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Inhibin normally is produced by ovarian granulosa cells and testicular Sertoli cells. Extragonadal inhibin expression also has been detected in the placenta, pituitary gland, and liver. It may be difficult to make a distinction between adrenal cortical tumors, pheochromocytoma, and metastatic carcinomas including renal cell and hepatocellular carcinoma. Immunohistochemical expression of inhibin &agr;-subunit was evaluated to determine whether any usefulness of immunostaining could be found for inhibin &agr;-subunit in the differential diagnosis of adrenal glandular lesions. The authors performed immunostaining against inhibin &agr;-subunit on 5 cases of normal adrenal gland, 1 case of adrenal cortical hyperplasia, 25 cases of adrenal cortical adenoma, 6 cases of adrenal cortical carcinoma, 21 cases of pheochromocytoma, 8 cases of metastatic carcinoma, and 10 cases of primary renal cell carcinoma. Normal adrenal gland showed a strong immunoreactivity against inhibin &agr;-subunit, especially in the inner layer of the adrenal cortex, representing the zona reticularis, but adrenal medulla was negative for inhibin &agr;-subunit. Adrenal cortical hyperplasia associated with Cushing's syndrome showed a strong, diffuse immunoreactivity for inhibin &agr;-subunit. Immunoreactivity against the inhibin &agr;-subunit was identified in all cases of adrenal cortical adenoma and carcinoma, especially in the adrenal cortical neoplasm with Cushing's syndrome, which showed a strong reactivity. However, immunoreactivity was absent in two metastatic carcinomas from the liver and colon and most of the pheochromocytomas, except three cases with weak focal positivity for inhibin &agr;-subunit. Four cases of metastatic renal cell carcinoma and 10 cases of primary renal cell carcinoma revealed no immunoreactivity. Metastatic adenocarcinoma from the prostate showed a weak immunoreactivity for inhibin &agr;-subunit. Metastatic hepatoblastoma was negative against inhibin &agr;-subunit with endogenous biotin blocking. Immunoexpression for inhibin &agr;-subunit is useful for making distinction between adrenal cortical tumors, pheochromocytoma, and metastatic carcinoma. Inhibin &agr;-subunit may be valuable as part of a diagnostic immunohistochemical panel in adrenal glandular lesions.
Applied Immunohistochemistry & Molecular Morphology – Wolters Kluwer Health
Published: Sep 1, 2001
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