Description

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)

 


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