偶然发现的肾上腺肿块:功能和形态学研究。

S M Corsello, S Della Casa, L Bollanti, V Rufini, C A Rota, F Danza, S Colasanti, C Vellante, L Troncone, A Barbarino
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引用次数: 14

摘要

在过去的两年中,我们连续检查了17例患者(11名女性,6名男性,20-66岁),这些患者在超声检查或计算机断层扫描中发现了一个意料之外的肾上腺肿块,原因无关。11例手术切除9(2)个直径5和12 cm的嗜铬细胞瘤,病理诊断;5、6cm神经节神经瘤2个;5例良性皮质腺瘤(3 ~ 5cm),尸检1例(弥散性恶性嗜铬细胞瘤,16cm),细针活检1例(伪性肾上腺肿块,6cm,再生肝结节)。其余6例未经组织学诊断的肿块直径小于3cm。内分泌研究显示嗜铬细胞瘤患者尿中儿茶酚胺、香草扁桃酸和肾上腺素分泌增多,神经节瘤患者尿中儿茶酚胺、香草扁桃酸和肾上腺素分泌增多。2例手术切除的皮质腺瘤和3例未手术切除的偶发瘤出现血浆肾素活性低。其中2例血清醛固酮水平升高,最终诊断分别为康氏腺瘤和地塞米松抑制性高醛固酮血症伴双侧结节性增生。一个不适当的皮质醇分泌被记录在皮质腺瘤切除。放射-胆固醇扫描显示5例切除的良性皮质腺瘤和4例未手术的偶发瘤中肾上腺肿块一侧单侧摄取增加(一致摄取)。在2个神经节瘤中发现肾上腺肿块一侧摄取减少(摄取不一致),而在其余2个未手术的偶发瘤和假性肾上腺肿块中发现不确定的双侧摄取。(摘要删节250字)
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Incidentally discovered adrenal masses: a functional and morphological study.

In the last two years we have examined 17 consecutive patients (11 females and 6 males, 20-66 years old) in whom an unsuspected adrenal mass was discovered by ultrasonography or computed tomography performed for unrelated reasons. Pathological diagnosis was available in 11 cases based on surgical excision in 9 (2 pheochromocytomas of 5 and 12 cm in diameter; 2 ganglioneuromas of 5 and 6 cm; and 5 benign cortical adenomas between 3 and 5 cm), autopsy in 1 (a disseminated malignant pheochromocytoma of 16 cm) and fine-needle biopsy in 1 (a pseudo-adrenal mass of 6 cm, that was a regenerative hepatic nodule). The remaining 6 non histologically diagnosed masses were less than 3 cm in diameter. Endocrine studies showed elevated urinary excretion of catecholamines, vanillylmandelic acid and metanephrines in the pheochromocytomas and borderline high values in ganglioneuromas. A low plasma renin activity was encountered in 2 operated cortical adenomas and 3 non operated incidentalomas. In 2 of the latters aldosterone serum levels were elevated and the final diagnoses respectively were Conn's adenoma and dexamethasone-suppressible hyperaldosteronism with bilateral nodular hyperplasia. An inappropriate cortisol secretion was documented in a cortical adenoma removed. Radio-cholesterol scintiscan showed unilateral or increased uptake on the side of adrenal mass (concordant uptake) in the 5 benign cortical adenomas removed and in 4 non operated incidentalomas. A decreased uptake on the side of the adrenal mass (discordant uptake) was found in the 2 ganglioneuromas while an indeterminate bilateral uptake was found in the 2 remaining non operated incidentalomas and in the pseudo-adrenal mass.(ABSTRACT TRUNCATED AT 250 WORDS)

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