When a patient presents with a clinical picture of adrenal cortical hyperfunction, what would be the anatomic changes in the adrenal cortex?


Three major functional disorders of the adrenal glands are hypercortisolism, hyperaldosteronism, and virilization/feminization. Each type of these disorders may be due to cortical hyperplasia, cortical adenoma, or carcinoma. Cushing’s syndrome (hypercortisolism), the most common, can be caused by many pathologic processes. It may be due to bilateral cortical hyperplasia (70%) stimulated by adrenocorticotropic hormone (ACTH) released from a pituitary micro-or macroadenoma (Cushing’s disease). Secretion of ectopic ACTH is a less common cause of Cushing’s syndrome (approximately 10%) and comes from nonpituitary tumors such as small-cell carcinomas of the lung, bronchial carcinoid tumors, and others. Adrenal cortical adenoma and carcinoma account for most ACTH-independent sources of hypercortisolism (approximately10%–20%). Primary cortical hyperplasia being responsible for Cushing’s syndrome is uncommon.


Congenital Adrenal Hyperplasia Primary Aldosteronism Adrenocortical Adenoma Cortical Adenoma Sertoli Cell Tumor 
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