DNA-CYTOFLUOROMETRIC ANALYSIS OF ADRENOCORTICAL TUMORS

抄録

Cytofluorometric measurement of nuclear DNA was performed on individual cells isolated from paraffin sections of 20 cases of adrenocortical tumor. Eight cases of Cushing's syndrome, 9 cases of primary aldosteronism, 2 cases of non-functioning adenomas and one case of adrenal carcinoma were obtained by surgical resection and one case of normal adrenal gland was obtained by autopsy.
Isolated cell smears stained with 4', 6-diamino-2-phenyl-indole dihydrochrolide (DAPI). Nuclear DNA measurement was carried out by an epi-illumination cytofluorometer. Correlated study with both the DNA distribution pattern and histopathological examination was made.
The DNA distribution pattern of normal adrenal gland was diploid, i.e., consisting of a single large peak in 2C range without any polyploid cells (with DNA content exceeding 3×2C). In Cushing's adenoma, the DNA distribution pattern was similar to that of normal adrenal gland. However, three cases showed diploid pattern with polyploid cells (4.6%, 0.9% and 1.3% respectively). Histopathologically, one case could not be distinguished from the typical Cushing's adenomas, but other two cases showed dissimilarities in the size of nucleus as well as irregularities in shapes. In primary aldosteronism, all cases showed diploid, however 6 of 9 cases demonstrated a double peak which consisted of the first large peak in 2C range and the second peak in 4C range. Polyploid cell appeared in almost all cases (1.3%-7.8%), which was more frequent than that of Cushing's adenomas (1.7%-5.6%), and the range of DNA content (1.3C, 14.8C) was more widely spread than that of Cushing's adenomas (1.3C, 11.9C). In non-functioning adenoma, DNA distribution pattern was diploid with polyploid cells (0.3%, 0.6%) and adrenocortical carcinoma was aneuploid in which the first major peak was 2.7C and 27.8% of polyploid cells.