HETEROGENEOUS DISTRIBUTION OF NUCLEAR-DNA CONTENT IN TUMORS OF THE ADRENAL-GLANDS

By flow cytometric DNA analysis 23 adrenal tumors (7 phaeochromocytoma s (PCC), 5 corticoadrenal (CA) carcinomas, 4 CA adenomas, 4 nodular hy perplasias, 2 myelolipomas, 1 ganglioneuroma) were studied. Clinically , they were diagnosed as 9 incidentalomas, 5 PCC, 5 Gushing's syndrome or disease, 2 Conn's disease, 1 adrenogenital syndrome due to 21-beta -hydroxylase deficit and 1 nonfunctioning abdominal mass. After surger y, DNA ploidy and cell percentage distribution in the phases of the ce ll cycle have been calculated in 2-11 tissue samples from each tumor m ass, the mass weight was recorded and the patients were clinically fol lowed-up for 5-48 months. Cells containing aneuploid DNA were found in at least one sample of 13/23 tumors, including 3/7 PCC, 4/5 carcinoma s, 3/4 adenomas and 3/4 hyperplasias. An elevated cell percentage dist ribution in the proliferative phases of the cell cycle (S+G2-M=>11%) w as observed more frequently in the carcinoma samples (63%) than in the PCC (50%), myelolipomas (33%), adenomas (22%) or hyperplasias (0%). D uring the clinical follow-up period, one patient was lost for a malign ant PCC with diploid DNA; 3 still survive with clinical symptoms, incl uding one operated for a bilateral adrenal myelolipoma associated with the syndrome due to 21-beta-hydroxylase deficit and still present ect opic testicular secretion, and 2 for hypodiploid CA carcinomas; the re maining patients are alive without disease, including the one who had a carcinoma containing cells with hypo- and hyperdiploid DNA, and anot her one operated for a carcinoma with diploid DNA invading the liver, followed-up for just 5 months. The reported data evidence that single tissue samples can mislead the analysis of DNA content and cell cycle distribution in adrenal gland tumors, while multiple samples from diff erent areas allow the detection of aneuploid and/or proliferating cell s. The observation of cells containing aneuploid DNA does not seem to have indipendent prognostic value in the proliferative diseases of the adrenal glands, while the absence of elevated percentages of cells in S and/or G2-M phases, and a tumor mass weight <50 g, can represent us eful parameters to discriminate between benign and malignant diseases.