Pheochromocytoma

Author: Mikael Häggström

Gross processing

As per Adrenal tumors

Evaluation

Typical features.

A pheochromocytoma with coagulative necrosis, displayed at gross pathology (upper left) and light microscopy at low (upper right), medium (lower left) and high magnification (lower right) showing ghost cells.

Architecture can be nested (zellballen), trabecular or solid arrangement of tumor cells. Sustentacular cells may be seen surrounding nests, as rather spindly cells.

Further workup

For a diagnosis of pheochromocytoma, look for any adverse histopathologic features such as vascular or capsular invasion, diffuse growth pattern, necrosis, increased mitotic activity or atypical mitotic figures.

Example report

Right adrenal gland, resection: Adrenal pheochromocytoma (3.0 cm tumor). Surgical margins are negative for neoplasia. (Optionally: Comment: This adrenal pheochromocytoma exhibits no adverse histopathologic features such as vascular or capsular invasion, diffuse growth pattern, necrosis, increased mitotic activity or atypical mitotic figures. Nonetheless, metastatic potential is difficult to predict based on histologic parameters.)

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