Endocrine Abstracts

JOINT1628

Introduction: Primary aldosteronism (PA) is the most frequent secondary hypertension, reaching about 5% of all hypertensive population. It is believed that two thirds of PA cases are caused by bilateral idiopathic hyperplasia (BIH) of adrenal cortex. Subjects with PA due to aldosterone-producing adenoma (APA) are diagnosed easier among hypertensive, mostly due to clinical picture of hypokalaemia. The aim of this study was to analyse the type of histopathologic features in patients with primary aldosteronism treated in our Centre for Endocrine Surgery and compare to the finding in adrenal tumour operated due to hypercorticism.

Material and methods: Our study included 40 patients with primary aldosteronism (PA group) and one control group, of 20 patients with hypercorticism due to adrenocortical tumour, 10 with Cushing’ syndrome (CS) and 10 with subclinical CS (SCS).

Results: There was no significant difference between groups related to the age (P = 0.147), nor sex distribution, although a higher number of women in all groups was recorded (P = 0.099). Systolic and diastolic blood pressures were significantly higher in PA group (P = 0.005 and P = 0.002 respectivaly), with the lowest levels in NFA+HT group. The significanteley higher mean arterial pressure (MAP) was also found in PA group (P = 0.001). The largest tumour size was measured in CS+SCS group, then in PA group (P<0.001). All patients with PA had low serum potassium level. On light microscopy, aldosterone-producing adrenal cortical adenomas appear partially or completely encapsulated, with a compressed fibrous rim or fibrous “pseudocapsule” at the expansile borders of the tumor. The morphology of individual cells may be quite heterogeneous, with varying proportions of 4 different types of cells: clear cells resembling zona fasciculata cells, cells resembling ZG cells, compact cells indistinguishable from those of the zona reticularis, and a group of cells designatedas “hybrid” cells with cytologic features of both zona fasciculata and ZG cells.

Conclusion: We founded that the hybrid celles indipendetly or with ligt cells like zona fscicullata has been predominated in 60% cases with PA, most frequently then in the group SCS+CS.