These photomicrographs belong to the adrenal taken at autopsy of an older adult who died in hospital of renal failure and resistant shock.
He had been recently diagnosed with AA amyloidosis. The cause of his resistant shock was thought to be due to sepsis, although no organisms were ever detected and he did not respond to antimicrobial therapy.
Amyloidosis of the adrenal glands is a rare but recognized cause of primary adrenal insufficiency, which results from the loss of adrenocortical cells due to the accumulation of amyloid. In this case, it is not clear whether the significant degree of amyloid deposition in the adrenal glands seen here contributed to the patient’s clinical presentation or death.