Fig. 2

Histopathological findings of the resected left adrenal gland (September 2009). a Gross appearance of the cut surface of the left adrenal tumor 3 cm in size showed the inferior surface to be necrotic. b−i Microscopic examination of the left adrenal tumor (b, d−f; hematoxylin and eosin staining. c, g−i; chromogranin A staining). Nontumoral adrenal gland in the right lower corner, and well-encapsulated tumor in the remainder of the photograph (b). The tumor had a large area of coagulative necrosis in the center. The necrotic material contained morphologically ghost cells (d, e) and was immunohistochemically markedly positive for chromogranin A (c, g, h). There were numerous hemosiderin-laden macrophages and histiocytes accompanied by vascular proliferation in the region adjacent to the area of necrosis (e, h). The viable region along the periphery of the tumor contained numerous cells undergoing pyknosis (f), and the cytoplasm of the tumor cells was positive for chromogranin A staining (i)