Table 3.

Histopathologic Features of Proliferative Adrenocortical Lesions.

Hismiddleathologic Feature	Adrenocortical Hyperplasia	Adrenocortical Adenoma	Adrenocortical Carcinoma
Nodularity	Multiple, variably sized, and discrete	Single, expansile, and >1 cm in diameter	Exceedingly large
Adrenomegaly	May be present	Present	Present, even palpable by external examination
Demarcation	Well-demarcated		Poorly demarcated
Cellular features	Well demarcated cells	Well-differentiated cells to polygonal cells with large nuclei and prominent nucleoli
Mitotic rate	Rare	<1 per 10 high-power field	>1 per 10 high-power field
Necrosis	Infrequent		Frequent and extensive
Metastasis	Absent	No invasion or metastasis	Vascular invasion and distant metastasis