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Chambre C, McMurray E, Baudry C, Lataud M, Guignat L, Gaujoux S, Lahlou N, Guibourdenche J, Tissier F, Sibony M, Dousset B, Bertagna X, Bertherat J, Legmann P, Groussin L. The 10 Hounsfield units unenhanced computed tomography attenuation threshold does not apply to cortisol secreting adrenocortical adenomas. Eur J Endocrinol 2015; 173:325-32. [PMID: 26243637 DOI: 10.1530/eje-15-0036] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/01/2023]
Abstract
CONTEXT Computed tomography (CT) unenhanced attenuation value of <10 Hounsfield units (HU) has an excellent specificity (98%) to diagnose lipid-rich adrenocortical adenomas (ACAs) with a weaker sensitivity (71%). OBJECTIVE To determine from a routine clinical perspective if unenhanced attenuation value is influenced by cortisol secretion in ACAs. DESIGN This was a retrospective study of cases collected between 2009 and 2012. SETTING This study was conducted in a tertiary-care university hospital. PATIENTS Seventy-two patients operated on for an ACA (Weiss score ≤ 2) were analysed. Thirty-four patients had an ACA oversecreting cortisol (Cush-ACA). Thirty-eight patients had an ACA without cortisol oversecretion (Non Hyper-ACA). MAIN OUTCOME MEASURE CT unenhanced attenuation value was correlated with the functional status. The Weiss score items were analysed. RESULTS Among the 34 patients with a Cush-ACA a minority (n = 7) had an unenhanced attenuation value under 10 HU. Among the high precontrast density (> 10 HU) Cush-ACAs, washout analysis after contrast administration was consistent with the benign nature of the tumor in ∼ 60% of the cases. Less than 25% clear cells (lipid-rich cells), a Weiss score item, was present in 50% of the Cush-ACAs in favour of a lipid-poor content. CONCLUSIONS Unenhanced attenuation value has a poor sensitivity to diagnose an ACA in case of cortisol oversecretion due to poor lipid content. Nevertheless, the accuracy of washout analysis was preserved in the group of Cush-ACAs.
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Affiliation(s)
- Claire Chambre
- Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceINSERM U1016CNRS UMR8104, Institut Cochin, Paris, France Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin
| | - Emily McMurray
- Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceINSERM U1016CNRS UMR8104, Institut Cochin, Paris, France Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin
| | - Camille Baudry
- Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceINSERM U1016CNRS UMR8104, Institut Cochin, Paris, France Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin
| | - Marine Lataud
- Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceINSERM U1016CNRS UMR8104, Institut Cochin, Paris, France Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin
| | - Laurence Guignat
- Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceINSERM U1016CNRS UMR8104, Institut Cochin, Paris, France
| | - Sébastien Gaujoux
- Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceINSERM U1016CNRS UMR8104, Institut Cochin, Paris, France Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin
| | - Najiba Lahlou
- Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceINSERM U1016CNRS UMR8104, Institut Cochin, Paris, France Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin
| | - Jean Guibourdenche
- Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceINSERM U1016CNRS UMR8104, Institut Cochin, Paris, France Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin
| | - Frédérique Tissier
- Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceINSERM U1016CNRS UMR8104, Institut Cochin, Paris, France Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin
| | - Mathilde Sibony
- Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceINSERM U1016CNRS UMR8104, Institut Cochin, Paris, France Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin
| | - Bertrand Dousset
- Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceINSERM U1016CNRS UMR8104, Institut Cochin, Paris, France Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin
| | - Xavier Bertagna
- Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceINSERM U1016CNRS UMR8104, Institut Cochin, Paris, France Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin
| | - Jérôme Bertherat
- Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceINSERM U1016CNRS UMR8104, Institut Cochin, Paris, France Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin
| | - Paul Legmann
- Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceINSERM U1016CNRS UMR8104, Institut Cochin, Paris, France Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin
| | - Lionel Groussin
- Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceINSERM U1016CNRS UMR8104, Institut Cochin, Paris, France Department of EndocrinologyReferral Center for Rare Adrenal Diseases, Cochin Hospital, Assistance Publique Hôpitaux de Paris, Université Paris Descartes, Sorbonne Paris Cité, 27, rue du Faubourg Saint Jacques, 75014 Paris, FranceDepartment of EndocrinologyDiabetes Mellitus, and Metabolic Diseases, Avicenne Hospital, Assistance Publique Hôpitaux de Paris, Paris XIII University, 93009 Bobigny, FranceMetabolic UnitWestern General Hospital, Edinburgh, UKDepartment of RadiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceUniversité Paris DescartesSorbonne Paris Cité, Paris, FranceDepartment of Digestive and Endocrine SurgeryHormonal BiologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Pitié-Salpétrière, Pierre et Marie Curie Université, Paris, FranceDepartment of PathologyAssistance Publique Hôpitaux de Paris, Hôpital Cochin
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