Weiss System (Adrenocortical Carcinoma)

Weiss system for adrenocortical carcinoma: nine histopathologic criteria, each 1 point.

Open the calculator → Runs in your browser. Data leaves only if you deliberately send a problem report from the interactive tool.

Example

High nuclear grade
Yes
Mitotic rate > 5 per 50 HPF
Yes
Necrosis
Yes

Result: Weiss 3 of 9 — >= 3: adrenocortical carcinoma (malignant).

The tool opens with these values already filled in. Replace them with your own.

What the result means

Threshold
≥ 3 indicates adrenocortical carcinoma (malignant); 0-2 a benign adenoma. This is the 1989 modified cutoff (the 1984 original used ≥ 4).

What you enter

  • High nuclear grade (Fuhrman III-IV)
  • Mitotic rate > 5 per 50 HPF
  • Atypical mitotic figures
  • Clear (lipid-rich) cells <= 25% of the tumor
  • Diffuse architecture (> 33% of the tumor)
  • Necrosis
  • Venous invasion
  • Sinusoidal invasion
  • Capsular invasion
How this is calculated
Criteria
9 items, 1 point each: high nuclear grade, mitoses > 5/50 HPF, atypical mitoses, clear cells ≤ 25%, diffuse architecture > 33%, necrosis, and venous, sinusoidal, and capsular invasion.

Weiss LM, Medeiros LJ, Vickery AL Jr. Pathologic features of prognostic significance in adrenocortical carcinoma. Am J Surg Pathol. 1989;13(3):202-206. (Original: Weiss LM. Am J Surg Pathol. 1984;8(3):163-169.) Read the sources: Weiss 1989 ↗, Weiss 1984 ↗

A reference and educational tool. Not medical, legal, or financial advice, and not a substitute for clinician judgment.

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Built by Clay Good. Source on GitHub.