Zytologische Beobachtungen an der hyperplastischen Nebennierenrinde des Menschen

Ultrastructural morphometry of normal adrenal cortex and of hyperplastic adrenals in gushing's disease

Surgical specimens of 4 normal adrenal glands and of 5 hyperplastic ones in Cushing's disease were studied ultrastructurally. The ultrastructure of the three zones of each adrenal gland was morphometrically and statistically analyzed. Comparing the statistical data of the three zones of the normal gland, the development of smooth endoplasmic reticuium and rough endoplasmic reticuium showed an increase from the outer zona glomerulosa to the inner zona fasciculata and reticularis. Also, the mitochondria were more numerous in the inner zona reticularis than in the outer zones. In Cushing's disease, the smooth endoplasmic reticuium, the rough endoplasmic reticuium, and the mitochondria were developed to a significantly higher degree than in normal human adrenal glands. The distribution of the cell organelles in the zona fasciculata and zona reticularis is almost alike in normal adrenal glands and in the adrenal cortex in Cushing's disease, except that the smooth endoplasmic reticuium in the zona reticularis was less extensive than in the zona fasciculata. The volume percentages of lipid vacuoies in the hyperplastic zona fasciculata in Cushing's disease was strongly and significantly decreased in comparison to normal adrenal glands. Our ultrastructural findings and the statistical data were in accordance with the results from animal experiments with adrenocorticotropic hormone (ACTH) stimulation and confirmed former qualitative ultrastructural findings concerning human adrenal gland changes in ACTH-dependent Cushing's disease.

Ultrastructure of cortisol-secreting adrenal adenomata

Two adrenocortical adenomata causing Cushing's syndrome were examined by electron microscopy. Adenomatous cells were arranged in islets and contained ovoid nuclei with a prominent nucleoli. Mitochondria were polymorphic and displayed tubular and lamelliform cristae. Some cells were apparently devoid of lipid droplets and possessed an exceedingly well developed SER, the tubules of which were intermingled with small stacks of ribosome-studded cisternae, while other parenchymal cells contained large clumps of lipid droplets and scanty SER tubules. A conspicuous Golgi apparatus and many dense bodies of probable lysosomal nature were also observed. These findings suggest that the adenomata are derived from the zona fasciculata and that lipid-laden and lipid-free cells are, respectively, resting and actively secreting elements.

Changes in the fine structure and function of a hormone-secreting adrenocortical tumour investigated in tissue culture

Tissue cultures of a surgically removed adrenocortical tumour causing Cushing's syndrome, and tissue cultures from the attached, tumour-free adrenal were studied. There were two cell types characteristic of tumour tissue. The cell type occurring most frequently had pronounced hypertrophied agranular endoplasmic reticulum. A fewer number of lipid-rich cells containing many electron-dense granules could also be found. The ratio of cells changed during cultivation. In the 17 days tumour culture, a higher percentage of lipid-rich cells could be observed. In spite of continuous ACTH treatment, the initially high hydrocortisone level decreased, gradually. It may be assumed that the lipid-rich cells are of reduced ability as regards hydrocortisone production.