Adrenal Gland PA III

Irene Suryahudaya patolog-dermatolog

Adrenal gland consists of

Cortex : mesoderm,urogenital ridge Medulla neural crest Each adult adrenal gland weighs from 4 to 6 grams.

Cortex adrenal

Three definitive cortical zones : Zona glomerulosa, 10% of the cortex Zona fasiculata, 80% Zona reticularis, 10% Z. Glomerulosa mineralocorticoid aldosteron Z. fasiculata glucocorticoid Z. reticularis glucocorticoid

Mineralocorticoid

Synthesis : z.gromerulosa The main one : aldosteron major regulator of extracellular fluid volume aldosteron major regulator of potasium metabolism

Glucocorticoid
Synthesis : z. fasiculata z. reticularis Glucorticoid cortisol Hypothalamus/CRH Hypophyse /ACTH Cortisol effect----------

Pathology of the adrenal cortex

Hypofungsi cortex adrenal (Hypoadrenalism) Hyperfungsi cortex adrenal (Hyperadrenalism)

Hypoadrenalism

Mineralo+glucocorticoid Cause : primer sekunder Primer acute adrenocortical hypofungsi Primer chronic adrenocortical hypofungsi Sekunder adrenocortical hypofungsi

Primer acute adrenocortical insuffisiency

Waterhouse-Friderichsen Syndrome Cause : meningococcus DIC circulatory collaps

Primer chronic adrenocortical insufficiency

Addisons disease Caused by chronic destructive proses adrenal cortex Tbc, sarcoidosis, cancer Autoimmune disease

Hyperfungsi adrenal cortex

Cushing syndrome Conns syndrome Adrenal virilism and congenital adrenal hyperplasia (CAH)

Cushing Syndrome

Pathogenesis: Hipophyse Adrenal Ectopic Iatrogenic

Conns syndrome

Etiologi: Adenoma producing aldosteron Idiopatic

Adrenogenital Syndrome

Males precocious puberty females virilism newborns congenital cortical hyperplasia enymze defect (21-hydroxylase deficiency) adults adrenal cortical adenomas and carcinomas

Adrenal lesions

Adenoma Cyst

Adrenal medula

Pheochrocytoma MEN Neuroblastoma Ganglioneuroma

Thymus

Thymus Hypoplasia Thymus Hyperplasia Tumor Thymoma

Pineal gland Parathyroid gland