Adrenal gland and paraganglia
Pheochromocytoma / paraganglioma
Features to report

Author: Nat Pernick, M.D. (see Authors page)
Editorial Board Member Review: Debra Zynger, M.D.

Revised: 15 August 2017, last major update February 2005

Copyright: (c) 2002-2017, PathologyOutlines.com, Inc.

PubMed Search: Paraganglioma [title] features
Cite this page: Pernick, N. Pheochromocytoma / paraganglioma - features to report. PathologyOutlines.com website. http://pathologyoutlines.com/topic/adrenalparagangliomareport.html. Accessed December 16th, 2017.
Definition / general
  • Recommendations for reporting of pheochromocytoma and paraganglioma (Hum Pathol 2003;34:112):
    • Familial or sporadic (based on clinical history)
    • Tumor size / weight
    • Site of origin
    • Bilateral or not
    • Histologic type with brief reference to clinical or endocrinologic data
    • Composite features (ganglioneuroma, MPNST, other)
    • Surgical margins
    • Extent of mitotic activity
    • Extent of tumor necrosis
    • Other features
    • Other prognostic features (invasion of adjacent tissue, angiolymphatic invasion)
    • Regional lymph nodes (# involved / # inspected)
  • Pheochromocytoma of the adrenal gland scaled score (PASS) (score of ≥ 4 is concerning for malignancy):
    • Periadrenal adipose invasion (+2)
    • > 3 mitosis per 10 high powered fields (+2)
    • Atypical mitoses (+2)
    • Necrosis (+2)
    • Cellular spindling (+2)
    • Marked nuclear pleomorphism (+2)
    • Cellular monotony (+2)
    • Large nests or diffuse growth (+2)
    • High cellularity (+2)
    • Capsular invasion (+1)
    • Vascular invasion (+1)
    • Hyperchromasia (+1)
Microscopic (histologic) images

Images hosted on PathOut server:

PASS criteria - images contributed by Debra Zynger, M.D.