Key result
Genomic analysis of novel APCC-to-APA transitional lesions reveals mutations suggesting mAPA develops from APCCs.
Why the study?
There has been no report describing an APCC-to-APA transitional lesion despite evidence that APCCs produce aldosterone autonomously and may be an origin of APA.
Population
Two patients with primary aldosteronism and unilateral multiple adrenocortical micronodules
Comparison
APCC-like portions versus mAPA-like portions within pAATLs
Design
Case report with histological, immunohistochemical, and next-generation sequencing analyses
Authors
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Should not alter primary aldosteronism management; hypothesis-generating for APCC-to-APA progression and needs validation in larger cohorts.
Case Report (n=2)
Identified a novel aldosterone-producing pathology (pAATL) and provided genetic evidence that aldosterone-producing adenomas may develop from existing subcapsular aldosterone-producing cell clusters via somatic mutations.
Nishimoto et al. (2015) conducted a case report in Primary aldosteronism (n=2). Histological and genomic examination of possible APCC-to-APA transitional lesions (pAATLs) was evaluated on Identification of APA-associated somatic mutations in pAATLs. Histological and genomic analysis of two patients with primary aldosteronism identified novel APCC-to-APA transitional lesions harboring APA-associated mutations, suggesting mAPA develops from APCCs.
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