Pheochromocytoma – Adrenal Medulla

by Carlo Raj, MD

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    Let’s get into pathology. Inside the medulla, you have a benign tumour. This benign tumour episodically might then be releasing epinephrine. When you increase your epinephrine, what happens? You’re going to have increased blood pressure for reasons we’ve talked about. Beta-1 receptor activity increasing your heart contractions, increases systolic blood pressure. Uncommon neoplasm, but my goodness, do you want to know this for your boards. These are your medulla chromaffin cells. Whenever you have... now, for board purposes know this… clinically speaking, in medicine, the term or the concept of paraganglioma is actually quite complicated. I will give you the-the absolute minimum or what’s necessary for you to get the questions right here, but if you find a-a epinephrine producing tumour outside the adrenal medulla, then you call this a paraganglioma. When from extra adrenal chromaffin cells, the operative word extra, this is then referred to as being paraganglioma. So, where would this be located if it’s not in the adrenal medulla? Bifurcations, of what? Bifurcations of blood vessels such as the carotids up here, internal/external bifurcation of the carotid artery and then the iliacs. Pheochromocytoma, reaction with dichromate fixation helps you… you want to know about a particular staining mechanism. Tumours of the adrenal medulla generally may be sporadic associated with inherited… we’ll talk about this in great detail. Including neurofibromatosis type I, we’ll talk more about neurofibromatosis type I in neuropathology in which then gives rise to a particular type of brain issue called neurofibroma all associated with and you must know of von Hippel-Lindau disease. Von Hippel-Lindau disease is extremely important for you and I in pathology because of its molecular mechanisms including something called hypoxia-inducible factor 1-alpha and the fact that it works on your VEGF. If you’re not familiar with any of that, this would...

    About the Lecture

    The lecture Pheochromocytoma – Adrenal Medulla by Carlo Raj, MD is from the course Adrenal Gland Disorders.

    Included Quiz Questions

    1. Paraganglioma
    2. Pheochromocytoma
    3. Metastatic tumor with lung origin
    4. Adrenal carcinoma
    5. Adrenal adenoma
    1. Tuberous sclerosis
    2. NF1
    3. von Hippel-Lindau disease
    4. Succinate dehydrogenase subunit gene mutation
    5. MEN 2
    1. Lethargy
    2. Palpitations
    3. Headache
    4. Tremors
    5. Sweating
    1. Paroxysmal/episodic
    2. Higher in arms than legs
    3. Consistently above 160/110
    4. Response rapidly to diuretics
    5. Accompanied by drastic increase in renin
    1. 10% unilateral
    2. 10% malignant
    3. 10% familial
    4. 10% extra adrenal
    5. 10% in children

    Author of lecture Pheochromocytoma – Adrenal Medulla

     Carlo Raj, MD

    Carlo Raj, MD

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