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The Korean Journal of Pathology 2011;45(3): 306-310.
doi: https://doi.org/10.4132/KoreanJPathol.2011.45.3.306
Composite Pheochromocytoma or Paraganglioma of Adrenal Gland: A Case Report with Immunohistochemical Studies and Electron Microscopic Examination.
Hyeyoon Chang, Hoiseon Jeong, Younghye Kim, Sung Hye Park, Aeree Kim
1Department of Pathology, Korea University Guro Hospital, Korea University School of Medicine, Seoul, Korea. ark@korea.ac.kr
2Department of Pathology, Seoul National University College of Medicine, Seoul, Korea.
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.
Key Words: Composite pheochromocytoma and ganglioneuroma, Pheochromocytoma; Paraganglioma; Adrenal glands