Adrenal gland and paraganglia
Normal
Histology - Adrenal medulla

Author: Severino Rey Nodar, M.D., Ph.D. (see Authors page)

Revised: 12 January 2016, last major update April 2013

Copyright: (c) 2002-2016, PathologyOutlines.com, Inc.

Related: Histology-Adrenal cortex
Cite this page: Histology, Adrenal medulla. PathologyOutlines.com website. http://pathologyoutlines.com/topic/adrenalglandhistology_medulla.html. Accessed April 24th, 2017.
Definition / General
  • Region with basophilic staining cells with granular cytoplasm and no stored lipid
  • Composed of neural crest cells called chromaffin cells (also called pheochromocytes, medullary cells) with a multilineage differentiation potential; also sustentacular cells
  • Chromaffin cells: arranged in small nests and cords separated by prominent vasculature; take up chromium salts strongly, turns brown-black after exposure to Zenker's solution (potassium dichromate); large polygonal cells with poorly outlined borders, abundant granular and usually basophilic cytoplasm, mild variation in cell size; occasionally has PAS+ hyaline droplets
  • Sustentacular cells: supporting cells, spindle cells at periphery of nests of chromaffin cells; associated with rich vasculature; S100+, difficult to identify with routine staining
  • Ganglion cells: occasional single cells or small clusters associated with myelinated nerve bundles
  • Central vein: has thick wall of smooth muscle
  • Also many venous channels which drain blood from cortical sinusoids, pass through medulla to drain into medullary vein
Micro Images

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Adrenal medulla

Positive Stains
  • Chromogranin, synaptophysin, neurofilament, tyrosine hydroxylase, epinephrine and S100 (sustentacular cells)
Negative Stains
  • Keratin, vimentin
Electron Microscopy Description
  • Numerous mitochondria
  • Norepinephrine producing cells have 250 nm electron opaque neurosecretory granules, with prominent halo between granule membrane and dense core
  • Epinephrine producing cells have 190 nm finely granular neurosecretory granules, filling the enclosing membrane and no halo
  • Moderate amount of rough endoplasmic reticulum, interdigitating blunt cytoplasmic processes with poorly developed cell junctions
  • Sustentacular cells have moderate amounts of rough endoplasmic reticulum and occasional lipid droplets, but no neurosecretory granules