adrenal gland
DESCRIPTION
Adrenal GlandTRANSCRIPT
-
Adrenal GlandDr. Muhartono, M.Kes, Sp.PA
-
Adrenal gland consists of Cortex : mesoderm, urogenital ridge Medulla neural crestEach adult adrenal gland weighs from 4 to 6 grams.
-
Cortex adrenalThree definitive cortical zones : Zona glomerulosa, 10% of the cortex Zona fasiculata, 80% Zona reticularis, 10% Z. Glomerulosa mineralocorticoid aldosteron Z. fasiculata glucocorticoid Z. reticularis glucocorticoid
-
MineralocorticoidSynthesis : z. gromerulosaThe main one : aldosteron major regulator of extracellular fluid volumealdosteron major regulator of potasium metabolism
-
GlucocorticoidSynthesis : z. fasiculata z. reticularisGlucorticoid cortisol Hypothalamus/CRH Hypophyse /ACTHCortisol effect-----------
-
Pathology of the adrenal cortexHypofungsi cortex adrenal (Hypoadrenalism)Hyperfungsi cortex adrenal (Hyperadrenalism)
-
HypoadrenalismMineralo+glucocorticoid Cause : primer sekunder Primer acute adrenocortical hypofungsiPrimer chronic adrenocortical hypofungsiSekunder adrenocortical hypofungsi
-
Primer acute adrenocortical insuffisiencyWaterhouse-Friderichsen SyndromeCause : meningococcusDIC circulatory collaps
-
Primer chronic adrenocortical insufficiencyAddisons diseaseCaused by chronic destructive proses adrenal cortexTbc, sarcoidosis, cancerAutoimmune disease
-
Hyperfungsi adrenal cortexCushing syndromeConns syndromeAdrenal virilism and congenital adrenal hyperplasia (CAH)
-
Cushing SyndromePathogenesis: Hipophyse Adrenal Ectopic Iatrogenic
-
Conns syndromeEtiologi: Adenoma producing aldosteron Idiopatic
-
Adrenogenital Syndrome
Males precocious puberty females virilismnewborns congenital cortical hyperplasia enymze defect (21hydroxylase deficiency)adults adrenal cortical adenomas and carcinomas
-
Adrenal lesionsAdenomaLesi kuning jinggaCystKarsinoma kortek adrenalSangat ganasDiff baik-anaplastikInvasi PD, metastasis kgb, paru
-
Adrenal medulaPheochrocytoma MENNeuroblastomaGanglioneuroma
-
feokromositomaJarangKatekolamin dan hipertensi25% di medula, 75% ekstra adrenalSporadik 90%Terkait sindrom 10%
-
MEN II F, hiperplasia medula adrenal, karsinoma medulary tyroid, hiperplasia C tyroid dan hiperplasia paratyroidMEN IIIF, hiperplasia tyroid, karsinoma medulary, neuroma, Von hippel lindaukista, RCC, F, angiomatosis, hemagioblastomaVon reklinghausen neurofibromatosis, schwanoma, meningioma, glioma, FSturger weber hemangioma kavernosum n trigeminus, F
-
Tumor 10%10% bilateral10% ekstraadrenal10% anak10% malignancy
-
Morfologi zeballen
-
Klinis HipertensiGagal jantungInfark miokardLaboratorium katekolamin urin dan plasmaCT, MRI, USG
-
Neuroblastoma < 5 tahunSel-sel bentuk bulat kecil dengan latarbelakang neurofibrilerPseudoroette homer wrightDiferensiasi sel ganglion ganglioneuroblastoma-ganglioneuromaMetastasis