The adrenal glands sit just above the kidneys. Their function is to make hormones crucial for life. There are two major areas of each adrenal gland: the outer cortex and inner medulla. The cortex is further subdivided into a zona glomerulosa, zona fasciculata and a zona reticularia. These zones make steroid hormones for the body. The inner medulla makes catecholamine hormones that support the fight-or-flight response. Problems in the adrenal gland can cause serious physiological derangement.
Inborn Adrenal Defects
Adrenal gland disorders may be present at birth. According to "Robbins and Cotran Pathologic Basis of Disease" by Vinay Kumar, these birth defects may be isolated to the adrenal glands or part of a syndrome with other features. Accessory adrenal tissue is the growth of extra adrenal tissues apart from the adrenal glands. Adrenal hypoplasia is where one or both adrenals fail to develop and adrenal union occurs as the two glands adhere to each other. Congenital adrenal hyperplasia occurs when problems in the synthesis of one or more adrenal hormones shunts the excess precursor hormones into other types, leading to insufficiency in some hormones and excesses in others. Beckwith-Wiedemann syndrome causes overgrowth and excess function of the adrenals as well as other enlarged organs and facial abnormalities.
Adrenal Exess
Some problems of adrenal excess may be congenital, such as congenital adrenal hyperplasia, according to Pathology Outlines. Others are acquired. Cushing syndrome is caused by excess cortisol, a stress hormone made in the cortex of the kidney. The syndrome causes rapid weight gain, excess sweating, high blood sugar and psychological disturbances. Similarly, hyperaldosteronism is caused by excessive amounts of the adrenal cortex hormone aldosterone. This is a hormone responsible for salt retention in response to low sodium or low blood pressure in the body. This syndrome causes high blood pressure and low potassium, often leading to fatigue, muscle and nerve problems.
Adrenal Insufficiency
Adrenal insufficiency occurs when the adrenals do not synthesize enough of one or more hormones. Addison's disease is characterized by absent or decreased levels of the steroid hormones, particularly cortisol and aldosterone. It may be caused by infections of the adrenal glands, the immune system mistakenly attacking the adrenal glands or low blood pressure, which can occur during shock. Symptoms may include low blood pressure and blood glucose, confusion and psychosis.
Benign Tumors
Adrenocortical adenomas are overgrowths of benign tissue in the adrenal cortex forming a tumor. A study reported in "Modern Pathology" by Dr. Alexander Stojadinovic and others found such growths in 2 to 4 percent of the population on routine CT scans. Pheochromocytomas are a second type of tumor. They are benign 90 percent of the time, and tend grow in the adrenal medulla, producing hormones such as epinephrine, also known as adrenalin. Symptoms may include headache, high blood pressure, sweating and anxiety according to the MayoClinic.com. Another type of benign lesion includes cysts, which are hollowed out spherical cavities in the tissue.
Cancerous Tumors
Adrenocortical carcinomas are rare and aggressive cancerous tumors, according to the research reported in "Modern Pathology." The size of the tumor on imaging such as CT scan is the best initial way to distinguish benign from malignant tumors in the adrenal gland as the malignant tumors tend to be larger. Some of these tumors are functional, meaning that they produce hormones and symptoms of hormone excess. Neuroblastic tumors are cancerous tumors of the adrenal medulla found principally in children.
References
- "Robbins and Cotran Pathologic Basis of Disease"; Vinay Kumar et al; 2009
- Pathology Outlines: Adrenal Gland and Paraganglia
- "Modern Pathology"; Adrenocortical Adenoma and Carcinoma: Histopathological and Molecular Comparative Analysis; Dr. Alexander Stojadinovic et al.; May 2003
- MayoClinic.com: Pheochromocytoma: Symptoms
