Immunohistochemistry was carried out using the peroxidase-antiperoxidase method on fresh frozen human tissue. In cases where fresh frozen tissue was unavailable, immunohistochemistry was performed on formalin-fixed, paraffin-embedded adrenal sections (4 μm) using an automated immunostainer with cover tile technology (Bond-III system, Leica Biosystems). NPNT antibody (HPA003711, Sigma; 1:50 dilution), and CYP11B2 antibody (custom mouse anti-human antibody from Dr Celso E. Gomez-Sanchez)22 (link) were used as the primary antibodies. Further details are provided in the Data Supplement.