336 CLINICAL CONSIDERATIONS 



origin, in the author's opinion, is to be sought in the androgenic 

 tissue. The latter group of tumors produce abnormalities of 

 the reproductive system and will be discussed in the next 

 chapter. The tumors of the interrenal tissue are not char- 

 acterized by any distinctive clinical symptomatology. Unlike 

 the corresponding growths of certain other endocrine organs 

 they do not manifest any symptoms attributable to an over- 

 production of their specific hormone. It is only by their 

 malignancy which expresses itself by their extension and ready 

 metastasis, or by their destruction of the cortex to such an 

 extent as to produce the symptoms of Addison's disease that 

 their presence in the body is manifested. 



Because of certain very superficial similarities, earlier work- 

 ers often confused tumors of the adrenal cortex with the more 

 commonly occurring hypernephroma of renal origin. 642 The 

 latter are not derived from the adrenals and should be more 

 accurately denoted as renal or Grawitz tumors. The differ- 

 entiation between tumors of renal and adrenal origin has been 

 clearly pointed out by Glynn and Guthrie, 227 Goldzieher, 230 and 

 most recent authors. 



The growths occurring in the adrenal cortex may be classi- 

 fied as: 1) simple hyperplasia, 2) cortical adenomata, and 3) 

 malignant carcinomata. 



Hyperplasia. Simple hyperplasia of the adrenals is a 

 physiological response of the glands to an increased demand for 

 the cortical hormone. Any condition requiring an excessive 

 secretion of the hormone will therefore be expected to lead to 

 hyperplasia. Infections, particularly, result in hypertrophic 

 enlargement of the adrenals. Thus in an infant, 8 weeks old, 

 dying of enteritis, Broster and Vines 95 found the adrenals to 

 weigh 16.5 grams. Lucien and Parisot 407 have denoted as 

 chronic hyperplastic adrenalitis, a condition in which the 

 adrenal enlarges as a result of an inflammation of the cortical 

 cells brought about by some toxic irritation. 



Cortical hyperplasia may occur either in the form of a diffuse 



