Flow cytometry analysis of deoxyribonucleic acid ploidy in benign and malignant aldosterone-producing neoplasms of the adrenal gland

Studies of nuclear deoxyribonucleic acid (DNA) ploidy were performed to determine if ploidy was a marker of a malignant disease or a predictor of prognosis. Paraffin-embedded specimens from 20 benign and six malignant aldosterone-producing neoplasms were examined by flow cytometry. For 17 of the benign aldosteronomas, the DNA histograms were similar to those for samples of normal adrenal cortical parenchyma of adult humans. The three DNA histograms from benign (histologically and clinically) aldosteronomas and all six malignant aldosterone-producing neoplasms were abnormal. Tissue from the adrenal gland from three of the patients with malignant aldosterone-producing tumors exhibited a DNA tetraploid and polyploid pattern; adrenal tissue from three other patients with malignant tumors were classified as having DNA aneuploid histogram patterns. Only patients with DNA aneuploid histogram patterns subsequently died of the disease. Flow cytometry may have an important role prognostically, rather than diagnostically, in the evaluation of aldosterone-producing malignant neoplasms, because the DNA histograms from three benign adenomas were abnormal.