Adrenal gland & paraganglia
Other nonneoplastic
Focal adrenalitis
Author: Lan L. Gellert, M.D., Ph.D.
Last author update: 1 May 2017
Last staff update: 17 November 2022
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PubMed Search: focal adrenalitis
Table of Contents
Definition / general | Epidemiology | Etiology | Clinical features | Microscopic (histologic) description | Microscopic (histologic) images | Positive staining - disease | Differential diagnosisCite this page: Gellert LL. Focal adrenalitis. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/adrenalfocaladrenalitis.html. Accessed April 2nd, 2025.
Definition / general
- Aggregates of lymphocytes and plasma cells in adrenal gland
- Usually incidental finding
- Common in elderly
Epidemiology
- Reportedly present in up to 48% of autopsies (Virchows Arch A Pathol Anat Histol 1974;364:191)
Etiology
- Uncertain, possibly immune mediated
Clinical features
- Clinically apparent only after more than 90% of the adrenal cortex destroyed
Microscopic (histologic) description
- Aggregates of lymphocytes and plasma cells, often perivascular, in adrenal cortex and medulla
Microscopic (histologic) images
Images hosted on other servers:
Various images
Positive staining - disease
- Most infiltrating cells are CD3+ T cells, which primarily express CD4; CD8+ T cells are fewer
- A considerable proportion of CD4+ T cells were considered activated based on interleukin 2 receptor expression (Clin Exp Immunol 1989;77:101)
Differential diagnosis
- Autoimmune adrenalitis: Inflammation more diffuse, sometimes with follicle formation; often associated with marked cortical atrophy
- Adrenal tuberculosis: granulomatous inflammation in adrenal gland
- Viral infection in adrenal gland: CMV, EBV infection, usually in patients with immunodeficiency disorders
- Xanthogranulomatous adrenalitis: diffuse histiocytic inflammation in adrenal gland, with occasional lipofuscin crystals and focal necrosis (Endocr Pathol 2015;26:229)
