A 35-year-old woman undergoes adrenalectomy for a 4-cm adrenocortical mass. Histological features predicting malignancy include high mitotic rate, atypical mitoses, venous invasion, capsular invasion, and necrosis. These criteria are scored using the:
- A Modified TNM AJCC staging
- B Weiss criteria (score ≥3 indicates malignancy) ✓
- C Fuhrman nuclear grading
- D Gleason grading system
Correct answer: B. Weiss criteria (score ≥3 indicates malignancy)
Explanation
The Weiss system is the standard histological classification for adrenocortical neoplasms, evaluating 9 criteria (high nuclear grade, mitotic rate >5/50HPF, atypical mitoses, clear cell content <25%, diffuse architecture >33%, necrosis, venous invasion, sinusoidal invasion, capsular invasion); a score ≥3 indicates adrenocortical carcinoma with high sensitivity and specificity. The TNM staging is a clinical/surgical staging for prognosis after diagnosis. Fuhrman grading applies to clear cell renal carcinoma. Gleason grading is for prostate adenocarcinoma.
Reference: Robbins & Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.