Adrenal Cytomegaly: Quantitative Assessment by Image Analysis

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Abstract
Adrenal cytomegaly was found in 23 or 0.8% of 2711 pediatric autopsies, including a 13-year-old girl with leukemia and a 20-year-old woman with cystic fibrosis. Cytomegaly of pancreatic islet and acinar cells and pituitary cells was also noted. DNA quantitation by image analysis indicates that cytomegalic cells of the adrenal cortex, pancreas, and pituitary contain increased amounts of DNA (hyperdiploid aneuploid), with adenocytes containing over 25 times the normal amount of DNA in some instances. These data and morphological features suggest that cytomegaly is a reflection of polyploidy due to either partial DNA replication or partial DNA replication plus other modes of polyploidization. Although the mechanism(s) by which these changes evolve remains unknown, regressive processes do not seem to be directly involved. We speculate that polyploidization is, in this setting, a response to physiological demand, a concept that also has relevance to the interpretation of morphology and DNA ploidy profiles of endocrine tumors.