It is always bilateral, chronic and progressive. The loss of the cortical tissus is in some cases complete, the medulla being spared. An apparently secondary and final involvement of the medulla however has been reported. It belongs to the ultimate phase of the disease. Within the cortex, the Glomerulosa may be partly spared containing but a few droplets of Lipoids, so that actually the main lesion concerns the two inner cortical layers. There is practically no regenerative power (Kovács) and no inflammatory reaction. The stroma remains intact. There are no adhesions to the adjacent tissues. Accessory nodes are involved in the same necrotizing process. Duffin stressed the close resemblance of both Adrenals, each one being of the same weight and containing approximately the identical amount of residual cortex. Smallness of heart and Aorta, underdevelopment of secondary sexual characters, late menarche, Status lymphaticus, familial incidence are interesting features. Association with atrophy
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