ADRENAL GLANDS

HISTOLOGY HISTOPHYSIOLOGY HISTOCHEMISTRY

 Also

called “suprarenal glands”
• One at the cranial pole of each kidney

 Left

and right-sided glands

• Left gland is crescentic and right gland is pyramidal
 Has

head, body, and tail  Measures 5 x 3 x 1 cm  Normal weight of 4-6 grams each after dissection of fat

CORTEX
 Occupies

part  Three vaguely defined layers: a thin zona glomerulosa (contiguous with the capsule); middle, thick zona fasciculata; inner, moderately thick zona reticularis  Transition is gradual but can be sharpened  Coelomic mesoderm

the greatest

Zona glomerulosa
 Consists

of short columnar cells closely packed into ovoid groups or in columns--arc)  Nuclei stain deeply  Cytoplasm contains basophilic material (diffuse or clumped)  Lipid droplets are scarce  15% cortical volume

Zona fasciculata
 Polyhedral

cells larger than those of the ZG  Arranged in anastomosing cords (radial orientation)  Centrally placed nucleus (usually two per cell)  Basophilic cytoplasm (more in the periphery than in the inner part)

Zona fasciculata
 Lipid

droplets are numerous (cytoplasm is reduced into thin film)  Consequently in stained sections (lipid removal), cytoplasm appears vacuolated  Thin transitional region between the ZG and ZF (free of lipid droplets)  It contain mitotic figures  70 – 80% of the cortical volume

Zona reticularis
 Cells

are arranged as clearly anastomosing cords  Transition between this zone and ZF is gradual, cells differing little  Cytoplasm contains fewer lipids; granular and eosinophilic  Thinner than ZG or ZF

Zona reticularis
 Toward

the medulla- variable number of “light” and “dark” cells (staining affinities)  Nuclei of the light cells are pale-staining while the dark cells are shrunken and hyperchromatic  Dark cells contain clumps of yellow or brownish pigment

FUNCTIONS OF CORTEX: Hormone Action
Essential for life (removal or damage is fatal)  Synthesizes and secrete corticosteroid (mineralocorticoids, glucocorticoids and sex hormones) – ZG produces mineral corticoids (increases sodium and water absorption and potassium secretion) – ZF produces glucocorticoids – ZR produces androgen and estrogen

MEDULLA
 Irregular

cells arranged in rounded groups or short cords surrounded by venules and capillaries  When fixed in fluid containing KCr2O7, fine brown granules are seen  Appears green with FeCl3
– Chromaffin reaction (presence of epinephrine) – Chromaffin cells
 Ectodermal

origin

Chromaffin cells
 Multilineage

differentiation potential  Large polygonal cells with poorly outlined borders  Mild variation in sizes  Small nests and cords  Take up chromium salts strongly  Abundant granular and basophilic cytoplasm  PAS+ hyaline droplets
– Note: Sustentacular cells

Sympathetic ganglion cells
 Occasional

single cells or small clusters associated with myelinated nerve bundles  Their axons end around the chromaffin cells

 The

medulla also contains collections of small round cells with deeply staining nuclei and little cytoplasm
– Probably lymphocytes

FUNCTIONS OF MEDULLA: Epinephrine
 Not

essential for life

– Not certain that it plays any important role
 Unlike

the cortex, the medulla stores high concentrations of its specific product  Elaborates epinephrine  Epinephrine is readily oxidized (phenolic & OH)
– Recognized by the chromaffin reaction and the color reactions with ferric salts and other compounds
 Has

a powerful sympathomimetic action; effect on clotting time, BP, carbohydrate metabolism, and GIT is essentially the same as that produced by stimulation of sympathetic nerves alone

FUNCTIONS OF MEDULLA: Epinephrine
 Medulla

is unessential for normal activity since no physiological disturbances are produced  There is no deficiency disease of the adrenal medulla  Hyperfunction of the medulla in man occurs rarely, with certain tumors of the medulla or of extramedullary chromaffin tissues containing epinephrine

CONNECTIVE TISSUE AND VASCULAR SYSTEM OF ADRENAL GLAND
 Connective

tissue of adrenal gland consists of a thick collagenous fibrous capsule which extends through the cortex  Capsule- dense network of branches of the main arteries of the gland, some capillaries and veins, a nerve plexus and lymphatics  Major branches of arteries, nerves and lymphatics also penetrate the cortex  Arteries and nerves continue almost exclusively into the medulla  Lymphatics confined in the cortex

CONNECTIVE TISSUE AND VASCULAR SYSTEM OF ADRENAL GLAND
 Supporting

framework of the cortex consists of reticular

fibers  Also encloses the medullary cell cords and support capillaries, veins, and nerves  Collagenous fibers appear around the larger tributaries of the veins and merge with the capsular CT  Penetrates ZG as sinusoids (anastomosing cords)  Traverses the cortex radially from the capsule – ZF  Some venules in the capsule but none in the cortex

CONNECTIVE TISSUE AND VASCULAR SYSTEM OF ADRENAL GLAND
 From

the capsule, some major arterial branches penetrate the cortex with few branches as they reach the medulla  In the medulla, they repeatedly branch to form a capillary net around the cords and clumps of cells  Capillaries empty into the same venous system which drains the cortex (uniting to form the central veinsuprarenal vein)

LYMPHATICS AND NERVES OF ADRENAL GLAND
 Lymphatics

are limited to the capsule and its cortical trabeculae, and to the connective tissue of the large veins  The rich nerve plexus in the capsule includes some sympathetic ganglion cells

DISEASES OF THE ADRENAL GLAND

Beckwith-Wiedemann Syndrome
markedly enlarged (up to 150 microns) and bizarre polyhedral cells with eosinophilic granular cytoplasm and large hyperchromatic nuclei with pseudoinclusions in adrenal cortex; no/rare mitotic figures
 numerous

Beckwith-Wiedemann Syndrome
 Gigantism,

macroglossia, abdominal wall defects, craniofacial abnormalities, midfacial hypoplasia, adrenocortical hyperplasia  May have brain damage due to hypoglycemia, causing mental retardation or death  Incidence of 1 per 13,000 births  Due to abnormality of 11p15.5

Adrenoleukodystrophy
 ballooning

and striation of zona fasciculata and reticularis cells; cells may have large cortical vacuoles and clefts (representing lipid dissolved during processing); medulla unchanged

Adrenoleukodystrophy
 Rare,

X linked recessive, affects 1 in 120,000

males  Progressive demyelination of central and peripheral nervous system (dementia, blindness, quadriplegia)  Due to mutations of adrenoleukodystrophy protein (ADLP) at Xq28, which cause defective oxidation of long-chain fatty acids; cholesterol esters and gangliosides accumulate in membranes of adrenal cortex, brain, other organs