Adrenal Gland - Hemorrhage

Image of hemorrhage in the adrenal gland from a female F344/N rat in a chronic study
Adrenal gland - Hemorrhage in a female F344/N rat from a chronic study. Extensive, diffuse hemorrhage (Hem) is present in the cortex and medulla.
Figure 1 of 4
Image of hemorrhage in the adrenal gland from a female F344/N rat in a chronic study
Adrenal gland - Hemorrhage in a female F344/N rat from a chronic study (higher magnification of Figure 1). Extensive, diffuse hemorrhage is present in the cortex.
Figure 2 of 4
Image of hemorrhage in the adrenal gland cortex from a male B6C3F1/N mouse in a chronic study
Adrenal gland, Cortex - Hemorrhage in a male B6C3F1/N mouse from a chronic study. Extensive, diffuse hemorrhage replaces much normal cortex.
Figure 3 of 4
Image of hemorrhage in the adrenal gland cortex from a male B6C3F1/N mouse in a chronic study
Adrenal gland, Cortex - Hemorrhage in a male B6C3F1/N mouse from a chronic study (higher magnification of Figure 3). Extensive, diffuse cortical hemorrhage almost obliterates the normal cortical architecture.
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comment:

Adrenal gland hemorrhage ( Figure 1image opens in a pop-up window , Figure 2image opens in a pop-up window , Figure 3image opens in a pop-up window , and Figure 4image opens in a pop-up window ) is characterized by the presence of variable amounts of extravasated blood cells in the cortex and/or medulla. Hemorrhage can be focal or diffuse and range in severity from a small focal area to extensive involvement that can distort or even obliterate normal architecture ( Figure 1image opens in a pop-up window , Figure 2image opens in a pop-up window , Figure 3image opens in a pop-up window , and Figure 4image opens in a pop-up window ).

Adrenal hemorrhage can be secondary to many spontaneous or treatment-related pathologic processes such as primary vascular disease, systemic coagulopathy, infarction, and septicemia. Many chemicals, as well as very high doses of exogenous adrenocorticotropic hormone (ACTH), are known to cause adrenal hemorrhage (primarily in the cortex), often in association with necrosis.

recommendation:

Adrenal hemorrhage should be diagnosed and assigned a severity grade, site modifier (i.e., cortex, medulla), and distribution modifier (i.e., focal, diffuse). If it is present in both the cortex and medulla, the site modifier may be omitted and the location described in the pathology narrative. Hemorrhage secondary to other lesions (e.g., cystic degeneration, inflammation, or necrosis) should not be diagnosed separately, unless warranted by severity, but may be described in the pathology narrative.

references:

Braun AG. 1990. Survival, Age-Associated Disease and Neoplasia of the B6C3F1 Mouse: Lifespan Phase. MRI-NTP 52-89-145. TSI Mason Research Institute, Worcester, MA.

Burkhardt WA, Guscetti F, Boretti FS, Todesco AI, Aldajarov N, Lutz TA, Reusch CE, Sieber-Ruckstuhl NS. 2011. Adrenocorticotropic hormone, but not trilostane, causes severe adrenal hemorrhage, vacuolization, and apoptosis in rats. Dom Anim Endocrinol 40:155-164.
Abstract: http://www.ncbi.nlm.nih.gov/pubmed/21194873

Hamlin MH, Banas DA. 1990. Adrenal gland. In: Pathology of the Fischer Rat: Reference and Atlas (Boorman GA, Eustis SL, Elwell MR, Montgomery CA, MacKenzie WF, eds). Academic Press, San Diego, 501-518.
Abstract: http://www.ncbi.nlm.nih.gov/nlmcatalog/9002563

National Toxicology Program. 2012. NTP TR-571. Toxicology and Carcinogenesis Studies of Kava Kava Extract (CAS No. 9000-38-8) in F344/N Rats and B6C3F1 Mice (Gavage Studies). NTP, Research Triangle Park, NC.
Abstract: http://ntp.niehs.nih.gov/go/36127

Nyska A, Maronpot RR. 1990. Adrenal gland. In: Pathology of the Mouse: Reference and Atlas (Maronpot RR, Boorman GA, Gaul BW, eds). Cache River Press, Vienna, IL, 509-536.
Abstract: http://www.cacheriverpress.com/books/pathmouse.htm

Szabo S, Lippe IT. 1989. Adrenal gland: Chemically induced structural and functional changes in the adrenal cortex. Toxicol Pathol 17:317-329.
Abstract: http://www.ncbi.nlm.nih.gov/pubmed/2675282