Adrenal Cystic Lesions: A Clinicopathological Analysis of 25 Cases with Proposed Histogenesis and Review of the Literature

• Published in: Endocrine pathology Vol. 19; no. 4; pp. 274 - 281
• Main Authors: Chien, Hui-Ping, Chang, Yu-Sun, Hsu, Pei-Sung, Lin, Jen-Der, Wu, Yi-Chin, Chang, Hui-Lang, Chuang, Cheng-Keng, Tsuei, Ke-Hung, Hsueh, Chuen
• Format: Journal Article
• Language: English
• Published: New York New York : Humana Press Inc 01.12.2008; Humana Press Inc; Springer Nature B.V
• Subjects: Adenoma; adrenal cystic lesions; Adrenal Gland Diseases - diagnostic imaging; Adrenal Gland Diseases - pathology; Adrenal Glands - diagnostic imaging; Adrenal Glands - pathology; Adult; Aged; Aged, 80 and over; Cysts; Cysts - diagnostic imaging; Cysts - pathology; D2-40; Endocrinology; endothelial cyst; Endothelium - pathology; epithelial cyst immunohistochemistry; Female; Histogenesis; Humans; Infant, Newborn; Lesions; Literature reviews; Male; Medicine; Medicine & Public Health; Middle Aged; Neuroblastoma; Oncology; Pathology; pseudocyst; Schwann cells; Tomography, X-Ray Computed; endothelial cyst; pseudocyst; adrenal cystic lesions; epithelial cyst immunohistochemistry; D2-40
• ISSN: 1046-3976; 1559-0097
• DOI: 10.1007/s12022-008-9046-y

Adrenal cystic lesions are uncommon and we analyzed clinical and pathologic features of 25 such cases from a single institute over 23 years. There were 16 pseudocysts, eight endothelial cysts, and one epithelial cyst. Seven of eight endothelial cysts were confirmed to be lymphangiomatous by D2-40 immunostaining. We suggest that pseudocysts and endothelial cysts may have different histogenesis. The proposed mesothelial origin of adrenal epithelial cyst cannot be confirmed in our example. Seven adrenal pseudocysts were associated with tumor, including two pheochromocytomas, one neuroblastoma, one adrenal cortical carcinoma, one adrenal cortical adenoma, one myelolipoma, and one schwannoma. The distinction of true cystic lesion from cystic neoplasm is important and requires thorough sampling of the specimens.