PMC3036999_01
CAMT: Areas of ganglioneuroma (thick arrow) are seen admixed with areas of pheochromocytoma (thin arrow) (original magnification x20)
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F1
Microscopically, the normal adrenal cortex was seen to be peripherally compressed by a well-circumscribed tumor comprising pheochromocytoma and ganglioneuroma [Figure 1].
Ganglioneuroma component of CAMT with many ganglion cells intricately associated with spindle schwannian stroma (original magnification x40)
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F2
It consisted of bundles of spindle cells (Schwann cells) admixed with mature ganglion cells [Figure 2].
Pheochromocytoma component of CAMT with polygonal cells arranged in cords and trabeculae within loose Schwannian matrix (original magnification x20)
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F3
The pheochromocytoma component (accounting for 10% of the mass) consisted of large polygonal cells arranged in nests and cords (Zellballen pattern), bordered by spindle-shaped sustentacular cells with delicate fibrovascular stroma [Figure 3].
Immunostaining with chromogranin highlights the pheochromocytoma element of CAMT (original magnification x10
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F4
Pheochromocytoma cells were highlighted by chromogranin [Figure 4], synaptophysin and neuron specific enolase (NSE).