Female 61 years

Back and loin pain. Huge left adrenal mass displacing kidney, spleen and pancreas. Previous breast cancer. Left adrenalectomy performed.

Macroscopic description:
an enlarged adrenal gland with attached kidney weighing together 1360g.....The adrenal gland was attached to the upper pole/medial surface of the kidney measuring 160x100x90mm. Cut surface showed a variegated appearance with pale and dark areas and areas of necrosis. The gland was covered by a thin white capsule.

Microscopic description:
The lesion was a tumour comprising medium sized polygonal cells with occasional foci of residual adrenal cortex at the edges. There was brisk mitotic activity, and no capsular invasion was seen. Immunohistochemistry: CK20, CK7 and EMA +ve, and weakly +ve with PGP9.5 and synaptophysin. Melan A, inhibin, chromogranin, ER and PR -ve, occasional cells S100+ve, but no sustentacular cells, occasional nuclei TTF1 +ve, Ki67 index around 50%, BRST 1 -ve.

Female 14 years

Solitary nodule in left lobe of thyroid, FNA THY4, ? Papillary carcinoma, left thyroid lobectomy.

Microscopic description:
This lesion was submitted with a proffered diagnosis of minimally invasive follicular carcinoma. It comprised a well circumscribed follicular nodule with a thick fibrous capsule. There was also one prominent focus of capsular invasion with associated vascular invasion. The nuclei were optically clear and most members thought that these nuclei showed nuclear features of papillary carcinoma. Most members thought this was a FVPC with microinvasion, a few members also considered follicular carcinoma with microinvasion, or follicular adenoma

Female 59 years

Previous radioiodine therapy for thyrotoxicosis. Nodular gland, FNA suggestive of oncocytic follicular neoplasm.

Female age unknown

Nodule from tracheo-oesophageal groove.

Male 69 years

Thyroid nodule. USS showed large nodule in right lobe and two small nodules in left. Right lobectomy performed. Also had had a recent nephrectomy. Pre-operative US core biopsy cytology of the thyroid showed of the right lobe had shown a lesion that could have been a metastatic RCC or could have been a follicular thyroid lesion., thy4, hence diagnostic hemithyroidectomy. The cytology showed cells that were thyroglobulin +/-, Cd10-ve and RCC1 -ve. Proferred diagnosis was of intrathyroidal metastasis of conventional (clear cell) RCC.

Female 42 years

Nodular left lobe of thyroid, lobectomy following non-diagnostic cytology.

Male 70 years

Cushing's syndrome, right adrenalectomy. Additional History - increasing weight. Specimen of left adrenal gland once stripped of fat measuring 60 x 35 x 35mm and weighing 18g with a small ragged defect in the capsule at one edge measuring 20 x 4mm in area. Gland had a bright yellow nodular appearance, no rim of normal adrenal tissue identified. Microscopically there was expansion of the zona fasiculata cells with a smaller amount of zona reticularis. Nest of cortical cells were separated by thin fibrous bands, with areas of mild to moderate nuclear pleomorphism. Mitoses less than 0/50 HPF. Proffered diagnosis was of adrenal cortical hyperplasia rather than cortical adenoma. The cells were large/expanded and lipid laden and that gland capsule was well defined with a mixture of clear cells and compact cells and that NO defined nodule was present. The lipid laden cells were present because the patient was receiving adrenal gland blockade. No nodular areas were present and the lesion showed expansile growth.

Female 41 years

Right upper quadrant pain. CT - adrenal mass, non-functioning.

Microscopic description:
Yellow mass 10 x 75 x 50mm with a smooth intact surface and adjacent attenuated adrenal gland 75 x 15 x 10mm, weighing 110g.