Flow Cytometric Determinations of Ploidy and Proliferation Patterns of Adrenal Neoplasms: An Adjunct to Histological Classification

Abstract

Flow cytometric deoxyribonucleic acid measurements were performed with propidium iodide on 7 adrenal neoplasms and 4 normal adrenal glands to determine how useful this technique would be in defining malignancy. The 4 cases classified histologically as carcinoma all had aneuploid stemlines of 2.7, 3.3, 3.4 and 3.6c respectively, whereas the 4 normal glands and an aldosteronoma had only a small percentage (less than 10 per cent) of hyperdiploid cells (greater than 2c) at the tetraploid level (4c). A pheochromocytoma and benign adenoma had significant tetraploid populations of 30 and 18 per cent, respectively, with no evidence of aneuploid cells. Flow cytometry determination of deoxyribonucleic acid ploidy values is an accurate, objective, quantitative mean to identify adrenal malignancy and should have a role in the pathological evaluation of adrenal neoplasms.

Adrenocortical Carcinoma

“…Over 30 years ago, cytogenetic and flow cytometry techniques began to be applied to study ACC (179). One of the first genetic assessments with flow cytometry revealed aneuploidy (a genomic aberration consistently observed in most cancers) in 4 of 4 ACCs, yet only diploidy or tetraploidy in normal adrenal cortices and benign adrenal tumors (180). These results were validated in 2 larger studies.…”

Different opinions on classification of DNA histograms produced from paraffin‐embedded tissue

“…Key terms: Flow cytometry, histogram classification, paraffin-embedded sample Flow cytometric nuclear DNA content analysis has been shown to predict prognosis in several types of human cancer. The technique has been considered to be objective (4, 11,13,15,16,18) in contrast to, for example, histological grade, which is said to be based largely on subjective criteria (4). As a consequence, there is increasing clinical interest in using DNA flow cytometric data in selection of treatment for cancer patients.…”

Genetics and epigenetics of adrenocortical tumors

“…Karyotyping studies of ACCs demonstrated that ACCs present a large number of chromosomal aberrations, including segmental duplications, rearrangements and aberrant chromosomes. Cytogenetic and flow cytometry studies further corroborated these findings, demonstrating that most ACCs exhibit aneuploidy/polyploidy, while ACAs are almost always diploid (Klein, Kay et al 1985, Bowlby, DeBault et al 1986, Limon, Dal Cin et al 1987, Marks, Wyandt et al 1992). Clonality studies have shown that, while ACCs are invariably of monoclonal origin, some ACAs can be polyclonal (Beuschlein, Reincke et al 1994, Gicquel, Leblond-Francillard et al 1994).…”