Fibrosis of the human heart and systemic organs in adrenal adenoma

In experimental animals, chronic mineralocorticoid (MC) excess is associated with fibrosis of the myocardium and systemic organs, where both a reactive, i.e. interstitial and perivascular, and reparative, i.e. microscopic scarring following cardiac myocyte necrosis, fibrosis are found. We sought to determine if a similar fibrous tissue response was present in human myocardium and systemic organs in association with adrenal adenoma. Postmortem specimens of heart, adrenals, pancreas, lungs, kidney and liver were obtained from 5 patients (age 67 +/- 5 years) with autopsy-proven adrenal adenoma. Documented histologically normal tissue from age-matched patients was used for comparison. Tissue sections were stained with the collagen specific stain Sirius Red F3BA and analyzed using normal and polarized light. Reactive and/or reparative fibrosis was found in the heart, pancreas, adrenal glands and lungs, but not in the kidney or liver. These observations support a link between chronic MC excess and fibrosis of the heart and systemic organs in humans with adrenal adenoma.