Seven histologic parameters were used to study adrenal cortical tumors in order to separate those which were metastases free after 10 years from those with metastases.
Parameter |
Finding |
Points |
regressive changes such as necrosis, hemorrhage, fibrosis or calcification |
none or little regressive change |
0 |
|
moderate or extensive change |
5.7 |
preservation of normal architecture |
mainly normal structure |
0 |
|
mainly abnormal structure |
1.6 |
nuclear atypia |
no or only slight atypia |
0 |
|
moderate or strong nuclear atypia |
2.1 |
nuclear hyperchromasia |
no or only slight hyperchromasia |
0 |
|
moderate or marked hyperchromasia |
2.6 |
structure of nucleoli |
normal structure |
0 |
|
abnormal structure |
4.1 |
mitotic activity, defined as number of mitotic figures per 10 high power fields (400x) |
0-2 per 10 HPF |
0 |
|
> 2 per 10 HPF |
9 |
invasion of capsule and/or blood vessel wall |
no invasion |
0 |
|
invasion present |
3.3 |
histologic index =
= SUM (values for features present)
Interpretation:
• minimum score: 0
• maximum: 28.4
• histologic index <= 8 were disease free for more than 10 years
• histologic index >= 24 developed metastasis within 10 years
• histologic index between 8 and 24 with tumor weight < 35 grams were disease free for more than 10 years
• histologic index between 8 and 24 with tumor weight > 35 grams were more often to develop metastases (88%), but not all did (12% did not)
Specialty: Hematology Oncology, Surgery, general, Endocrinology
ICD-10: ,