A 33-year-old man comes to the office due to episodic headaches for several months accompanied by sweating and feelings of anxiety that spontaneously resolve after 15-30 minutes. He has no other medical conditions and takes no medications. His brother recently had surgery to treat hyperparathyroidism. Blood pressure is 180/110 mm Hg, and pulse is 102/min. Laboratory results show normal serum electrolytes and renal function. CT scan of the abdomen reveals a mass in the right adrenal gland. Which of the following cells have the same embryological origin as the tissue responsible for this patient's current condition?

Question

A 33-year-old man comes to the office due to episodic headaches for several months accompanied by sweating and feelings of anxiety that spontaneously resolve after 15-30 minutes.  He has no other medical conditions and takes no medications.  His brother recently had surgery to treat hyperparathyroidism.  Blood pressure is 180/110 mm Hg, and pulse is 102/min.  Laboratory results show normal serum electrolytes and renal function.  CT scan of the abdomen reveals a mass in the right adrenal gland.  Which of the following cells have the same embryological origin as the tissue responsible for this patient's current condition?

Quizplus · Accepted Answer

11ec160b_373d_7b0b_9249_01b7a87995f9_MD0001_00 This patient with severe hypertension, headaches, and an adrenal mass has typical features of pheochromocytoma, a catecholamine-secreting tumor of the chromaffin cells of the adrenal medulla. Pheochromocytoma can be sporadic or associated with several familial disorders, especially multiple endocrine neoplasia (MEN) type 2 (particularly likely in this patient given his family history of hyperparathyroidism). MEN type 2 is associated with germ-line mutations in the RET proto-oncogene and is characterized by: Neural crests are embryological structures composed of parallel strips of cells arising from the ectoderm at the margin of the neural tube. The chromaffin cells of the adrenal medulla are derived from neural crest tissue (the adrenal cortex is derived from the mesoderm). Structures arising from neural crest cells can be remembered with the mnemonic "SOME SALT" (Schwann cells, odontoblasts, melanocytes, enterochromaffin cells, spinal membranes [pia and arachnoid], adrenal medulla/ganglia, laryngeal cartilage, tracheal cartilage). (Choices A, B, and C) Capillary endothelial cells and cardiac myocytes are mesodermal derivatives that arise from primitive endothelium. Interstitial fibroblasts also arise from the mesoderm. (Choice E) Thyroid follicular cells are an endodermal derivative, arising from the pharyngeal epithelium at the base of the tongue. Although the parafollicular, calcitonin-secreting C cells were previously thought to originate from neural crest tissue, recent studies suggest that they have an endodermal origin. Educational objective: Neural crests are embryological structures composed of parallel strips of cells arising from the ectoderm at the margin of the neural tube. Structures derived from neural crest cells include Schwann cells, odontoblasts, melanocytes, enterochromaffin cells, spinal membranes, adrenal medulla/ganglia, laryngeal cartilage, and tracheal cartilage. __________ References: Familial pheochromocytomas and paragangliomas. (http://www.ncbi.nlm.nih.gov/pubmed/23933153) The neural crest: a versatile organ system. (http://www.ncbi.nlm.nih.gov/pubmed/25227568)

A 33-Year-Old Man Comes to the Office Due to Episodic