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Case Reports
. 2019 Sep 8;21(1):16-19.
doi: 10.1016/j.jccase.2019.08.018. eCollection 2020 Jan.

Isolated left adrenal medullary hyperplasia

Hiroaki Kawano  1 , Takao Ando  2 , Yohei Shida  3 , Daisuke Niino  4 , Koji Maemura  1 , Kioko Kawai  5
Affiliations
Case Reports

Isolated left adrenal medullary hyperplasia

Hiroaki Kawano et al. J Cardiol Cases. .

Abstract

A 44-year-old Japanese man was referred to our hospital for the evaluation of paroxysmal hypertension. 123I-metaiodobenzylguanidine (MIBG) single-photon emission computed tomography (SPECT) revealed specific uptake in the left adrenal gland in addition to high levels of serum and urinary catecholamines although computed tomography and magnetic resonance imaging were not able to detect a definite adrenal mass. Left adrenalectomy was performed and he was diagnosed with adrenal medullary hyperplasia (AMH). A diagnosis of unilateral AMH is important because AMH resection can effectively treat hypertension. <Learning objective: Isolated unilateral adrenal medullary hyperplasia (AMH) is a relatively rare disease that causes hypertension, and is generally diagnosed only after catecholaminergic symptoms mimicking pheochromocytoma. However, a diagnosis of unilateral AMH is important because AMH resection can effectively treat hypertension. 123I-MIBG-SPECT is an important diagnostic modality for a diagnosis of unilateral AMH even though computed tomography and magnetic resonance imaging are not able to detect a definite adrenal mass.>.

Keywords: Catecholamine; Hypertension; Pathology.

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Figures

Fig. 1
Fig. 1
Diagnostic imaging. Abdominal computed tomography (A) and magnetic resonance image (B) show a small nodule (5 mm in diameter) of the left adrenal gland (arrows). The strong uptake of the left adrenal gland is observed on 123I-metaiodobenzylguanidine scintigraphy [C, planner image; D, single-photon emission computed tomography (SPECT) image, the left adrenal gland] (arrows) and the slight uptake was seen in the right adrenal gland (E, SPECT image, the right adrenal gland) (arrow).
Fig. 2
Fig. 2
Histopathological findings of resected left adrenal gland. (A) Adrenal medullary hyperplasia in left adrenal medulla (arrows) (hematoxylin and eosin staining; bar, 500 μm). (B) Nests and trabecular formations of large pleomorphic cells with granular cytoplasm and round nuclei (hematoxylin and eosin staining; bar, 100 μm). (C and D) Large pleomorphic cells are positive for chromogranin A (arrows; bar, 500 μm: D; bar, 100 μm).
See this image and copyright information in PMC

References

    1. Korpershoek E., Petri B.J., Post E., van Eijck C.H., Oldenburg R.A., Belt E.J. Adrenal medullary hyperplasia is a precursor lesion for pheochromocytoma in MEN2 syndrome. Neoplasia. 2014;16:868–873. - PMC - PubMed
    1. Dralle H., Schröder S., Gratz K.F., Grote R., Padberg B., Hesch R.D. Sporadic unilateral adrenomedullary hyperplasia with hypertension cured by adrenalectomy. World J Surg. 1990;14:308–315. - PubMed
    1. Qupty G., Ishay A., Peretz H., Dharan M., Kaufman N., Luboshitzky R. Pheochromocytoma due to unilateral adrenal medullary hyperplasia. Clin Endocrinol (Oxf) 1997;47:613–617. - PubMed
    1. Maki Y., Irie S., Ohashi T., Ohmori H. A case of unilateral adrenal medullary hyperplasia. Acta Med Okayama. 1989;43:311–315. - PubMed
    1. Kurihara K., Mizuseki K., Kondo T., Ohoka H., Mannami M., Kawai K. Adrenal medullary hyperplasia. Hyperplasia-pheochromocytoma sequence. Acta Pathol Jpn. 1990;40:683–686. - PubMed

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