{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,11]],"date-time":"2026-09-11T01:50:15Z","timestamp":1789091415463,"version":"build-2803163510"},"reference-count":43,"publisher":"Oxford University Press (OUP)","issue":"6","license":[{"start":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T00:00:00Z","timestamp":1748563200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/pages\/standard-publication-reuse-rights"}],"funder":[{"name":"Sao Paulo Research Foundation","award":["2019\/15873-6"],"award-info":[{"award-number":["2019\/15873-6"]}]},{"name":"FAPESP fellowship","award":["2021\/09879-1"],"award-info":[{"award-number":["2021\/09879-1"]}]},{"name":"FAPESP fellowship","award":["2021\/10101-5"],"award-info":[{"award-number":["2021\/10101-5"]}]},{"DOI":"10.13039\/501100003593","name":"National Council for Scientific and Technological Development","doi-asserted-by":"publisher","award":["304091\/2021-9"],"award-info":[{"award-number":["304091\/2021-9"]}],"id":[{"id":"10.13039\/501100003593","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2025,5,30]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The utility of histopathological classification based on aldosterone synthase (CYP11B2) immunostaining in unilateral primary aldosteronism (PA) for predicting clinical and biochemical outcomes after adrenalectomy remains controversial.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>We conducted a cohort study involving 131 consecutive patients with unilateral PA who underwent unilateral adrenalectomy. Aldosterone-producing adrenal lesions were classified according to the HISTALDO criteria. Biochemical and clinical outcomes were assessed using the PASO criteria.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among the 131 adrenal lesions, classical and non-classical histology were identified in 101 (77.09%) and 30 (22.91%) cases, respectively. In the classical group, 89 cases were classified as aldosterone-producing adenoma (APA), and 12 as aldosterone-producing nodule (APN). Within the non-classical group, 27 cases (90%) had multiple aldosterone-producing micronodules, and 3 cases (30%) had multiple APNs. Patients with classical histology were younger (P = .028) and predominantly female (P = .028) compared to those with non-classical histology. Classical histology was associated with higher rates of complete biochemical success (97.03% vs 68.97%, P &amp;lt; .001) and complete hypertension remission (34.34% vs 10.71%, P &amp;lt; .001) compared to non-classical histology. Although clinical and biochemical outcomes were similar between APA and APN, their immunohistological characteristics differed (fewer clear cells and stronger CYP11B2 staining in APN). In multivariable analysis, classical histology remained independently associated with complete biochemical (P &amp;lt; .001) and clinical (P = .037) success.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Classical histology was an independent variable associated with more severe PA, complete biochemical and hypertension remission in surgically treated patients with unilateral PA. Moreover, the distinction between APA and APN did not differentiate outcome.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1093\/ejendo\/lvaf118","type":"journal-article","created":{"date-parts":[[2025,6,5]],"date-time":"2025-06-05T07:50:07Z","timestamp":1749109807000},"page":"763-775","source":"Crossref","is-referenced-by-count":11,"title":["Histopathological evaluation based on CYP11B2 staining predicts outcomes in unilateral primary aldosteronism"],"prefix":"10.1093","volume":"192","author":[{"given":"Tatiana S","family":"Goldbaum","sequence":"first","affiliation":[{"name":"Unidade de Adrenal, Laborat\u00f3rio de Endocrinologia Molecular e Celular LIM25, Divis\u00e3o de Endocrinologia e Metabologia, Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo 01246-903 ,","place":["Brasil"]},{"name":"Departamento de Patologia, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo 01246-903 ,","place":["Brasil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Felipe L","family":"Ledesma","sequence":"additional","affiliation":[{"name":"Departamento de Patologia, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo 01246-903 ,","place":["Brasil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Augusto G","family":"Guimaraes","sequence":"additional","affiliation":[{"name":"Unidade de Adrenal, Laborat\u00f3rio de Endocrinologia Molecular e Celular LIM25, Divis\u00e3o de Endocrinologia e Metabologia, Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo 01246-903 ,","place":["Brasil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessica","family":"Okubo","sequence":"additional","affiliation":[{"name":"Unidade de Adrenal, Laborat\u00f3rio de Endocrinologia Molecular e Celular LIM25, Divis\u00e3o de Endocrinologia e Metabologia, Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo 01246-903 ,","place":["Brasil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eduardo Z","family":"Kawahara","sequence":"additional","affiliation":[{"name":"Unidade de Adrenal, Laborat\u00f3rio de Endocrinologia Molecular e Celular LIM25, Divis\u00e3o de Endocrinologia e Metabologia, Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo 01246-903 ,","place":["Brasil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2332-5863","authenticated-orcid":false,"given":"Vinicius F","family":"Calsavara","sequence":"additional","affiliation":[{"name":"Department of Computational Biomedicine, Biostatistics Shared Resource, Cedars-Sinai Medical Center , Los Angeles, CA 90048 ,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luiz A","family":"Bortolotto","sequence":"additional","affiliation":[{"name":"Unidade de Hipertens\u00e3o, Instituto do Cora\u00e7\u00e3o (InCor), Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo 05403-900 ,","place":["Brasil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jose L","family":"Chambo","sequence":"additional","affiliation":[{"name":"Divis\u00e3o de Urologia, Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo 05403-000 ,","place":["Brasil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Candida B V","family":"Fragoso","sequence":"additional","affiliation":[{"name":"Laborat\u00f3rio de Horm\u00f4nios e Gen\u00e9tica Molecular LIM42, Divis\u00e3o de Endocrinologia e Metabologia, Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo 01246-903 ,","place":["Brasil"]},{"name":"Unidade de Oncologia End\u00f3crina, Instituto do C\u00e2ncer do Estado de S\u00e3o Paulo (ICESP), Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo 01246-000 ,","place":["Brasil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Adelaide A","family":"Pereira","sequence":"additional","affiliation":[{"name":"Unidade de Adrenal, Laborat\u00f3rio de Endocrinologia Molecular e Celular LIM25, Divis\u00e3o de Endocrinologia e Metabologia, Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo 01246-903 ,","place":["Brasil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Pio-Abreu","sequence":"additional","affiliation":[{"name":"Unidade de Hipertens\u00e3o, Disciplina de Nefrologia, Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo 05403-000 ,","place":["Brasil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Giovanio V","family":"Silva","sequence":"additional","affiliation":[{"name":"Unidade de Hipertens\u00e3o, Disciplina de Nefrologia, Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo 05403-000 ,","place":["Brasil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o V","family":"Silveira","sequence":"additional","affiliation":[{"name":"Unidade de Hipertens\u00e3o, Instituto do Cora\u00e7\u00e3o (InCor), Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo 05403-900 ,","place":["Brasil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fernanda M","family":"Consolim-Colombo","sequence":"additional","affiliation":[{"name":"Unidade de Hipertens\u00e3o, Instituto do Cora\u00e7\u00e3o (InCor), Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo 05403-900 ,","place":["Brasil"]},{"name":"Departamento de Medicina Interna, Faculdade de Medicina, Universidade Nove de Julho , S\u00e3o Paulo 03155-000 ,","place":["Brasil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Luciano F","family":"Drager","sequence":"additional","affiliation":[{"name":"Unidade de Hipertens\u00e3o, Instituto do Cora\u00e7\u00e3o (InCor), Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo 05403-900 ,","place":["Brasil"]},{"name":"Unidade de Hipertens\u00e3o, Disciplina de Nefrologia, Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo 05403-000 ,","place":["Brasil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"William C","family":"Nahas","sequence":"additional","affiliation":[{"name":"Divis\u00e3o de Urologia, Hospital das Cl\u00ednicas, Faculdade de Medicina da Universidade de S\u00e3o Paulo , S\u00e3o Paulo 05403-000 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