Adrenal Cortical Neoplasms in the Pediatric Population

核异型性 病理 医学 多形性(细胞学) 人口 异型性 环境卫生 免疫组织化学
作者
Jacqueline A. Wieneke,Lester D.�R. Thompson,Clara S. Heffess
出处
期刊:The American Journal of Surgical Pathology [Lippincott Williams & Wilkins]
卷期号:27 (7): 867-881 被引量:319
标识
DOI:10.1097/00000478-200307000-00001
摘要

Adrenal cortical neoplasms in pediatric patients (<20 years) are rare. The clinical manifestations and biologic behavior of these lesions can be quite distinct from their histologically similar counterparts in the adult population, making pathologic criteria for distinguishing benign from malignant tumors equivocal. We undertook a study of 83 adrenal cortical neoplasms to determine if adult clinical and histologic features can be applied to pediatric patients in an outcome-based analysis. Most of the patients (50 girls and 33 boys) presented with hormone-related symptoms present for a mean of 6.8 months. The tumors ranged in size from 2 to 20 cm (mean 8.8 cm). Histologic parameters examined included capsular and/or vascular invasion, extraadrenal soft tissue extension, growth pattern, cellularity, necrosis, cytoplasmic eosinophilia, nuclear pleomorphism, nuclear-to-cytoplasmic ratio, prominent nucleoli, mitotic figures, atypical mitotic figures, bands of fibrosis, and calcifications. Immunophenotypically, there was reactivity with inhibin, vimentin, CK5, and focally with p53 and Ki-67. All patients underwent adrenalectomy, and 20 patients received adjuvant therapy. All patients with tumors classified as adenomas (n = 9) were alive, without evidence of disease (mean 14.7 years), whereas 21 patients with carcinomas had died with disease (mean 2.4 years). Only 31% of histologically malignant tumors behaved in a clinically malignant fashion. Features associated with an increased probability of a malignant clinical behavior included tumor weight (>400 g), tumor size (>10.5 cm), vena cava invasion, capsular and/or vascular invasion, extension into periadrenal soft tissue, confluent necrosis, severe nuclear atypia, >15 mitotic figures/20 high power fields, and the presence of atypical mitotic figures. Vena cava invasion, necrosis, and increased mitotic activity (>15 mitotic figures/20 high power fields) independently suggest malignant clinical behavior in multivariate analysis.
最长约 10秒,即可获得该文献文件

科研通智能强力驱动
Strongly Powered by AbleSci AI
更新
PDF的下载单位、IP信息已删除 (2025-6-4)

科研通是完全免费的文献互助平台,具备全网最快的应助速度,最高的求助完成率。 对每一个文献求助,科研通都将尽心尽力,给求助人一个满意的交代。
实时播报
苗广山完成签到,获得积分10
刚刚
stop here完成签到,获得积分10
刚刚
1秒前
hhh发布了新的文献求助10
1秒前
3秒前
semiaa完成签到,获得积分10
3秒前
汉堡包应助小猪采纳,获得10
6秒前
甜蜜的荟发布了新的文献求助10
6秒前
芜6完成签到,获得积分10
8秒前
berkelerey12138完成签到,获得积分10
8秒前
刘雪完成签到 ,获得积分10
9秒前
完美梨愁完成签到 ,获得积分10
9秒前
yyy完成签到,获得积分10
9秒前
李健的粉丝团团长应助zzzz采纳,获得10
10秒前
Dudidu完成签到,获得积分10
10秒前
一颗大树完成签到,获得积分10
11秒前
潇洒的浩然完成签到,获得积分10
12秒前
比比谁的速度快应助曾珍采纳,获得50
12秒前
14秒前
NiNi完成签到,获得积分10
15秒前
Ther完成签到,获得积分20
16秒前
傲娇白安完成签到,获得积分10
17秒前
17秒前
甜蜜的荟完成签到,获得积分20
18秒前
婷儿完成签到,获得积分10
18秒前
牛牛发布了新的文献求助10
18秒前
Hoper完成签到,获得积分10
18秒前
张曰淼完成签到,获得积分10
19秒前
共渡完成签到,获得积分10
21秒前
凉白开完成签到 ,获得积分10
22秒前
跳跃的太君完成签到,获得积分10
23秒前
小猪发布了新的文献求助10
23秒前
独特问夏完成签到,获得积分10
24秒前
24秒前
25秒前
魔幻蓉完成签到,获得积分10
25秒前
杠赛来完成签到,获得积分10
25秒前
ccy完成签到 ,获得积分10
26秒前
Ch185完成签到,获得积分10
27秒前
欣喜的复天完成签到,获得积分10
29秒前
高分求助中
【提示信息,请勿应助】关于scihub 10000
Les Mantodea de Guyane: Insecta, Polyneoptera [The Mantids of French Guiana] 3000
徐淮辽南地区新元古代叠层石及生物地层 3000
The Mother of All Tableaux: Order, Equivalence, and Geometry in the Large-scale Structure of Optimality Theory 3000
Handbook of Industrial Diamonds.Vol2 1100
Global Eyelash Assessment scale (GEA) 1000
Picture Books with Same-sex Parented Families: Unintentional Censorship 550
热门求助领域 (近24小时)
化学 材料科学 医学 生物 工程类 有机化学 生物化学 物理 内科学 纳米技术 计算机科学 化学工程 复合材料 遗传学 基因 物理化学 催化作用 冶金 细胞生物学 免疫学
热门帖子
关注 科研通微信公众号,转发送积分 4038368
求助须知:如何正确求助?哪些是违规求助? 3576068
关于积分的说明 11374313
捐赠科研通 3305780
什么是DOI,文献DOI怎么找? 1819322
邀请新用户注册赠送积分活动 892672
科研通“疑难数据库(出版商)”最低求助积分说明 815029