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Expression of insulin-like growth factor binding protein 1-6 genes in adrenocortical tumors and pheochromocytomas.

The insulin-like growth factor (IGF) system appears to be important in the regulation of adrenal growth and hormone synthesis. As IGF-binding proteins (IGFBPs) modify IGF bioactivity, we investigated the expression of IGFBP 1-6 genes in different adrenal tumors and hyperplasias to further clarify the role of the IGF system in adrenal pathophysiology. IGFBP-1 mRNA levels were too low to be detected by Northern blot analysis, but could be found by RT-PCR in some tumors and hyperplastic adrenals. Other IGFBPs were detected by Northern blotting. IGFBP-3 mRNA levels were very low in normal adrenals. In adrenal tumors and hyperplastic adrenals, IGFBP-3 mRNA expression was usually higher than in normal adrenals. In hormonally active adrenocortical carcinomas, IGFBP-2, -4, -5 and -6 mRNA levels were lower than in nonfunctional carcinomas and normal adrenals. The low IGFBP mRNA expression in the hormone-producing carcinomas was associated with high IGF-II mRNA content. In adrenocortical adenomas from patients with Cushing's or Conn's syndrome, mean IGFBP mRNA levels were higher than in normal adrenals or in hormonally inactive adenomas. In nodular and bilateral hyperplasias, IGFBP-2, -3 and -4 mRNA expression was on average higher than in normal adrenals but varied substantially, as did IGFBP mRNA levels in pheochromocytomas. In comparison to normal adrenals, pheochromocytomas expressed on average higher levels of IGFBP-2 and -4 but less IGFBP-5 and -6 mRNAs. Our data show that the six IGFBPs 1-6 are expressed at variable level in adrenal tumors and hyperplasias. The low level of IGFBP mRNAs in hormonally active adrenocortical carcinomas was of particular interest.

Adenoma↗

[Value of sonography, computed tomography and angiography in adrenal diagnosis].

Between 1979 and 1982, 47 patients with pathological process of the adrenals were surgically treated after preceding thorough non-evasive angiographic diagnosis (6 phaeochromocytomas, 20 adrenal adenomas, 8 adrenal hyperplasias, 5 adrenal carcinomas, 5 adrenal cysts and 3 adrenal metastases). The most consistently accurate results were obtained via adrenal phlebography with an accuracy of 94%. This was followed by non-evasive computed tomography (87%). Compared with the data given in literature, hormone determination in the adrenal venous blood was less favourable (79%). Selective adrenal arteriography, which was used less often, yielded correct results in 83% of the cases, whereas the number of accurate diagnoses achieved via sonography was lowest with 54%.

Adenoma↗

Establishment and characterization of a strain of human adrenal tumor cells that secrete estrogen.

We report the establishment of a new cell line, designated Fang-8, which originated from a human adrenal adenocarcinoma. It has been continuously propagated during the past 20 months. The cells exhibit an epithelioid morphology, resembling the cell structure of the zona reticularis when viewed by electron microscopy. Since passage 12, the cells showed a characteristic ring-forming property in culture. The cells produce neither testosterone, mineralocorticosteroids, nor glucocorticosteroids; instead, they possess the unique function of estrogen production. Karyotypic analysis revealed a 100% aneuploid, unstable karyotype in the hyperdiploid stem line. Identification of the Y chromosome was uncertain. In view of these characteristics, Fang-8 represents a new human cell line, unlikely to be contaminated with HeLa strains, and different from another cell line derived from human adrenal cortex andenocarcinoma, namely SW-13(ATCC CCL 105).

Adenocarcinoma↗

Expression of murine 21-hydroxylase in mouse adrenal glands and in transfected Y1 adrenocortical tumor cells.

The S region of the murine major histocompatibility complex contains two structurally related genes (21-OHase A and 21-OHase B) that encode 21-hydroxylase (21-OHase), an enzyme essential for the synthesis of adrenal steroids. Expression of these two genes has been analyzed by using oligonucleotide probes specific for the 21-OHase A and B genes and by DNA-mediated gene transfer. Hybridization of the oligonucleotides to blots of BALB/c adrenal RNA demonstrated that all 21-OHase mRNA is derived from the 21-OHase A gene. Cosmids bearing either the 21-OHase A or B gene were introduced into Y1 adrenocortical tumor cells by cotransfection with pSV2-neo. Cells transfected with the 21-OHase A gene expressed 21-OHase as determined by steroid metabolism and by RNA blot hybridization; 21-OHase transcripts were not detected in parent Y1 cells or in cells transfected with the 21-OHase B gene. Treatment of 21-OHase A transfectants with adrenocorticotropin increased 21-OHase mRNA levels by up to 10-fold, thus mimicking the observed effect of this hormone on 21-OHase levels in primary adrenal cultures. The regulated expression of the 21-OHase A gene in transfected Y1 cells should provide a useful system for the investigation of factors controlling the adrenal-specific regulation of 21-OHase activity.

Adrenal Cortex Neoplasms↗

Expression of HER-2/neu receptor protein in adrenal tumors.

The HER-2/neu protein is overexpressed in many human carcinomas obtained from different tissues and may represent a useful target for therapy with the commercially available monoclonal antibody trastuzumab (herceptin). Novel therapeutic options are needed for metastasized adrenocortical cancer. Therefore, we studied expression of the HER-2/neu cell surface receptor protein using three different antibodies in 12 adrenal adenomas, 17 adrenocortical carcinomas and 5 pheochromocytomas. Normal adrenals (n = 5) served as controls. One adenoma showed very weak membranous immunostaining with the Dako antibody, two others showed a nonspecific cytoplasmic staining pattern. A nonspecific reaction in the cytoplasm was demonstrable in seven carcinomas with the Novocastra antibody. In all pheochromocytomas, a granular intracytoplasmic and, rarely, slightly membranous immunostaining with the Dako antibody was found. From our data we conclude that specific and significant membranous immunostaining indicating strong overexpression (grade 3) of HER-2/neu protein is not present in adrenocortical tumors. The granular cytoplasmic immunostaining of the medulla may be helpful for differentiation of adrenocortical tumors from pheochromocytomas.

Adrenal Cortex Neoplasms↗

Multiple endocrine neoplasias in a dog: corticotrophic tumour, bilateral adrenocortical tumours, and pheochromocytoma.

In a 10-year-old ovariohysterectomized standard Schnauzer, the finding of dexamethasone-resistant hypersecretion of cortisol, the results of computed tomography, and elevated plasma concentrations of ACTH suggested the presence of both adrenocortical tumour and pituitary-dependent hyperadrenocorticism. The dog made an uneventful recovery after bilateral adrenalectomy and remained in good health for 31/2 years with substitution for the induced hypoadrenocorticism. Then the enlarged pituitary caused neurological signs and eventually euthanasia was performed. The surgically excised right adrenal contained a well-circumscribed tumour of differentiated adrenocortical tissue and in the left adrenal there were two adrenocortical tumours and a pheochromocytoma. The unaffected parts of the adrenal cortices were well developed and without regressive transformation. At necropsy there were no metastatic lesions. The cells of the pituitary tumour were immunopositive for ACTH and had characteristics of malignancy. The present combination of corticotrophic tumour, adrenocortical tumours, and pheochromocytoma may be called 'multiple endocrine neoplasia' (MEN), but does not correspond to the inherited combinations of diseases known in humans as the MEN-1 and the MEN-2 syndromes. It is suggested that the co-existence of hyperadrenocorticism and pheochromocytoma may be related to the vascular supply of the adrenals. Some chromaffin cells of the adrenal medulla are directly exposed to cortical venous blood, and intra-adrenal cortisol is known to stimulate catecholamine synthesis and may promote adrenal medullary hyperplasia or neoplasia.

Adrenal Cortex Neoplasms↗

Hyperaldosteronism in a cat with metastasised adrenocortical tumour.

In a 12-year-old male shorthaired cat with attacks of hypokalaemic muscular weakness in spite of oral potassium supplementation, highly elevated plasma aldosterone concentrations in combination with low plasma renin activity pointed to primary hyperaldosteronism. Ultrasonography and computed tomography revealed a large left-sided adrenal tumour growing into the phrenicoabdominal vein and the caudal vena cava. The tumour and its intravascular extension were surgically removed, but the subsequent stenosis of the caudal vena cava caused congestion and renal failure. At autopsy pulmonary micrometastases of the aldosteronoma were found.

Adrenal Cortex Neoplasms↗