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KMID : 0357920110450030306
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Korean Journal of Pathology
2011 Volume.45 No. 3 p.306 ~ p.310
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Composite Pheochromocytoma or Paraganglioma of Adrenal Gland: A Case Report with Immunohistochemical Studies and Electron Microscopic Examination
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Chang Hye-Yoon
Jeong Hoi-Seon
Kim Young-Hye
Park Sung-Hye
Kim Ae-Ree
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Abstract
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Composite pheochromocytoma or paraganglioma of the adrenal gland is a well-recognized, yet extremely rare tumor with only one case reported in Korea. We report a case of incidentally found composite pheochromocytoma and ganglioneuroma of the adrenal gland in a 44-year-old female composed of intermingled components of pheochromocytom, ganglioneuroma, and cells with intermediate features. On immunohistochemical staining, the pheochromocytoma component was positive for synaptophysin and chromogranin, but negative for S-100 protein. Staining for the S-100 protein revealed sustentacular cells which formed a peripheral coat around the “Zellballen” and Schwann cells. The Fontana-Masson stain defined neuromelanin granules of ganglion cells and the ganglion cells expressed neural markers such as neurofilament proteins. Ultrastructural findings revealed pheochromocytes with a round or ovoid nucleus and occasionally prominent nucleolus containing numerous adrenaline and noradrenaline granules.
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KEYWORD
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Composite pheochromocytoma and ganglioneuroma, Pheochromocytoma, Paraganglioma, Adrenal glands
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