THE PATHOLOGY OF THE ADRENAL GLAND IN ADDISON’S DISEASE WITH SPECIAL REFERENCE TO ADRENOCORTICAL CONTRACTION

Abstract

“Cytotoxic” necrosis, atrophy or contraction of the adrenal cortex associated with functional insufficiency has been recognized as a clinicopathologic entity for many years (Barker, 1929; Guttman, 1930; Duffin, 1943). It is also well known that the incidence of adrenocortical contraction as a cause of Addison’s disease now equals or exceeds that of tuberculosis of the adrenal. Nevertheless, the continuing uncertainty among endocrinologists about the essential nature of the process is evidenced by a recent report (Rogoff, 1944) in which the lesions of contraction were confused with ischemic lesions of the adrenal. This study was stimulated by the receipt at the Army Institute of Pathology, from the beginning of World War II through 1946, of pathologic material from 15 patients who exhibited adrenocortical contraction at autopsy; during the same period only 10 cases of Addison’s disease resulting from tuberculosis or fibrocaseous destruction were accessioned.