC were destructed with various degrees of rupture,collapse,sparsity or disappearance (P ＜ 0.01).Conclusion ACC lacks characteristic immune phenotype,but increased diameter,distant metastasis,thick collagen fibers and destructed reticular fibrillar network are helpful in the diagnosis of ACC.