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Primary Aldosteronism with Aldosterone-Producing Adenoma Consisting of Pure Zona Glomerulosa-Type Cells in a Pregnant Woman

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Abstract

Aldosterone-producing adenoma (APA) consisting of pure zona glomerulosa (ZG)-type cells is extremely rare, and primary aldosteronism complicated by pregnancy is also rare. We report a case of APA discovered in a 32-year-old pregnant woman who visited our hospital for hypertension and hypokalemia at 26 weeks gestation. Elevated plasma aldosterone concentration and hypokalemia were observed, and an magnetic resonance imaging scan demonstrated a right adrenal mass. A laparoscopic adrenalectomy was performed because of refractory hypokalemia. Pathologically, the adrenal mass was diagnosed as APA, and in addition to the cytological features, in situ hybridization and real-time polymerase chain reaction proved that all the component cells were ZG-type cells. The cells also showed estrogen receptor β immunoreactivity and melanocortin 2 receptor mRNA expression, suggesting that estrogen and/or ACTH might be related to the proliferation of APA cells during pregnancy. Our case is the first report of APA consisting of ZG-type cells discovered during pregnancy.

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Acknowledgments

The authors thank Mrs. Amanda Nishida for critical comments and Mrs. Kanako Hayashi for technical assistance. The authors did not receive any funding concerning this manuscript and declare that there is no conflict of interest that would prejudice its impartiality.

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Authors and Affiliations

  1. Department of Pathology, Japanese Red-Cross Nagasaki Atomic Bomb Hospital, Nagasaki, 852-8511, Japan

    Kazuto Shigematsu & Osamu Takahara

  2. Division of Molecular Microbiology and Immunology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8523, Japan

    Noriyuki Nishida

  3. Division of Nephro-Urology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, 852-8523, Japan

    Hideki Sakai & Tsukasa Igawa

  4. Department of Cardiovascular Internal Medicine, Nagasaki Municipal Hospital, Nagasaki, 850-8555, Japan

    Shin Suzuki

  5. Department of Pathology, Nagasaki Prefecture Medical Health Operation Group, Isahaya, 859-0401, Japan

    Kioko Kawai

  6. Division of Pathology, Nagasaki University Graduate School of Biomedical Sciences, 1-12-4 Sakamoto, Nagasaki, 852-8523, Japan

    Kazuto Shigematsu

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  1. Kazuto Shigematsu
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  2. Noriyuki Nishida
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  3. Hideki Sakai
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  4. Tsukasa Igawa
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  7. Osamu Takahara
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Correspondence to Kazuto Shigematsu.

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Shigematsu, K., Nishida, N., Sakai, H. et al. Primary Aldosteronism with Aldosterone-Producing Adenoma Consisting of Pure Zona Glomerulosa-Type Cells in a Pregnant Woman. Endocr Pathol 20, 66–72 (2009). https://doi.org/10.1007/s12022-009-9060-8

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  • DOI: https://doi.org/10.1007/s12022-009-9060-8

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