Journal
JOURNAL OF CLINICAL ENDOCRINOLOGY & METABOLISM
Volume 106, Issue 1, Pages 42-54Publisher
ENDOCRINE SOC
DOI: 10.1210/clinem/dgaa484
Keywords
primary aldosteronism; diagnostic histopathology; CYP11B2; adrenal gland; immunohistochemistry
Categories
Funding
- European Research Council (ERC) under the European Union's Horizon 2020 research and innovation program [694913]
- Deutsche Forschungsgemeinschaft (DFG, German Research Foundation) [314061271-TRR 205]
- Clinician Scientist PRogram In Vascular MEdicine (PRIME) [MA 2186/14-1]
- German Conn Registry-Else-Kroner Hyperaldosteronism Registry [2015_A171, 2019_A104]
- Clinical Research Priority Program of the University of Zurich for the CRPP Hypertension Research Network (HYRENE)
- National Heart, Lung and Blood Institute [R01 HL144847]
- National Institute of General Medical Sciences [U54 GM115428]
- National Institute of Diabetes and Digestive and Kidney Diseases [R01 DK106618]
- JSPS KAKENHI (Japan Society for the Promotion of Science) [JP18K08500]
- Health Labour Sciences Research grant [H29-Nanji-Ippan-046]
Ask authors/readers for more resources
The HISTALDO 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.
T 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.
Authors
I am an author on this paper
Click your name to claim this paper and add it to your profile.
Reviews
Recommended
No Data Available