通过对类固醇生成酶进行免疫组化分析诊断出的两名患者的双侧醛固酮生成腺瘤。

Bilateral aldosterone-producing adenomas in two patients diagnosed by immunohistochemical analysis of steroidogenic enzymes.

作者信息

Watanabe N, Tsunoda K, Sasano H, Omata K, Imai Y, Ito S, Abe K

机构信息

Second Department of Internal Medicine, Tohoku University School of Medicine, Sendai, Japan.

出版信息

Tohoku J Exp Med. 1996 Jun;179(2):123-9. doi: 10.1620/tjem.179.123.

DOI:10.1620/tjem.179.123

PMID:8875768

Abstract

Bilateral adrenal aldosterone-producing adenomas (APA) are rare. It is important to distinguish bilateral APA from idiopathic hyperaldosteronism (IHA) which is due to bilateral hyperplasia of the adrenal cortex. We present two patients with bilateral APA in whom the diagnosis was made histochemically by analyzing steroidogenic enzymes. They showed hypokalemia, high plasma aldosterone concentration (PAC) and suppressed plasma renin activity (PRA). Bilateral adrenal tumors were represented by computed tomography, and surgical resection was performed. In both cases, cytochrome P-450 and other enzymes that were involved in aldosterone synthesis were found mainly in tumor, but little in the zona glomerulosa of the adjacent adrenals, which showed paradoxical hyperplasia. Such cases are difficult to distinguish from IHA. The two disorders were differentiated by immunohistochemical analysis of steroidogenic enzymes.

摘要

双侧肾上腺醛固酮分泌性腺瘤（APA）较为罕见。将双侧APA与因肾上腺皮质双侧增生所致的特发性醛固酮增多症（IHA）区分开来很重要。我们报告了两名双侧APA患者，通过分析类固醇生成酶进行组织化学诊断。他们表现为低钾血症、高血浆醛固酮浓度（PAC）和血浆肾素活性（PRA）受抑制。通过计算机断层扫描显示双侧肾上腺肿瘤，并进行了手术切除。在这两个病例中，发现参与醛固酮合成的细胞色素P - 450和其他酶主要存在于肿瘤中，而相邻肾上腺的球状带中含量很少，且球状带表现为矛盾性增生。此类病例很难与IHA区分。通过对类固醇生成酶进行免疫组织化学分析来区分这两种疾病。