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Adrenocortical Carcinoma pp 107–126Cite as

Classical Histopathology and Immunohistochemistry

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Abstract

The histopathological diagnosis of adrenocortical carcinoma (ACC) and its differentiation from adrenal adenomas based on nine criteria: nuclear structures, mitotic rate, atypical mitoses, less than 26% clear cells, diffuse architecture, invasion of intratumorous sinusoidal structures, invasion of veins, invasion of capsule, and necroses. If three or more criteria are present and a metastasis of an extra-adrenal tumor or a primary medullary tumor are excluded by structural characteristics or immunohistochemical stainings, an ACC can be diagnosed. Its weight should exceed 100 g, its size should be larger than 5 cm. The typical immunohistochemical marker profile comprehends negativity for chromogranin A and (mostly) for keratin and an expression of inhibin, melan A, calretinin, and (mostly) synaptophysin. The Ki-67 index should exceed 3%. The differential diagnosis to medullary tumors, metastases, and other tumors are presented. The TNM-system for staging is discussed.

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Authors and Affiliations

  1. Institute of Pathology of the Marienkrankenhaus, Alfredstraße 9, 22087, Hamburg, Germany

    Wolfgang Saeger

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  1. Wolfgang Saeger
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Correspondence to Wolfgang Saeger .

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Editors and Affiliations

  1. Zina Pitcher Place 109, Ann Arbor, 48109-2200, Michigan, USA

    Gary D. Hammer

  2. Dept. Internal Medicine, Div. Pulmonary & Critical Care Medicine, University of Michigan Health System, Zina Pitcher Place 109, Ann Arbor, 48109-2200, Michigan, USA

    Tobias Else

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Saeger, W. (2009). Classical Histopathology and Immunohistochemistry. In: Hammer, G., Else, T. (eds) Adrenocortical Carcinoma. Springer, New York, NY. https://doi.org/10.1007/978-0-387-77236-3_8

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