Functional Pathology of Aldosterone‐producing Adenoma

Abstract

In addition to the morphological examination, the measurement of the content of corticosteroids was done in aldosterone-producing adenoma. Histologically, the adenoma consists of four types of cells. The major component of the adenoma was clear-type cells. In this type of cells, the activities of 38hydroxysteroid dehydrogenase and glucose-6-phosphate dehydrogenaee showed weakly positive. The Ane structure was characterized by numerous lipid vacuoles and poor organellae. On the contrary, intermediate-and compact-type cells revealed higher than moderate activities of these enzymes. Moreover, marked development of smooth endoplasmic reticulum and mitochondria was noted. Zona glomerulosa-type cells were observed only in a small part. The content of aldosterone and corticosterone in aldosterone-producing adenoma was signiflcantly larger than those of the other type of adenoma. A tendency of positive correlation between the increase of compact-type cells and content of aldosterone was found. The cell origin of this aldosterone-producing adenoma and functional role of clear-and compact-type cells were also discussed. ACTA PATHOL. JPN. 30: 961-976, 1980. IntraEuctionAldosterone-producing tumors have been shown to have considerable macroscopic and histological characteristics. Such reports, however, were either limited to histological observations alonelo or a t the level of case reports including electron microscopic o b~e r v a t i o n s~~,~~.In the present study, the morphology of aldosterone-producing tumor was studied by histological, enzyme histochemical and electron microscopic methods. At the same time, further analysis was attempted from the viewpoint of functional pathology utilizing quantitative procedure of corticosteroid hormones in the tumor. -~ ___--*:Crr %9& W e BLP, E[B1 S& #ah, I%% FIT All communication and reprint requests to: Prof. Hideo TSUCHIYAMA,

Comparative studies between hormone contents and morphological appearances in human adrenal cortex. - Special reference to non-functioning tumors (adenoma and adenomatous nodule) and functioning adenoma.

“…Therefore, it is suggested that compact-type cells play an important role in synthesis and secretion of aldosterone, and that clear-type cells play a role mainly in the storage of steroid precursors. These results support Tsuchiyama's speculation (20,21,23), and they differ slightly from the result obtained by Harada (7). This difference is probably due to the difference of methods of measuring the steroid content and cell proportion.…”

“…Adrenocortical tumors are composed of clear-type cells with large amount of lipid droplets and compact-type cells with a few or no fine lipid granules (20,21). Symington et al (17,18,19) and Tsuchiyama (20,21,23) have suggested that cleartype cells play a role in the storage of steroid precursors and that compact-type cells TABLE 1. Cases of non-functioning tumor; primary aldosteronism and Cushing's syndrome play a role in active synthesis and secretion of steroids.…”

11.BETA.-hydroxylase in mitochondrial fractions of functioning and non-functioning adrenocortical tumors.

“…Very interestingly several ultrastructural studies revealed that the shape of mitochondria varied remarkably from case to case of adrenocortical adenoma and carcinoma ; Tuchiyama et al 1980). This finding implies some possible abnormality of mitochondrial steroidogenic enzyme activities.…”

Regulatory Role of ACTH on Aldosterone in Aldosterone-Producing Adenoma

“…Another type of cells have large amounts of intracellular lipid and are similar to zona fasciculata (ZF) cells 28 (ZF cells are responsible for producing and secreting cortisol, rather than aldosterone, in normal condition and express higher level of ACTH receptor than ZG cells). Also, a hybrid of the two types of cells above has been reported 28 .…”

“…One type of the cells have little lipid storage in cytoplasm and morphologically resemble the cells in zona glomerulosa (ZG) of the adrenal gland 28 , which is the site of physiological aldosterone production under the regulation of AII 28 . Another type of cells have large amounts of intracellular lipid and are similar to zona fasciculata (ZF) cells 28 (ZF cells are responsible for producing and secreting cortisol, rather than aldosterone, in normal condition and express higher level of ACTH receptor than ZG cells). Also, a hybrid of the two types of cells above has been reported 28 .…”