Menon Varna, Krishnamurthy Shanta V
Department of Pathology, Tata Memorial, Hospital, Mumbai.
Indian J Pathol Microbiol. 2006 Jan;49(1):7-11.
Adrenal cortical carcinomas are rare neoplasms and the definitive diagnostic criteria are distant metastasis and / or local invasion. Due to advances in imaging techniques, adrenal cortical neoplasms are discovered earlier and are smaller, increasing the need for more accurate diagnosis and pathologic indicators of prognosis. A twelve year retrospective clinicopathologic analysis of 15 histopathologically proven cases of adrenocortical carcinomas was done. Clinical details including radiologic findings, endocrine manifestations and gross finding were analysed. Hematoxylin and eosin stained slides were reviewed. Emphasis was on application of Weiss criteria. All fifteen tumors fulfilled Weiss criteria of malignancy, ie. all 15 possessed 3 or more of these criteria of malignancy. Functional tumors showed a greater representation of mixed cell type. It was concluded that Weiss criteria is easy to apply and that a combined evaluation of clinical features, size, weight and microscopic appearance seems necessary for the diagnosis of adrenocortical carcinomas.
肾上腺皮质癌是罕见肿瘤，明确的诊断标准是远处转移和/或局部侵犯。由于成像技术的进步，肾上腺皮质肿瘤更早被发现且体积更小，这就增加了对更准确诊断和预后病理指标的需求。对15例经组织病理学证实的肾上腺皮质癌病例进行了为期12年的回顾性临床病理分析。分析了包括影像学表现、内分泌表现和大体所见在内的临床细节。复查了苏木精-伊红染色切片。重点是应用魏斯标准。所有15个肿瘤均符合恶性肿瘤的魏斯标准，即所有15个肿瘤均具备3项或更多这些恶性标准。功能性肿瘤中混合细胞型的比例更高。得出的结论是，魏斯标准易于应用，对肾上腺皮质癌的诊断似乎有必要综合评估临床特征、大小、重量和显微镜下表现。
