case_images: PMC5838465_01
case_images: Hyperplastic adrenal cortex.
case_images: CRIE2018-3963274.001.jpg
case_images: PMC5838465_01_CRIE2018-3963274.001.jpg
case_images: fig1
case_images: Diffuse adrenal cortical hyperplasia was noted (Figure 1).
case_images: Adrenal gland, pheochromocytoma, and diffuse growth pattern with high cellularity. H&E x40.
case_images: CRIE2018-3963274.002.jpg
case_images: PMC5838465_01_CRIE2018-3963274.002.jpg
case_images: fig2
case_images: Immunostaining was positive for ACTH and synaptophysin and negative for chromogranin, inhibin, calretinin, and S-100 protein.  Figure 2 shows the pathology of adrenal tumor, pheochromocytoma, and diffuse growth pattern.  Figure 3 depicts positive immunostraining for ACTH.  Figure 4 depicts the tumor's vascular invasion, and the adrenal gland's hyperplastic cortex.
case_images: Positive Immunostaining for ACTH compatible with ectopic ACTH secretion by the tumor.
case_images: CRIE2018-3963274.003.jpg
case_images: PMC5838465_01_CRIE2018-3963274.003.jpg
case_images: fig3
case_images: Immunostaining was positive for ACTH and synaptophysin and negative for chromogranin, inhibin, calretinin, and S-100 protein.  Figure 2 shows the pathology of adrenal tumor, pheochromocytoma, and diffuse growth pattern.  Figure 3 depicts positive immunostraining for ACTH.  Figure 4 depicts the tumor's vascular invasion, and the adrenal gland's hyperplastic cortex.
case_images: Tumor, vascular invasion at tumor edge, and hyperplastic cortex. The arrow represents vascular invasion of the tumor.
case_images: CRIE2018-3963274.004.jpg
case_images: PMC5838465_01_CRIE2018-3963274.004.jpg
case_images: fig4
case_images: Immunostaining was positive for ACTH and synaptophysin and negative for chromogranin, inhibin, calretinin, and S-100 protein.  Figure 2 shows the pathology of adrenal tumor, pheochromocytoma, and diffuse growth pattern.  Figure 3 depicts positive immunostraining for ACTH.  Figure 4 depicts the tumor's vascular invasion, and the adrenal gland's hyperplastic cortex.