Nodule density on CT-scan correlates with CYP11B1 expression in a patient with ARMC5 mutated primary bilateral macronodular adrenal hyperplasia.

IF 2.3 3区 医学 Q2 PATHOLOGY
Fen Wang, Yu Luo, Zheng Liu, Junhui Xie
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引用次数: 0

Abstract

Purpose: Primary bilateral macronodular adrenal hyperplasia (PBMAH) is a rare subtype of Cushing's syndrome, with some cases exhibiting a familial aggregation tendency. The heterogenous expression of CYP11B1 mRNA among multiple adrenal nodules in PBMAH had not been previously reported. This study aims to investigate the correlation between CYP11B1 mRNA expression and Hounsfield unit (Hu) density in computed tomography (CT) scans in a patient with ARMC5 mutated PBMAH.

Methods: A 47-year-old male came to our hospital for headache and hypertension. He was diagnosed as PBMAH later and received adrenalectomy. DNA sequencing was performed on the patient's peripheral blood, his relatives' peripheral blood, and the patient's adrenal tissues. Additionally, four different adrenal nodules from the patient were collected to explore the relationship between CYP11B1 mRNA expression and Hu density in CT scanning.

Results: A family with autosomal dominant inherited PBMAH was identified. Second generation sequencing of peripheral blood and Sanger sequencing of adrenal tissues identified a novel ARMC5 pathogenic variant, c.1865-2_1865-1del, which was also present in the patient's brother, sister and nephew. The patient's adrenal was enlarged diffusely but cushingoid feature was not severe. The adrenal imaging showed bilateral macronodules resembling adrenal tumors. Notably, the Hu values varied significantly among different nodules, and interestingly, the CYP11B1 mRNA expression was found to be parallel to the Hu values.

Conclusions: We reported a family of PBMAH with novel ARMC5 pathogenic variant. The index patient exhibited heterogeneous adrenal nodules with distinct Hu values and CYP11B1 mRNA levels.

Abstract Image

Abstract Image

ARMC5突变原发性双侧肾上腺大结节增生患者ct扫描结节密度与CYP11B1表达相关
目的:原发性双侧肾上腺大结节增生(PBMAH)是一种罕见的库欣综合征亚型,部分病例表现出家族聚集倾向。CYP11B1 mRNA在PBMAH多发肾上腺结节中的异质表达此前未见报道。本研究旨在探讨ARMC5突变PBMAH患者的CYP11B1 mRNA表达与计算机断层扫描(CT)中Hounsfield单位(Hu)密度的相关性。方法:一名47岁男性以头痛高血压就诊。他后来被诊断为PBMAH并接受了肾上腺切除术。对患者外周血、亲属外周血和患者肾上腺组织进行DNA测序。此外,收集患者4个不同的肾上腺结节,探讨CT扫描中CYP11B1 mRNA表达与Hu密度的关系。结果:1例常染色体显性遗传PBMAH家族。外周血第二代测序和肾上腺组织Sanger测序鉴定出一种新的ARMC5致病变异c.1865-2_1865-1del,该变异也存在于患者的兄弟、姐妹和侄子中。患者肾上腺弥漫性增大,但库欣样征不严重。肾上腺影像学显示双侧大结节,类似肾上腺肿瘤。值得注意的是,不同结节的Hu值差异显著,有趣的是,CYP11B1 mRNA的表达与Hu值平行。结论:我们报道了一个具有新型ARMC5致病变异的PBMAH家族。指数患者表现为异质性肾上腺结节,具有不同的Hu值和CYP11B1 mRNA水平。
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来源期刊
Diagnostic Pathology
Diagnostic Pathology 医学-病理学
CiteScore
4.60
自引率
0.00%
发文量
93
审稿时长
1 months
期刊介绍: Diagnostic Pathology is an open access, peer-reviewed, online journal that considers research in surgical and clinical pathology, immunology, and biology, with a special focus on cutting-edge approaches in diagnostic pathology and tissue-based therapy. The journal covers all aspects of surgical pathology, including classic diagnostic pathology, prognosis-related diagnosis (tumor stages, prognosis markers, such as MIB-percentage, hormone receptors, etc.), and therapy-related findings. The journal also focuses on the technological aspects of pathology, including molecular biology techniques, morphometry aspects (stereology, DNA analysis, syntactic structure analysis), communication aspects (telecommunication, virtual microscopy, virtual pathology institutions, etc.), and electronic education and quality assurance (for example interactive publication, on-line references with automated updating, etc.).
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