International Histopathology Consensus for Unilateral Primary Aldosteronism

Author:

Williams Tracy Ann12ORCID,Gomez-Sanchez Celso E3,Rainey William E45,Giordano Thomas J56,Lam Alfred K7,Marker Alison8,Mete Ozgur910,Yamazaki Yuto11,Zerbini Maria Claudia Nogueira12,Beuschlein Felix113ORCID,Satoh Fumitoshi14,Burrello Jacopo2ORCID,Schneider Holger1,Lenders Jacques W M1516,Mulatero Paolo2ORCID,Castellano Isabella17,Knösel Thomas18,Papotti Mauro19,Saeger Wolfgang20,Sasano Hironobu11ORCID,Reincke Martin1ORCID

Affiliation:

1. Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Ludwig-Maximilians-Universität München, Germany

2. Division of Internal Medicine and Hypertension, Department of Medical Sciences, University of Turin, Turin, Italy

3. Endocrine Division, G.V. (Sonny) Montgomery VA Medical Center, and Department of Pharmacology and Toxicology and Medicine, University of Mississippi Medical Center, Jackson, MS, USA

4. Department of Molecular and Integrative Physiology, University of Michigan, Ann Arbor, MI, USA

5. Division of Metabolism, Endocrine, and Diabetes, Department of Internal Medicine, University of Michigan, Ann Arbor, MI, USA

6. Department of Pathology and Rogel Cancer Center, University of Michigan, Ann Arbor, MI, USA

7. School of Medicine, Griffith University, Gold Coast, Australia

8. Department of Histopathology, Cambridge University NHS Foundation Trust, Cambridge, UK

9. Department of Pathology, University Health Network, Toronto, Canada

10. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Canada

11. Department of Pathology, Tohoku University Graduate School of Medicine, Sendai, Japan

12. Departamento de Patologia, Faculdade de Medicina da Universidade de Sao Paulo, Sao Paulo, Brazil

13. Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Universitätsspital Zürich, Zürich, Switzerland

14. Division of Clinical Hypertension, Endocrinology and Metabolism, Tohoku University Graduate School of Medicine, Sendai, Japan

15. Department of Internal Medicine, Radboud University Medical Center, Nijmegen, The Netherlands

16. Department of Medicine III, University Hospital Carl Gustav Carus, Technical University Dresden, Dresden, Germany

17. Division of Pathology, Department of Medical Sciences, University of Turin, Turin, Italy

18. Institute of Pathology, Ludwig-Maximilians-Universität München, Germany

19. Department of Oncology, University of Turin, Turin, Italy

20. Institute of Pathology, Universität Hamburg, Germany

Abstract

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.

Funder

European Research Council

European Union’s Horizon 2020

Deutsche Forschungsgemeinschaft

Clinician Scientist PRogram In Vascular MEdicine

Else Kröner-Fresenius Stiftung

German Conn Registry-Else-Kröner Hyperaldosteronism Registry

Clinical Research Priority Program of the University of Zurich

CRPP Hypertension Research Network

National Heart, Lung, and Blood Institute

National Institute of General Medical Sciences

National Institute of Diabetes and Digestive and Kidney Diseases

Japan Society for the Promotion of Science

Health Labour Sciences Research

Publisher

The Endocrine Society

Subject

Biochemistry (medical),Clinical Biochemistry,Endocrinology,Biochemistry,Endocrinology, Diabetes and Metabolism

同舟云学术

1.学者识别学者识别

2.学术分析学术分析

3.人才评估人才评估

"同舟云学术"是以全球学者为主线,采集、加工和组织学术论文而形成的新型学术文献查询和分析系统,可以对全球学者进行文献检索和人才价值评估。用户可以通过关注某些学科领域的顶尖人物而持续追踪该领域的学科进展和研究前沿。经过近期的数据扩容,当前同舟云学术共收录了国内外主流学术期刊6万余种,收集的期刊论文及会议论文总量共计约1.5亿篇,并以每天添加12000余篇中外论文的速度递增。我们也可以为用户提供个性化、定制化的学者数据。欢迎来电咨询!咨询电话:010-8811{复制后删除}0370

www.globalauthorid.com

TOP

Copyright © 2019-2024 北京同舟云网络信息技术有限公司
京公网安备11010802033243号  京ICP备18003416号-3