Shigematsu Kazuto, Nakagaki Takehiro, Yamaguchi Naohiro, Kawai Kioko, Sakai Hideki, Takahara Osamu
Division of Pathology, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki 852-8523, Japan.
Eur J Endocrinol. 2008 Jun;158(6):867-78. doi: 10.1530/EJE-07-0626.
We have recently demonstrated that the adrenal cortices attached to aldosterone-producing adenoma (APA) contained microscopic subcapsular micronodules suggestive of active aldosterone production. In this study, we used in situ hybridization to investigate the mRNA expression of steroidogenic enzymes in the adrenal cortices attached to cortisol-producing adenoma (CPA) and clinically silent adenoma (non-functioning adenoma; NFA), in addition to APA.
Microscopic subcapsular micronodules, which were several hundreds of micrometers in size and spheroid in shape, were observed in the cortices attached to CPA and NFA, as well as APA, at high frequency. Most of the cortical nodules in zona fasciculata to zona reticularis showed a suppressed steroidogenesis in the cortices attached to adenoma, but some expressed intensely all necessary steroidogenic enzyme mRNAs for cortisol synthesis.
It is thus necessary to keep in mind, on the occasion of subtotal adrenalectomy, that lesions with the potential to later develop into functional adrenocortical nodules may be present in other parts of the ipsilateral or contralateral adrenal cortices.
我们最近证实，与醛固酮分泌性腺瘤（APA）相连的肾上腺皮质含有微小的包膜下小结节，提示有活跃的醛固酮生成。在本研究中，除了APA，我们还使用原位杂交技术研究了与皮质醇分泌性腺瘤（CPA）和临床无功能腺瘤（非功能性腺瘤；NFA）相连的肾上腺皮质中类固醇生成酶的mRNA表达。
在与CPA、NFA以及APA相连的皮质中，高频观察到大小为数百微米、呈球形的微小包膜下小结节。束状带至网状带的大多数皮质结节在与腺瘤相连的皮质中显示类固醇生成受抑制，但有些强烈表达了皮质醇合成所需的所有类固醇生成酶mRNA。
因此，在进行肾上腺次全切除术时，必须牢记同侧或对侧肾上腺皮质的其他部位可能存在有日后发展为功能性肾上腺皮质结节潜力的病变。
