Cushing syndrome-associated pheochromocytoma and adrenal carcinoma. An immunohistological investigation.
Seven adrenal carcinomas and seventeen pheochromocytomas (PHs), two of which were clinically associated with a Cushing's syndrome and one associated with multiple endocrine neoplasia Type II (MEN-II), were investigated immunohistologically with a panel of antibodies against intermediate filament proteins, a proliferation-associated nuclear antigen (Ki-67), neuroendocrine tumor markers, and different hormones on paraffin-embedded tissue sections and, from 19 cases, also on frozen tissue sections. Synaptophysin proved to be the most reliable tumor cell marker on both snap-frozen and paraffin-embedded tissue but, like antibodies against NSE, yielded unspecific stainings in the carcinomas. The two Cushing-associated pheochromocytomas (CaPH) showed the same immunohistological profile as the other PHs, except one chromogranin-negative tumor. Five PHs showed weak reactivity for calcitonin, one for serotonin, and two for a-HCG in small amounts. All PHs lacked other hormone expression, including ACTH. The average growth fraction was small (2.2%) in 13 cases, but 80% of the tumor cells were proliferating in one case of CaPH. Adrenal carcinomas showed only weak or no expression of keratin in one case, a homogenous or droplet, non-filamentous cytoplasmic staining with antibodies against neurofilament in frozen tissue section, and they were completely chromogranin-negative. The average growth fraction was 7.6% in 5 cases.
Hartmann
C A
CA
Institute of Pathology, Klinikum Steglitz, Free University of Berlin, FRG.
Gross
U
U
Stein
H
H
D000293:Adolescent; D000310:Adrenal Gland Neoplasms / Q000737:chemistry* / Q000150:complications / Q000473:pathology; D000328:Adult; D000368:Aged; D002648:Child; D002864:Chromogranins / Q000032:analysis; D003480:Cushing Syndrome / Q000150:complications / Q000378:metabolism*; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007382:Intermediate Filaments / Q000737:chemistry; D008297:Male; D008875:Middle Aged; D010673:Pheochromocytoma / Q000737:chemistry* / Q000150:complications / Q000473:pathology; D016708:Synaptophysin / Q000032:analysis
D002864:Chromogranins; D016708:Synaptophysin