title: Immunohistochemistry improves histopathologic diagnosis in primary aldosteronism.
abstract: 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: Department of Molecular Medicine and Surgery, Karolinska Institutet, Stockholm, Sweden. cristina.dahlqvist-volpe@sodersjukhuset.se
authors: Cristina
authors: C
authors: Volpe
authors: Anders
authors: A
authors: Höög
authors: Tadashi
authors: T
authors: Ogishima
authors: Kuniaki
authors: K
authors: Mukai
authors: Ming
authors: M
authors: Lu
authors: Marja
authors: M
authors: Thorén
authors: Bertil
authors: B
authors: Hamberger
mesh_terms: D000306:Adrenal Cortex Neoplasms / Q000150:complications / Q000201:enzymology* / Q000473:pathology; D000311:Adrenal Glands / Q000201:enzymology* / Q000473:pathology; D018246:Adrenocortical Adenoma / Q000150:complications / Q000201:enzymology* / Q000473:pathology; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000032:analysis; D019405:Cytochrome P-450 CYP11B2 / Q000032:analysis*; D005260:Female; D006801:Humans; D006929:Hyperaldosteronism / Q000201:enzymology* / Q000209:etiology / Q000473:pathology; D006965:Hyperplasia; D007150:Immunohistochemistry; D008297:Male; D008875:Middle Aged; D011237:Predictive Value of Tests; D013252:Steroid 11-beta-Hydroxylase / Q000032:analysis*
chemical_list: D015415:Biomarkers; D019405:Cytochrome P-450 CYP11B2; D013252:Steroid 11-beta-Hydroxylase