PMC4100689_01
(A) Abdominal T1-weighted MRI revealed the presence of a hyperintense lesion in the right adrenal. Photomicrographs of the resected right adrenal: (B) large eosinophilic cells comprising the large black node. Several areas with increased intracellular pigmentation can be appreciated (magnification, 200x).. (C) Several smaller nodules were found dispersed in the remaining adrenal cortex (magnification, 50x). (D) Immunohistochemical staining for beta-catenin showed membrane and cytoplasmic staining of the adenoma (magnification, 800x).
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Magnetic resonance imaging (MRI) confirmed the right adrenal nodule (Fig. 1A) with increased signal on the T2-weighted image, which enhanced after i.v. gadolinium administration. Microscopically, the tumor consisted of eosinophilic cells with extensive granular pigmentation (Fig. 1B). The tumor was embedded within an atrophic adrenal cortex peppered with multiple other pigmented nodules (Fig. 1C). Immunohistochemistry of beta-catenin, using a mouse MAB (#610154, diluted 1:200, BD Biosciences, San Jose, CA, USA), displayed a membranous and cytoplasmic staining in both the adenoma and the surrounding cortex (Fig. 1D).