دورية
Radiologically defined lipid-poor adrenal adenomas: histopathological characteristics
| العنوان: | Radiologically defined lipid-poor adrenal adenomas: histopathological characteristics |
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| المؤلفون: | De Leo, A., Mosconi, C., Zavatta, G., Tucci, L., Nanni, C., Selva, S., Balacchi, C., Ceccarelli, C., Santini, D., Pantaleo, M. A., Minni, F., Fanti, S., Golfieri, R., Pagotto, U., Vicennati, V., Di Dalmazi, G. |
| المصدر: | Journal of Endocrinological Investigation; 20240101, Issue: Preprints p1-8, 8p |
| مستخلص: | Background: Adrenal lipid-poor adenomas (LPA) are defined by high unenhanced density (≥ 10 HU), and absolute and relative contrast medium washout > 60% and > 40%, respectively, at computerized tomography (CT). To date, no thorough histopathological characterization has been performed in those frequent lesions (one-third of adrenal adenomas). Our aim was to analyze the histopathological characteristics of adrenal LPA. Methods: Patients with LPA (n= 57) were selected among consecutive subjects referred for an adrenal incidentaloma or ACTH-independent Cushing syndrome. FluoroDeoxyGlucose-Positron Emission Tomography (FDG-PET) was performed in 37 patients. In patients treated by adrenalectomy (n= 17), Weiss score and Lin–Weiss–Bisceglia score (in tumors composed entirely or predominantly of oncocytes) were calculated. Results: Radiological parameters did not differ among patients with ACTH-independent Cushing syndrome (n= 6) and those with adrenal incidentalomas associated with primary aldosteronism (n= 2), autonomous cortisol secretion (n= 14), or non-functioning (n= 35). Patients treated by adrenalectomy had larger tumors (28.9 ± 11.2 vs17.3 ± 8.4 mm,P< 0.001), higher CT unenhanced density (29.1 ± 11.0 vs23.1 ± 9.0 HU, P= 0.043), and FDG-PET adrenal uptake (9.0 ± 6.4 vs4.4 ± 2.3 SUV, P= 0.003) than non-operated ones. Oncocytic features > 75% of the tumor were detected in 12/17 cases (70.6%). Five of those showed borderline-malignant histopathological characteristics by Lin–Weiss–Bisceglia score. Among remaining non-oncocytic tumors, 1/5 had a Weiss score ≥ 3. Overall, 6/17 tumors (35.3%) had borderline-malignant potential. Radiological parameters were similar between patients with benign and borderline-malignant tumors. Conclusions: Adrenal LPA are a heterogeneous group of tumors, mostly composed of oncocytomas. Up to 1/3 of those tumors may have a borderline-malignant potential at histopathology. |
| قاعدة البيانات: | Supplemental Index |
| تدمد: | 03914097 17208386 |
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| DOI: | 10.1007/s40618-020-01198-5 |