BACKGROUND: In primary aldosteronism (PA) the main source of aldosterone hypersecretion is an aldosterone-producing adenoma (APA) or a bilateral hyperplasia. Histopathology of the adrenal gland from patients with PA has been difficult, as there are no morphological criteria to ascertain which are the cells that produce aldosterone. We therefore applied new specific antibodies to explore which cells in the adrenal contain the enzymes for aldosterone and cortisol production, respectively. METHODS: Adrenals from 24 patients with PA were studied. After routine preparation, consecutive sections were stained with antibodies for CYP11B1 (cortisol) and CYP11B2 (aldosterone) enzymes. RESULTS: APA had a strong immunoreactivity for CYB11B2. In adrenals from seven patients, we found no APA, but several nodules with strong CYB11B2 immunoreactivity, indicating aldosterone-producing nodular hyperplasia. CONCLUSIONS: Immunohistochemistry of adrenal steroidogenic enzymes provides novel diagnostic information. This may become an important part of routine histopathology, and contribute to improved clinical management in PA.
BACKGROUND: In primary aldosteronism (PA) the main source of aldosterone hypersecretion is an aldosterone-producing adenoma (APA) or a bilateral hyperplasia. Histopathology of the adrenal gland from patients with PA has been difficult, as there are no morphological criteria to ascertain which are the cells that produce aldosterone. We therefore applied new specific antibodies to explore which cells in the adrenal contain the enzymes for aldosterone and cortisol production, respectively. METHODS: Adrenals from 24 patients with PA were studied. After routine preparation, consecutive sections were stained with antibodies for CYP11B1 (cortisol) and CYP11B2 (aldosterone) enzymes. RESULTS: APA had a strong immunoreactivity for CYB11B2. In adrenals from seven patients, we found no APA, but several nodules with strong CYB11B2 immunoreactivity, indicating aldosterone-producing nodular hyperplasia. CONCLUSIONS: Immunohistochemistry of adrenal steroidogenic enzymes provides novel diagnostic information. This may become an important part of routine histopathology, and contribute to improved clinical management in PA.
Authors: Francesca Gioco; Teresa Maria Seccia; Elise P Gomez-Sanchez; Gian Paolo Rossi; Celso E Gomez-Sanchez Journal: Hypertension Date: 2015-08-03 Impact factor: 10.190
Authors: Tracy Ann Williams; Celso E Gomez-Sanchez; William E Rainey; Thomas J Giordano; Alfred K Lam; Alison Marker; Ozgur Mete; Yuto Yamazaki; Maria Claudia Nogueira Zerbini; Felix Beuschlein; Fumitoshi Satoh; Jacopo Burrello; Holger Schneider; Jacques W M Lenders; Paolo Mulatero; Isabella Castellano; Thomas Knösel; Mauro Papotti; Wolfgang Saeger; Hironobu Sasano; Martin Reincke Journal: J Clin Endocrinol Metab Date: 2021-01-01 Impact factor: 5.958