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Pathology for Urologists

Adrenal Gland: Cortex

Image A
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Image B
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  • The cortex is divided into 3 concentric zones ("GFR") (image A):
    • Zona glomerulosa (ZG)
      • Thin outermost layer, comprised of smaller cells arranged in small clusters (glomus) or trabeculae.
      • Produces mineralocorticoids.
    • Zona fasciculata (ZF)
      • Thickest layer (3/4), cells arranged in longer cords or columns (fascicles) perpendicular to the capsule.
      • Larger vacuolated cells rich in lipid content.
      • Produces glucocorticoids.
    • Zona reticularis (ZR)
      • Thin innermost layer, comprised of smaller cells arranged in cords going into different directions (reticulum or net-like).
      • Produces androgens.
  • Surrounded by a fibrous capsule.
  • Adrenocortical cells
    • Eosinophilic (pink) to pale vacuolated or reticulated cytoplasm (image B).
    • Zona fasciculata cells are relatively lighter staining.
    • Expresses α-inhibin and melan A.
    • Due to the nature of cytoplasm, may look like clear cell RCC in biopsy.
      • In contrast, clear cell RCC has "optically clear" cytoplasm with "chicken-wire" vasculatures and is carbonic anhydrase IX+.


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