Medicine and surgery

Organic and Functional Systems III

ENDOCRINE SYSTEM: HISTOLOGY and PRACTICAL

The suprarenal gland

A.Y.: 2020-2021
✓ Paired organs located in the retroperitoneal space of the

abdominal cavity.

✓ The right gland is flattened and triangular and the left

gland is semilunar in shape.

✓ Both embedded in the perirenal fat at the superior poles

of the kidneys.

✓ about 7 cm long, 3 cm high, with a weight of about 10 g.

✓ The adrenal glands are covered with a thick connective tissue
capsule from which trabeculae extend into the parenchyma,
carrying blood vessels and nerves.

✓ Each is an organ composed of two distinct parts: cortex and

medulla, with separate functions
As the adrenal glands produce various systemically-important hormones, therefore, they require
significant blood supply and are extremely well vascularized

The three chief sources of blood supply to the adrenal glands

include:
1. The superior adrenal arteries (which are small branches
coming off the inferior phrenic artery).
2. The middle adrenal artery (comes directly off the
abdominal aorta).
3. The inferior adrenal artery (originates from the renal
artery bilaterally).
✓ The vessels branches into many arterioles that enter the capsule
and break up into sinusoidal cortical capillaries.
✓ The sinusoidal capillaries, reach the corticomedullary junction
and drain into veins, which enter the medulla.
✓ Some arterioles from the capsule do not supply the cortex but go
directly into the medulla.
✓ The medulla has a dual blood supply: venous blood from both
cortex and medulla is drained by a large central adrenal (or
suprarenal) vein.
✓ The suprarenal vein drains directly into the inferior vena cava on
the right side and into the left renal vein on the left side.
 outer cortex

The adrenal gland consists of:

medulla

outer cortex

1. an outer cortex (80% to-90% of the gland);

2. an (reddish) inner medulla that comprises about 10% of the volume of the entire adrenal gland
and is usually 2 mm thick.
1. The cortex is the steroid-secreting portion. It lies beneath the capsule and constitutes nearly
90% of the gland by weight.
2. The medulla is the catecholamine-secreting portion. It lies deep to the cortex and forms the
center of the gland.
✓ The outer cortex and inner medulla of the adrenal differ structurally, functionally, and
developmentally.
✓ Mesoderm develops into the cortex and neural crest ectoderm develops into the medulla
✓ The cortex is essential to life, but the medulla is not.
✓ The medulla makes up 10% of the gland and in life is reddish-
brown.
✓ Its secretory cells are called chromaffin (medullary) cells because
of a characteristic chromaffin reaction in response to oxidation by
salts of chromic acid.
✓ The chromaffin cells are modified neurons.
✓ These cells are the source of the catecholamines epinephrine and
norepinephrine, which are stored in secretory granules.
Arrow, Granules containing
Epinephrine and norepinephrine.

Medullary hormones are released into the venous sinusoids lined by a fenestrated endothelial layer.
Chromaffin Cells - modified postganglionic sympathetic
neurons that secrete catecholamines.
Chromaffin cells are organized in ovoid clusters and short
interconnecting cords.

Ultrastructurally, the chromaffin cells are characterized by

numerous secretory vesicles with diameters of 100 to 300
nm, rER, and a well-developed Golgi apparatus.
Chromaffin cells containing secretory granules filled with the
catecholamines, epinephrine and norepinephrine.

Although these neurohormones are produced by different cell

populations in the medulla, the individual cells cannot be easily
distinguished.

But there is a way to distinguish them…

 ✓ The distinguishing ultrastructural feature of medullary chromaffin cells is the presence of
membrane-bound, electron-dense secretory vesicles.
✓ These Golgi-derived cytoplasmic organelles, 150-350 nm in diameter, are storage sites for the two
main peptide hormones of the medulla.

1. Epinephrine is stored in smaller vesicles

with a light or moderately dense core;
2. Norenephrine is in larger vesicles with
very high density content.

In humans, however, most vesicles contain

norepinephrine, and the same chromaffin cell typically
includes both hormones.
Ganglion cells are also present in the medulla.

Their axons extend peripherally to the parenchyma of the adrenal cortex to modulate its secretory
activity and innervate blood vessels.
Pheochromocytoma is a tumors of the adrenal medulla, that arises from catecholamine-producing
(chromaffin) cells.

Is a rare, usually noncancerous (benign) tumor.

Most pheochromocytomas are discovered in people between the ages of 20 and 50. But the tumor
can develop at any age.
The adrenal cortex is divided into three zones on
the basis of the arrangement of its cells:

1. Zona glomerulosa, the narrow outer zone

that constitutes up to 15% of the cortical
volume;
2. Zona fasciculata, the thick middle zone that
constitutes nearly 80% of the cortical volume;
3. Zona reticularis, the inner zone that
constitutes only 5% to 7% of the cortical
volume.
 The zona glomerulosa
✓ The cells of the zona glomerulosa are arranged in
closely packed ovoid clusters and curved columns
that are continuous with the cellular cords in the
zona fasciculata.
✓ Cells of the zona glomerulosa are relatively small The zona glomerulosa, the outermost and thinnest layer
of the cortex, is composed of steroid-secreting cells that
and columnar or pyramidal. are clustered into spherical shapes.

✓ Abundant smooth-surfaced endoplasmic

reticulum (sER), multiple Golgi complexes, large
mitochondria, free ribosomes, and some rER.
✓ A rich network of fenestrated sinusoidal
capillaries surrounds each cell cluster.
 The zona glomerulosa

The cells of the Z. glomerulosa have a central nucleus and lipid filled ("foamy") cytoplasm.
 The zona glomerulosa

The cells of the zona glomerulosa secrete the primary

mineralocorticoid called aldosterone, a compound

that functions in the regulation of sodium and

potassium homeostasis and water balance.

 The zona fasciculata

the middle and thickest layer of the

adrenal cortex
 The zona fasciculata
✓ The cells of the zona fasciculata are large and
polyhedral.
✓ They are arranged in long straight cords, one or two
cells thick, that are separated by sinusoidal capillaries.
✓ The cells of the zona fasciculata have a lightly staining
spherical nucleus.
✓ Binucleate cells are common in this zone.
✓ the cytoplasm is acidophilic and contains numerous
lipid droplets
 The zona fasciculata

capillary

Cells of zona fasciculata display the vacuolated cytoplasm

resulting from the extraction of lipid during tissue
processing.
The zona fasciculata
 The zona fasciculata
The principal secretion of the zona fasciculata are:

Glucocorticoids
… of which the predominant hormone is cortisol.
This hormone plays a role in the regulation of blood sugar via gluconeogenesis.
Cortisol also modulates the immune system and modulates the metabolism of fat, protein, and
carbohydrates.)

N.B. Hydrocortisone, a synthetic form of cortisol, is used in treatment of allergies and inflammation.
 The zona reticularis
Zona reticularis is the innermost portion of the cortex, forming a
meshwork of cells surrounded by fenestrated capillaries.
The zona reticularis

The cells have a central nucleus and

eosinophilic cytoplasm often with lipofuscin
pigment.
 The zona reticularis

✓ The zona reticularis produces androgens and plays a role in the development of secondary sexual
characteristics.
✓ The primary androgen produced in the zona reticularis is dehydroepiandrosterone (DHEA), which is
the most abundant hormone in the body.
✓ It serves as a precursor for the synthesis of many other hormones produced by the adrenal gland.
The function of these three zones can be remembered by the mnemonic triple S, "Salt, Sugar,
Sex," as they correlate to the function of the hormones produced in each layer of the adrenal
cortex.
 ✓ Addison's disease (adrenal insufficiency), is an uncommon disorder that occurs when our body doesn't
produce enough of certain hormones.
✓ In Addison's disease the adrenal glands produce too little cortisol and, often, too little aldosterone.
✓ Addison's disease occurs in all age groups and both sexes and can be life-threatening.
✓ Treatment involves taking hormones to replace those that are missing

Addison’s disease. Hyperpigmentation