{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T18:51:59Z","timestamp":1788547919455,"version":"build-2803163510"},"reference-count":40,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2017,9,4]],"date-time":"2017-09-04T00:00:00Z","timestamp":1504483200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000062","name":"National Institute of Diabetes and Digestive and Kidney Diseases","doi-asserted-by":"publisher","award":["1K08DK109116 R21DK103183"],"award-info":[{"award-number":["1K08DK109116 R21DK103183"]}],"id":[{"id":"10.13039\/100000062","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2017,12]]},"abstract":"Summary<\/jats:title>Objective<\/jats:title>Correct subtyping of primary aldosteronism (PA<\/jats:styled-content>) is essential for good surgical outcomes. Adrenal vein sampling (AVS<\/jats:styled-content>) and\/or computed tomography (CT<\/jats:styled-content>) are used for PA<\/jats:styled-content> subclassification. Clinical and\/or biochemical improvement after surgery, however, is not always achieved in patients with presumed unilateral PA<\/jats:styled-content>. We aimed to identify the pitfalls in PA<\/jats:styled-content> subclassification leading to surgical treatment failures.<\/jats:p><\/jats:sec>Patients and Design<\/jats:title>We retrospectively studied 208 patients who underwent adrenal vein sampling (AVS<\/jats:styled-content>) for PA<\/jats:styled-content> subclassification in a tertiary referral centre, between January 2009 and August 2016. Simultaneous bilateral AVS<\/jats:styled-content> was performed before and after cosyntropin administration. We implemented immunohistochemistry for aldosterone synthase (CYP<\/jats:styled-content>11B2) and 17\u03b1\u2010hydroxylase\/17,20 lyase (CYP<\/jats:styled-content>17A1) in adrenal glands resected from patients without improvement of PA<\/jats:styled-content> after surgical treatment and from those with limitations in AVS<\/jats:styled-content> interpretation.<\/jats:p><\/jats:sec>Results<\/jats:title>Of 55 patients who underwent adrenalectomy, three (5.5%) had no improvement of PA<\/jats:styled-content>. All three patients underwent partial adrenalectomy to remove a CT<\/jats:styled-content>\u2010detected nodule present on the same side with AVS<\/jats:styled-content> lateralization. Immunohistochemistry revealed a CYP<\/jats:styled-content>11B2\u2010negative nodule in both cases available. All patients who underwent total adrenalectomy based on AVS<\/jats:styled-content> lateralization benefitted from surgery, including three patients with unilateral unsuccessful AVS<\/jats:styled-content> and aldosterone suppression in the catheterized side vs inferior vena cava.<\/jats:p><\/jats:sec>Conclusions<\/jats:title>Radiographically identified adrenal nodules are not always a source of PA<\/jats:styled-content>, even when ipsilateral with AVS<\/jats:styled-content> lateralization. These data caution against reliance on imaging findings, either alone or in conjunction with AVS<\/jats:styled-content>, to guide surgery for PA<\/jats:styled-content>.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.13442","type":"journal-article","created":{"date-parts":[[2017,8,8]],"date-time":"2017-08-08T23:36:58Z","timestamp":1502235418000},"page":"665-672","source":"Crossref","is-referenced-by-count":88,"title":["Discordance between imaging and immunohistochemistry in unilateral primary aldosteronism"],"prefix":"10.1111","volume":"87","author":[{"given":"Aya T.","family":"Nanba","sequence":"first","affiliation":[{"name":"Division of Metabolism, Endocrinology, and Diabetes University of Michigan Ann Arbor MI USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazutaka","family":"Nanba","sequence":"additional","affiliation":[{"name":"Department of Molecular and Integrative Physiology University of Michigan Ann Arbor MI 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