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 the greatest
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
 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
 Irregularcells 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
 Themedulla 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
 Unlikethe 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 vein-
suprarenal 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

 numerous 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
 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