Figure 9c. PPNAD in a 28-year-old man. (a, b) Delayed contrast-enhanced CT scans show small nodules in the left (a) and right (b) adrenal glands (arrows). The remaining portions of the glands do not appear hyperplastic. (c) Photomicrograph (original magnification, x200; H-E stain) (left) shows nodules of enlarged and hyperchromatic cells (hyperplastic adrenocortical cells) (arrowhead) alternating with normal adrenocortical parenchyma (A). Photomicrograph (original magnification, x200; H-E stain) (right) reveals deeply eosinophilic cells with an abundance of lipofuscin pigment (arrows) and a focal cluster of hyperchromatic cells with dark blue staining (H). The latter are hematopoietic cells and are commonly seen incidentally in normal adrenal tissue. These findings indicate the presence of PPNAD, also known as micronodular hyperplasia.