TY - JOUR
AU1 - De Leo, A.
AU2 - Mosconi, C.
AU3 - Zavatta, G.
AU4 - Tucci, L.
AU5 - Nanni, C.
AU6 - Selva, S.
AU7 - Balacchi, C.
AU8 - Ceccarelli, C.
AU9 - Santini, D.
AU1 - Pantaleo, M. A.
AU1 - Minni, F.
AU1 - Fanti, S.
AU1 - Golfieri, R.
AU1 - Pagotto, U.
AU1 - Vicennati, V.
AU1 - Di Dalmazi, G.
AB - BackgroundAdrenal 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.MethodsPatients 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.ResultsRadiological 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 vs 17.3 ± 8.4 mm, P < 0.001), higher CT unenhanced density (29.1 ± 11.0 vs 23.1 ± 9.0 HU, P = 0.043), and FDG-PET adrenal uptake (9.0 ± 6.4 vs 4.4 ± 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.ConclusionsAdrenal 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.
TI - Radiologically defined lipid-poor adrenal adenomas: histopathological characteristics
JF - Journal of Endocrinological Investigation
DO - 10.1007/s40618-020-01198-5
DA - 2020-09-15
UR - https://www.deepdyve.com/lp/springer-journals/radiologically-defined-lipid-poor-adrenal-adenomas-histopathological-kfqe3IYJYk
SP - 1197
EP - 1204
VL - 43
IS - 9
DP - DeepDyve
ER -