Abstract: Objective There are a few reports on surgical treatment of idiopathic hyperaldosteronism (IHA),pathological profile and prognosis. The clinical and pathological characteristics and prognosis of 23 patients with IHA were retrospectively analyzed in order to support potential improvement of diagnosis and treatment outcome. Methods Clinical characteristics of 23 patients with IHA were analyzed retrospectively. HE staining and CYP11B2 immunostaining were performed for pathological microsocopic observation. Pathological features and surgical prognosis were analyzed. Results All samples were categorized as nonclassic pathology, including 12 cases with multiple aldosterone-producing nodules,10 cases with multiple or single aldosterone-producing micronodules. Only one case had aldosterone-producing diffuse hyperplasia. Unilateral adrenal resection was performed in all patients. Postoperatively, blood pressure and serum potassium recovered to normal range in 6 patients with a cure rate 26%. Blood pressure decreased but did not return to normal in 17 patients (improve rate 74%). Compared with the improved group, patients in the cured group had a lower pre-operative blood pressure (P＜0.05). Conclusions Multiple functional nodules and micronodules are the main types in adrenal pathology of IHA. Unilateral adrenal resections probably bring clinical benefits in these patients.

Key words: idiopathic hyperaldosteronism, pathological classification, surgical prognosis