{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,21]],"date-time":"2026-07-21T06:13:38Z","timestamp":1784614418246,"version":"3.55.0"},"reference-count":30,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2014,12,19]],"date-time":"2014-12-19T00:00:00Z","timestamp":1418947200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"name":"The Stockholm County, The Karolinska Institute, The Cancer Society in Stockholm","award":[",,"],"award-info":[{"award-number":[",,"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2015,5]]},"abstract":"<jats:title>Summary<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To investigate the long\u2010term outcome after unilateral adrenalectomy in patients with primary aldosteronism (<jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>) and to establish the role of functional pathology for the final diagnosis of aldosterone\u2010producing adenoma (<jats:styled-content style=\"fixed-case\">APA<\/jats:styled-content>) or hyperplasia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A single\u2010centre, retrospective cohort study in a hospital setting.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>Consecutive patients with <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>,<jats:italic> n<\/jats:italic>\u00a0=\u00a0120, who underwent unilateral adrenalectomy between 1985 and 2010. Preoperative and postoperative data were analysed. To indicate the site of aldosterone secretion in the resected adrenal, we added functional methods to routine histopathology, using <jats:italic>in situ<\/jats:italic> hybridization and immunohistochemistry to detect the presence of enzymes needed for aldosterone (<jats:styled-content style=\"fixed-case\">CYP<\/jats:styled-content>11B2) and cortisol (<jats:styled-content style=\"fixed-case\">CYP<\/jats:styled-content>11B1, <jats:styled-content style=\"fixed-case\">CYP<\/jats:styled-content>17A1) synthesis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The median follow\u2010up was 5\u00a0years and the cure rate of <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> 91%. Hypertension was improved in 97% and normalized in 38%. Functional histopathology changed the final diagnosis from <jats:styled-content style=\"fixed-case\">APA<\/jats:styled-content> to hyperplasia in 6 cases (7%). Five of these had no expression of or staining for aldosterone synthase in the adenoma, but only in nodules in the adjacent cortex. All except one <jats:styled-content style=\"fixed-case\">APA<\/jats:styled-content> patient were cured of <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content>. They had lower preoperative serum potassium and higher 24\u2010h urinary aldosterone than patients with hyperplasia. Among patients with hyperplasia 16 of 26 were cured.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Most patients were cured of <jats:styled-content style=\"fixed-case\">PA<\/jats:styled-content> by unilateral adrenalectomy. Almost all noncured benefitted from the operation as the blood pressure improved. Functional histopathology proved helpful in the distinction between <jats:styled-content style=\"fixed-case\">APA<\/jats:styled-content> and hyperplasia, and we recommend that functional histopathology should be added to routine histopathology to improve the diagnostic evaluation and aid in tailoring the follow\u2010up.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.12645","type":"journal-article","created":{"date-parts":[[2014,10,27]],"date-time":"2014-10-27T12:59:04Z","timestamp":1414414744000},"page":"639-647","source":"Crossref","is-referenced-by-count":33,"title":["Primary aldosteronism: functional histopathology and long\u2010term follow\u2010up after unilateral adrenalectomy"],"prefix":"10.1111","volume":"82","author":[{"given":"Cristina","family":"Volpe","sequence":"first","affiliation":[{"name":"Department of Molecular Medicine and Surgery Karolinska Institutet Stockholm Sweden"},{"name":"Department of Internal Medicine Division of Endocrinology S\u00f6dersjukhuset Stockholm 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