International Histopathology Consensus for Unilateral Primary Aldosteronism

Abstract 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 syntha...

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Vydáno v:	The journal of clinical endocrinology and metabolism Ročník 106; číslo 1; s. 42 - 54
Hlavní autoři:	Williams, Tracy Ann, Gomez-Sanchez, Celso E, Rainey, William E, Giordano, Thomas J, Lam, Alfred K, Marker, Alison, Mete, Ozgur, Yamazaki, Yuto, Zerbini, Maria Claudia Nogueira, Beuschlein, Felix, Satoh, Fumitoshi, Burrello, Jacopo, Schneider, Holger, Lenders, Jacques W M, Mulatero, Paolo, Castellano, Isabella, Knösel, Thomas, Papotti, Mauro, Saeger, Wolfgang, Sasano, Hironobu, Reincke, Martin
Médium:	Journal Article
Jazyk:	angličtina
Vydáno:	US Oxford University Press 01.01.2021 Copyright Oxford University Press
Témata:	Adrenal Glands - metabolism Adrenal Glands - pathology Adrenalectomy - methods Adrenalectomy - standards Adult Aldosterone Aldosterone synthase Clinical s Cohort Studies Consensus Corticosteroids Cytochrome P-450 Cytochrome P-450 CYP11B2 - metabolism Cytodiagnosis - methods Cytodiagnosis - standards Diagnosis Diagnostic Techniques, Endocrine - standards Female Germany Histological Techniques - standards Histopathology Humans Hyperaldosteronism Hyperaldosteronism - complications Hyperaldosteronism - diagnosis Hyperaldosteronism - surgery Hypertension Hypertension - diagnosis Hypertension - etiology Hypertension - surgery Immunohistochemistry Internationality Male Medical screening Middle Aged Nomenclature Practice Guidelines as Topic - standards Societies, Medical - standards Germany Japan diagnostic histopathology adrenal gland immunohistochemistry CYP11B2 primary aldosteronism
ISSN:	0021-972X, 1945-7197, 1945-7197
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Shrnutí:	Abstract 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.
Bibliografie:	ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 ObjectType-Undefined-3 These authors contributed equally.
ISSN:	0021-972X 1945-7197 1945-7197
DOI:	10.1210/clinem/dgaa484