Pathology Associated with Hormones of Adrenal Cortex

Abstract

Adrenal gland is an endocrine organ comprising of an outer cortex and inner medulla. These secrete various hormones that have a vital role in maintaining the normal homeostasis of the body. Lesions of adrenal cortex are quite common to encounter and most of these are related to the hormones secreted by three layers of adrenal cortex: the zona glomerulosa, the zona fasciculata, and the zona reticularis. Also it is very infrequent to encounter metastatic lesions in the adrenal glands too. So it is very important as a part of a clinician as well as a pathologist to know the pattern in which these hormones are secreted along with their physiological roles. Thus this chapter includes the disease that are related to excess as well as deficien-cies of the hormones secreted by adrenal cortex. The chapter also includes various genetic syndromes that are associated with the disorders associated with hormones of adrenal cortex. The last part of the chapter includes a brief description of various benign as well as malignant lesions, the pathological as well as the etiologi-cal aspects and the hormonal abnormalities associated. This chapter thus mainly focuses on the pathology associated with the adrenal cortex and hormones secreted by the various layers of adrenal cortex. hyperplasia). Decreased levels of this hormone also lead to an increase in lymphocytes and eosinophils, as a result of decreased immune-modulatory action of hydrocortisone. Measurement of baseline cortisol levels between 8:00 and 9:00 AM is the test used to diagnose AI. A serum cortisol level of value less than 5 μ g/mL favors diagnosis of AI. Stimulation test with cosyntropin which stimulates the cortex helps in differentiating primary and secondary AI. In this test 250 μ g of cosyntropin is administered intramuscularly or intravenously, and serum cortisol is measured 30 min after infusion. Serum cortisol value of ≥ 18 μ g/dL indicates a normal response. A cortisol peak <18 μ g/dL confirms the diagnosis of AI. Serum cortisol level ≥ 100 pg/mL confirms the diagnosis of Addison’s syndrome. Serum cortisol value of <10 pg/mL confirms diagnosis of secondary AI [35–39].