A Rare Case of Adrenocorticotropic Hormone (ACTH)-independent Macroadrenal Hyperplasia Showing Ectopic Production of ACTH
スポンサーリンク
概要
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A 57-year-old Japanese man presented with drug-resistant hypertension without Cushingoid features. Endocrinological tests revealed autonomous secretion of cortisol with suppressed plasma adrenocorticotropic hormone (ACTH). Imaging examinations showed multiple macronodules in the bilateral adrenal gland. These findings were consistent with subclinical Cushing's syndrome caused by ACTH-independent macronodular adrenal hyperplasia (AIMAH). Left adrenalectomy was performed and the resected adrenal lesion was consistent with the pathological diagnosis of AIMAH. Furthermore, in resected tissue, we demonstrated intraadrenal production of ACTH by immunohistochemical analysis and RIA. This is a very rare case of AIMAH showing ectopic production of ACTH, which may be associated with autonomous cortisol secretion.
著者
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Oki Yutaka
Department Of Internal Medicine Hamamatsu University School Of Medicine
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Sasano Hironobu
Department Of Anatomic Pathology Tohoku University School Of Medicine
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Nishikawa Tetsuo
Division Of Endocrinology And Metabolism Department Of Medicine Yokohama Rosai Hospital
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Fukuoka Junya
Department Of Neurosurgery Faculty Of Medicine University Of Toyama And Laboratory Of Pathology Toya
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Ishizawa Shin
Department Of Legal Medicine Faculty Of Medicine University Of Toyama
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Tobe Kazuyuki
The First Department of Internal Medicine, School of Medicine, University of Toyama, Toyama 930-0194, Japan
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Ishizawa Shin
Department of Pathology, Faculty of Medicine, University of Toyama, Japan
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Fukuoka Junya
Department of Surgical Pathology, Toyama University Hospital, Japan
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Iwata Minoru
The First Department of Internal Medicine, Faculty of Medicine, University of Toyama, Japan
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Okazawa Teruyo
The First Department of Internal Medicine, Faculty of Medicine, University of Toyama, Japan
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Taka Chihiro
The First Department of Internal Medicine, Faculty of Medicine, University of Toyama, Japan
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Yamazaki Katsuya
Kawai Clinic, Japan
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Nishikawa Tetsuo
Division of Endocrinology and Metabolism, Endocrinology and Diabetes Center, Department of Medicine, Yokohama Rosai Hospital, Japan
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Tobe Kazuyuki
The First Department of Internal Medicine, Faculty of Medicine, University of Toyama, Japan
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