Matsuda A, Beniko M, Ikota A, Yamazaki M, Koizumi S, Mizumoto H, Watanabe T, Matsuya K, Kunita H, Mashio Y, Sasano H
Department of Internal Medicine, Kin-ikyo chuo Hospital.
Intern Med. 1996 Dec;35(12):970-5. doi: 10.2169/internalmedicine.35.970.
A 41-year-old woman developed primary aldosteronism due to bilateral multiple aldosterone-producing adenomas (APA). She was suspected to have idiopathic hyperaldosteronism (IHA) 7 years previously. Although preoperative data suggest APA and IHA was suspected in a postoperative microscopic specimen, a definite clinical diagnosis could not be made. Cytochrome P-450 and other enzymes involved in aldosterone synthesis were found in the tumor portions but not in the zona glomerulosa of attached adrenals, which histopathologically showed "paradoxical hyperplasia". This was a rare case of bilateral multiple APA, which could be differentiated from IHA by immunohistochemical analysis of adrenal steroidogenic enzymes.
一名41岁女性因双侧多发性醛固酮瘤（APA）而患上原发性醛固酮增多症。7年前她被怀疑患有特发性醛固酮增多症（IHA）。尽管术前数据提示为APA，且术后显微镜检查标本怀疑为IHA，但仍无法做出明确的临床诊断。在肿瘤组织中发现了参与醛固酮合成的细胞色素P-450和其他酶，但在附着肾上腺的球状带中未发现，组织病理学显示为“矛盾性增生”。这是一例罕见的双侧多发性APA病例，可通过肾上腺类固醇生成酶的免疫组织化学分析与IHA相鉴别。
