The presnet study provides guidelines for the diagnosis of adrenal cortical tumors in Egyptian patients. This retrospective study included 40 patients of adrenal cortical tumors (28 adenoma and 12 carcinoma). They were admitted to Mansoura Urology and Nephrology Center between 1985-2002. All patients were surgically treated by adrenalectomy. Patients with adenoma were followed for a period ranging from 24-67 months. Clinical and laboratory improvement of adenoma was observed. Nine patients of carcinoma died of distant metastasis after 8 months and the other 3 patients were still alive 24 months after surgery. Hyaline globules which are PAS positive were detected in adrenal cortical adenoma and carcinoma and both types were positive for reticulin stain. Immunohistochemically; cytokeratin was expressed in 22/28 cases of adenoma and all cases 12/12 of carcinoma.
Vimentin was expressed in 20/23 cases of adenoma and 8/12 cases of carcinoma. The present study concluded that: (1)- Reticulin staining is useful for the diagnostic differentiation of adrenal cortical carcinoma from adrenal cortical adenoma. (2)- The expression of cytokeratin and vimentin is helpful in diagnosis, but the histopathological examination of paraffin sections remains the basic method. (3)- No significant correlation between immunohistochemical pattern of adrenocortical tumors and survival was observed.