ArticleEndocrine2017
Histopathological and genetic characterization of aldosterone-producing adenomas with concurrent subclinical cortisol hypersecretion: a case series.
Article in Endocrine, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 19 papers, 1 of them a synthesis that pooled it.
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Who cites it
19 citing papers in PubMed, 1 synthesis or guideline pooled it, 28 citations in OpenAlex.
- Cortisol Co-Secretion and Clinical Usefulness of ACTH Stimulation Test in Primary Aldosteronism: A Systematic Review and Biases in Epidemiological Studies.Frontiers in endocrinology · 2021Pooled it
- Primary Hyperaldosteronism: Epidemiology, Diagnosis, and Clinical Associations.Epidemiologia (Basel, Switzerland) · 2026Review
- Review
- Clinical significance of parathyroid hormone in mineral and glucose metabolism disorders among patients with primary aldosteronism.SAGE open medicine · 2025Article
- Autonomous cortisol secretion in patients with primary aldosteronism: prevalence and implications on cardiometabolic profile and on surgical outcomes.Endocrine connections · 2023Article
- High plasma aldosterone concentration is associated with worse 24-h ambulatory blood pressure profile in patients with primary aldosteronism.Hypertension research : official journal of the Japanese Society of Hypertension · 2023Article
- Primary Aldosteronism: State-of-the-Art Review.American journal of hypertension · 2022Article
- The Entity of Connshing Syndrome: Primary Aldosteronism with Autonomous Cortisol Secretion.Diagnostics (Basel, Switzerland) · 2022Review
- Primary aldosteronism - a multidimensional syndrome.Nature reviews. Endocrinology · 2022Review
- Primary aldosteronism: Pathophysiological mechanisms of cell death and proliferation.Frontiers in endocrinology · 2022Review
- Exploration of KCNJ5 Somatic Mutation and CYP11B1/CYP11B2 Staining in Multiple Nodules in Primary Aldosteronism.Frontiers in medicine · 2022Article
- Review
- Hypertension with unilateral adrenal aldosterone and cortisol cosecreting adenoma: A case report.Journal of clinical hypertension (Greenwich, Conn.) · 2021Article
- Bioinformatics-Based Identification of HDAC Inhibitors as Potential Drugs to Target EGFR Wild-Type Non-Small-Cell Lung Cancer.Frontiers in oncology · 2021Article
- Immunohistochemical Analysis of CYP11B2, CYP11B1 and β-catenin Helps Subtyping and Relates With Clinical Characteristics of Unilateral Primary Aldosteronism.Frontiers in molecular biosciences · 2021Article
- Primary aldosteronism concurrent with subclinical Cushing's syndrome: a case report and review of the literature.Journal of medical case reports · 2020Review
- Cortisol levels after cold exposure are independent of adrenocorticotropic hormone stimulation.PloS one · 2020Article
- Abnormal Dexamethasone Suppression Tests in a Rifapentine-Treated Patient With Primary Aldosteronism.Frontiers in endocrinology · 2020Article
- Advances in adrenal tumors 2018.Endocrine-related cancer · 2018Review
Corrections and comments
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Authors and funding
12 authors at 5 institutions in 3 countries.
Funding
Abstract
purposeAldosterone-producing adenomas with concurrent subclinical cortisol hypersecretion are reported in an increasing number of patients. Five aldosterone-producing adenomas from patients with primary aldosteronism and subclinical hypercortisolism were examined. THE AIMS OF OUR STUDY WERE: (1) to analyze pathological features and immunohistochemical expression of CYP11B1 (11β-hydroxylase) and CYP11B2 (aldosterone synthase) in these tumors; (2) to investigate somatic mutations involved in adrenal steroid hypersecretion and/or tumor growth.
methodsArchival micro-dissected paraffin-embedded slides from tumor specimens were used for histological and molecular studies. Immunohistochemistry was performed using monoclonal anti-CYP11B1 and anti-CYP11B2 antibodies. Cellular composition was determined by examining for known features of zona fasciculata and zona glomerulosa, and immunoreactivity for CYP11B1 and CYP11B2 by McCarty H-score. Spot regions for mutations in KCNJ5, ATP1A1, ATP2B3, CACNA1D, PRKACA, and CTNNB1 gene sequences were evaluated.
resultsFour APAs showed a predominant (≥50%) zona fasciculata-like cell pattern: one tumor had CYP11B1 H-score = 150, no detectable CYP11B2 expression, and harbored a PRKACA p.Leu206Arg mutation (that we have reported previously elsewhere), one had no CYP11B1 expression, CYP11B2 H-score = 40, and no mutations; the remaining two adenomas had high CYP11B1 H-score (160 and 240, respectively) and low CYP11B2 H-score (30 and 15, respectively), with the latter harboring a CTNNB1 p.Ser45Phe activating mutation. One of five aldosterone-producing adenomas had a predominant zona glomerulosa-like pattern, CYP11B1 H-score = 15, CYP11B2 H-score = 180, and no mutations.
conclusionsThe majority of aldosterone-producing adenomas with concurrent subclinical cortisol hypersecretion were composed mainly of zona fasciculata-like cells, while CYP11B1 and CYP11B2 immunostaining demonstrated clear heterogeneity. In a subset of cases, different somatic mutations may be involved in hormone excess and tumor formation.
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