Growth Patterns of Placental and Paraovarian Adrenocortical Heterotopias Are Different

Xu, Bo; Popiolek, Dorota

doi:10.1155/2013/205692

Cited by 4 publications

(7 citation statements)

References 27 publications

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“…22 Rare microscopic nodules of adrenocortical tissue have been described in the human placenta. 1,2,6–10 Including the initial report in 1980 by Cox and Chavrier, 7 11 cases of adrenocortical heterotopia of the placenta have been reported in 7 manuscripts. Three of these reports have used immunohistochemistry on single cases to support the concept of adrenocortical differentiation, 1,2,10 the remaining 8 cases were diagnosed by morphology alone.…”

Section: Discussionmentioning

confidence: 99%

“…1,2,6–10 Including the initial report in 1980 by Cox and Chavrier, 7 11 cases of adrenocortical heterotopia of the placenta have been reported in 7 manuscripts. Three of these reports have used immunohistochemistry on single cases to support the concept of adrenocortical differentiation, 1,2,10 the remaining 8 cases were diagnosed by morphology alone. 6–9 The earliest study with immunohistochemistry demonstrated granular cytoplasmic reactivity for rabbit antisera to DHEA-sulfate in the nodule.…”

Section: Discussionmentioning

confidence: 99%

“…The strongest evidence is from the Zhong case report describing a placental nodule and paraovarian nodule of adrenocortical heterotopia in separate patients. 2 Immunohistochemical staining for inhibin alpha and melan-A in the placental lesion was described as “weak to moderate cytoplasmic staining.” In our experience, the type of reactivity shown in their images can be difficult to distinguish from nonspecific background reactivity. In contrast to the placental lesion of adrenocortical heterotopia, the paraovarian nodule demonstrated focal positivity for calretinin (nuclear and cytoplasmic) and diffused melan-A staining stronger in cells with eosinophilic granular cytoplasm, focal CD10, and focal calretinin.…”

Section: Discussionmentioning

confidence: 99%

“…10 The most recent case reported diffuse "weak to moderate" granular cytoplasmic reactivity for inhibin alpha and melan-A, with moderate to strong membranous and cytoplasmic reactivity for Cam5.2. 2 Heterotopic benign hepatic tissue has also been noted in the placenta, most frequently described as microscopic foci in the same distribution as the adrenocortical heterotopias. [3][4][5][6][11][12][13][14][15][16] However, some larger masses were also reported.…”

Section: Discussionmentioning

confidence: 99%

“…Rare cases of heterotopic adrenocortical and hepatic nodules have been described in the placenta, with 10 cases of adrenocortical and 12 cases of hepatic heterotopia reported to date. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] The cases of hepatic heterotopia mostly resemble normal liver with the exception of no bile ducts. Two more recently reported cases noted a cleared cytoplasm in the hepatocytes.…”

Section: Introductionmentioning

confidence: 99%

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Heterotopic Nodules in the Placenta, an Immunohistochemical Re-evaluation of the Diagnosis of Adrenocortical Heterotopia

et al. 2020

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Background Rare nodules of heterotopic adrenocortical and hepatic tissue are reported in the placenta. A mechanism for adrenocortical tissue in the placenta has been perplexing, while hepatic tissue is generally considered related to yolk sac primordia. The clear cell morphology of these nodules is similar to the adrenal cortex of the adult; however, the fetal adrenal gland does not usually display clear cells. Methods We stained 9 placental nodules, histologically identical to “adrenocortical” heterotopia of the placenta, to determine whether adrenocortical differentiation could be confirmed. These cases include 3 archival cases initially diagnosed as “adrenocortical” heterotopia. Results Immunohistochemical staining with steroid factor-1 (SF-1), HepPar-1, and Arginase-1 showed that these nodules of clear cells are actually hepatic (SF-1 negative, HepPar-1, and Arginase-1 positive). PAS staining suggests that glycogen accumulation is responsible for the clear cytoplasm. In contrast, a nodule of adrenocortical heterotopia near the testis and the adrenal gland from a 38-week-old neonatal autopsy case confirm SF-1 reactivity as expected. Conclusion We propose that adrenocortical heterotopia in the placenta is a misnomer, and that these subchorionic nodules of clear cells demonstrate hepatic differentiation.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Heterotopic Nodules in the Placenta, an Immunohistochemical Re-evaluation of the Diagnosis of Adrenocortical Heterotopia

et al. 2020

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Adrenal Rests in the Uro-genital Tract of an Adult Population

et al. 2021

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Ectopic adrenal rests are a rare condition which can be found in various sites, generally in the retroperitoneum or pelvis along the path of gonadal descent. Their real prevalence is unknown. Males are more commonly affected, at least in the pediatric age. Adrenal rests are usually clinically silent and incidentally found in surgical samples, mostly in the pediatric population, and rarely in adults. With the aim of increasing knowledge and estimating the prevalence of ectopic adrenocortical tissue in the adult population, 44 adrenal rests in the urogenital tract of 40 adults are described. These represent approximately 0.07% of the total number of urogenital and gynecological surgeries performed in the 22 considered years. Adrenal rests were identified in the spermatic cord (10 males) and in paraovarian, parasalpingeal, or infundibulopelvic ligament locations (30 females). All but one was incidental findings. One case regarded an adrenocortical carcinoma arisen in adrenal rests. A literature review of adrenal ectopia in the urogenital tract of adults identified 57 reported cases from 53 patients, with similar clinicopathological features as those of our series, with the exception of a lower incidence of parasalpingeal locations. Despite their limited clinical implications, awareness of ectopic adrenal rests is essential also in adults for at least two reasons: (a) to correctly identify sources of adrenocortical hormone production in case of adrenal insufficiency or hormonal imbalance and (b) to avoid misinterpretations in the diagnostic workup of renal cell carcinoma, adrenocortical tumors, and rare gonadal neoplasms, including Sertoli/Leydig cell tumors.

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Heterotopias and Germ Cell Tumors

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Placental and Gestational Pathology

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Growth Patterns of Placental and Paraovarian Adrenocortical Heterotopias Are Different

Cited by 4 publications

References 27 publications

Heterotopic Nodules in the Placenta, an Immunohistochemical Re-evaluation of the Diagnosis of Adrenocortical Heterotopia

Heterotopic Nodules in the Placenta, an Immunohistochemical Re-evaluation of the Diagnosis of Adrenocortical Heterotopia

Adrenal Rests in the Uro-genital Tract of an Adult Population

Heterotopias and Germ Cell Tumors

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