title: Analysis of unilateral adrenal hyperplasia with primary aldosteronism from the aspect of messenger ribonucleic acid expression for steroidogenic enzymes: a comparative study with adrenal cortices adhering to aldosterone-producing adenoma.
abstract: Unilateral adrenal hyperplasia with primary aldosteronism is very rare and shows similar endocrine features to aldosterone-producing adenoma and bilateral adrenal hyperplasia. In this study, the mRNA expression of steroidogenic enzymes in unilateral adrenal hyperplasia was examined by in situ hybridization. We found subcapsular micronodules composed of spironolactone body-containing cells, which showed intense expression for 3beta-hydroxysteroid dehydrogenase, 11beta-hydroxylase, 18-hydroxylase, and 21-hydroxylase but not 17alpha-hydroxylase, indicating aldosterone production. This expression pattern was the same as that in unilateral multiple adrenocortical micronodules, reported recently. Additionally, it was noted that a nodule with active aldosterone production was closely adjacent to one showing intense 17alpha-hydroxylase expression. In the adrenal cortices adhering to aldosterone-producing adenoma, the majority of hyperplastic zona glomerulosa and hyperplastic nodules demonstrated a decreased steroidogenic activity. However, minute nodules indicative of active aldosterone production were found at high frequency. These results suggest that the subcapsular micronodules observed might be the root of aldosterone-producing adenoma. Furthermore, we emphasize the need for long-term follow-up after unilateral adrenalectomy or enucleation of the adenoma because of the possibility that buds with autonomous aldosterone production may still be present in the contralateral or remaining adrenal tissue.
authors.affiliation: Division of Pathology, Nagasaki University Graduate School of Biomedical Sciences, Sakamoto, Japan.
authors.forename: Kazuto
authors.initials: K
authors.lastname: Shigematsu
authors.forename: Kioko
authors.initials: K
authors.lastname: Kawai
authors.forename: Junji
authors.initials: J
authors.lastname: Irie
authors.forename: Hideki
authors.initials: H
authors.lastname: Sakai
authors.forename: Osamu
authors.initials: O
authors.lastname: Nakashima
authors.forename: Atsushi
authors.initials: A
authors.lastname: Iguchi
authors.forename: Junichiro
authors.initials: J
authors.lastname: Shimamatsu
authors.forename: Kazuhide
authors.initials: K
authors.lastname: Shimamatsu
authors.forename: Yasuyuki
authors.initials: Y
authors.lastname: Kusaba
authors.forename: Osamu
authors.initials: O
authors.lastname: Takahara
mesh_terms: D015096:3-Hydroxysteroid Dehydrogenases / Q000235:genetics / Q000378:metabolism; D000236:Adenoma / Q000201:enzymology* / Q000235:genetics / Q000473:pathology; D000302:Adrenal Cortex / Q000201:enzymology / Q000473:pathology*; D000306:Adrenal Cortex Neoplasms / Q000201:enzymology* / Q000235:genetics / Q000473:pathology; D019405:Cytochrome P-450 CYP11B2 / Q000235:genetics / Q000378:metabolism; D007839:Functional Laterality; D015972:Gene Expression Regulation, Neoplastic; D006801:Humans; D006929:Hyperaldosteronism / Q000201:enzymology* / Q000235:genetics; D006965:Hyperplasia / Q000201:enzymology / Q000235:genetics; D017403:In Situ Hybridization; D012333:RNA, Messenger / Q000378:metabolism*; D013252:Steroid 11-beta-Hydroxylase / Q000235:genetics / Q000378:metabolism; D013255:Steroid 21-Hydroxylase / Q000235:genetics / Q000378:metabolism; D013250:Steroid Hydroxylases / Q000235:genetics* / Q000378:metabolism
chemical_list: D012333:RNA, Messenger; D015096:3-Hydroxysteroid Dehydrogenases; D013250:Steroid Hydroxylases; D013255:Steroid 21-Hydroxylase; D019405:Cytochrome P-450 CYP11B2; D013252:Steroid 11-beta-Hydroxylase