International Histopathology Consensus for Unilateral Primary Aldosteronism

被引：178

作者：

Williams, Tracy Ann ^{[1
,2
]}

Gomez-Sanchez, Celso E. ^{[3
]}

Rainey, William E. ^{[4
,5
]}

Giordano, Thomas J. ^{[5
,6
,7
]}

Lam, Alfred K. ^{[8
]}

Marker, Alison ^{[9
]}

Mete, Ozgur ^{[10
,11
]}

Yamazaki, Yuto ^{[12
]}

Nogueira Zerbini, Maria Claudia ^{[13
]}

Beuschlein, Felix ^{[1
,14
]}

Satoh, Fumitoshi ^{[15
]}

Burrello, Jacopo ^{[2
]}

Schneider, Holger ^{[1
]}

Lenders, Jacques W. M. ^{[16
,17
]}

Mulatero, Paolo ^{[2
]}

Castellano, Isabella ^{[18
]}

Knosel, Thomas ^{[19
]}

Papotti, Mauro ^{[20
]}

Saeger, Wolfgang ^{[21
]}

Sasano, Hironobu ^{[12
]}

Reincke, Martin ^{[1
]}

机构：

[1] Klinikum Univ Munchen, Ludwig Maximilians Univ Munchen, Med Klin & Poliklin 4, Munich, Germany

[2] Univ Turin, Dept Med Sci, Div Internal Med & Hypertens, Turin, Italy

[3] Univ Mississippi, Med Ctr, Endocrine Div, GV Sonny Montgomery VA Med Ctr,Dept Pharmacol & T, Jackson, MS 39216 USA

[4] Univ Michigan, Dept Mol & Integrat Physiol, Ann Arbor, MI 48109 USA

[5] Univ Michigan, Dept Internal Med, Div Metab Endocrine & Diabet, Ann Arbor, MI 48109 USA

[6] Univ Michigan, Dept Pathol, Ann Arbor, MI 48109 USA

[7] Univ Michigan, Rogel Canc Ctr, Ann Arbor, MI 48109 USA

[8] Griffith Univ, Sch Med, Gold Coast, Australia

[9] Cambridge Univ NHS Fdn Trust, Dept Histopathol, Cambridge, England

[10] Univ Hlth Network, Dept Pathol, Toronto, ON, Canada

[11] Univ Toronto, Dept Lab Med & Pathobiol, Toronto, ON, Canada

[12] Tohoku Univ, Dept Pathol, Grad Sch Med, Sendai, Miyagi, Japan

[13] Univ Sao Paulo, Dept Patol, Fac Med, Sao Paulo, Brazil

[14] Univ Spital Zurich, Klin Endokrinol Diabetol & Klin Ernahrung, Zurich, Switzerland

[15] Tohoku Univ, Div Clin Hypertens Endocrinol & Metab, Grad Sch Med, Sendai, Miyagi, Japan

[16] Radboud Univ Nijmegen Med Ctr, Dept Internal Med, Nijmegen, Netherlands

[17] Tech Univ Dresden, Univ Hosp Carl Gustav Carus, Dept Med 3, Dresden, Germany

[18] Univ Turin, Dept Med Sci, Div Pathol, Turin, Italy

[19] Ludwig Maximilians Univ Munchen, Inst Pathol, Munich, Germany

[20] Univ Turin, Dept Oncol, Turin, Italy

[21] Univ Hamburg, Inst Pathol, Hamburg, Germany

来源：

JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM | 2021年 / 106卷 / 01期

基金：

日本学术振兴会; 欧洲研究理事会;

关键词：

primary aldosteronism; diagnostic histopathology; CYP11B2; adrenal gland; immunohistochemistry; FUNCTIONAL HISTOPATHOLOGY; ZONA GLOMERULOSA; CELL CLUSTERS; HYPERTENSION; EXPRESSION; MUTATIONS; DIAGNOSIS; OUTCOMES; KCNJ5;

D O I：

10.1210/clinem/dgaa484

中图分类号：

R5 [内科学];

学科分类号：

1002 ; 100201 ;

摘要：

T Objective: Develop a consensus for the nomenclature and definition of adrenal histopathologic features in unilateral primary aldosteronism (PA). Context: Unilateral PA is the most common surgically treated form of hypertension. Morphologic examination combined with CYP11B2 (aldosterone synthase) immunostaining reveals diverse histopathologic features of lesions in the resected adrenals. Patients and methods: Surgically removed adrenals (n = 37) from 90 patients operated from 2015 to 2018 in Munich, Germany, were selected to represent the broad histologic spectrum of unilateral PA. Five pathologists (Group 1 from Germany, Italy, and Japan) evaluated the histopathology of hematoxylin-eosin (HE) and CYP11B2 immunostained sections, and a consensus was established to define the identifiable features. The consensus was subsequently used by 6 additional pathologists (Group 2 from Australia, Brazil, Canada, Japan, United Kingdom, United States) for the assessment of all adrenals with disagreement for histopathologic diagnoses among group 1 pathologists. Results: Consensus was achieved to define histopathologic features associated with PA. Use of CYP11B2 immunostaining resulted in a change of the original HE morphology-driven diagnosis in 5 (14%) of 37 cases. Using the consensus criteria, group 2 pathologists agreed for the evaluation of 11 of the 12 cases of disagreement among group 1 pathologists. Conclusion: The HISTALDO (histopathology of primary aldosteronism) consensus is useful to standardize nomenclature and achieve consistency among pathologists for the histopathologic diagnosis of unilateral PA. CYP11B2 immunohistochemistry should be incorporated into the routine clinical diagnostic workup to localize the likely source of aldosterone production.

引用

页码：42 / 54

页数：13

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