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Adrenal Neuroblastoma
Etiology

May be congenital
Pathogenesis

Loss of neuroblastoma suppressor gene on distal short arm of chromosome 1
Amplification of N-myc oncogene (seen in cases that are more aggressive),
Epidemiology

Disease of children generally < 5 yrs. of age
May be congenital
General Gross Description

Soft
Tan with areas of hemorrhage and necrosis
•Examples:
Neuroblastoma (Cut Surfaces) Neuroblastoma (Cut Surface)
General Microscopic Description

Small cells with scant cytoplasm
Hyperchromatic nuclei
May be in sheets or nests
Homer-Wright pseudo-rosettes may surround neuropil (stroma like that of white matter)
Cells are positive with neuroendocrine markers such as NSE, chromogranin, and synaptophysin
•Examples:
Clinical Correlation

Present with bone pain, mass, or symptoms attributed to excess catechols
Usually metastatic disease at presentation
Prognosis related to extent of disease and improved by age <1 yr.
Hyperdiploidy associated with better prognosis; N-myc amplification with poor outcome
Treatment with chemotherapy
References

Rosai J. Ackerman's Surgical Pathology. 8th ed. St. Louis, Mosby-YearBook, 1996, pp. 1026-1033.

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Adrenal Neuroblastoma
Synopsis by: Melinda Sanders M.D. (T93000M95003)[158]
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