The pair of adrenals in the center are normal in size. Those at the top come from a patient with adrenal atrophy (with either Addison disease or long-term corticosteroid therapy). The adrenals at the bottom represent bilateral cortical hyperplasia. This could be due to a pituitary adenoma secreting ACTH (Cushing disease), or Cushing syndrome from ectopic ACTH production, or idiopathic adrenal hyperplasia.

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