异位肾上腺组织肾下嗜铬细胞瘤的罕见病例:尸检病例报告

Q4 Pharmacology, Toxicology and Pharmaceutics
R. Chiciudean, I. Jung, T. Bara, S. Gurzu
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引用次数: 0

摘要

摘要:嗜铬细胞瘤是由肾上腺髓质的嗜铬细胞引起的分泌儿茶酚胺的肿瘤。我们描述了一个不寻常的嗜铬细胞瘤位于肾下区,并伴有双侧肾上腺增生。病例介绍:一位70岁的病人因晕厥、出汗和高血压入院。计算机断层扫描显示左侧肾下区一个73×70×72毫米的腹膜后肿块。尿液中发现了高水平的甲肾上腺素和去甲肾上腺素。行肿瘤切除术。术后几天,血压突然下降,无法恢复,导致患者死亡。手术标本的组织病理学检查显示单一细胞增生,胞浆嗜酸性,细胞核圆形,核仁突出排列成簇,包膜和血管浸润。肿瘤细胞表达synaptophysin和chromogranin,抑制素A和S100蛋白无阳性表达。尸检时,两肾上腺均显示增生,但与肿瘤肿块无关。组织学、位置和免疫表型提示异位肾下嗜铬细胞瘤。结论:异位肾上腺组织嗜铬细胞瘤患者的临床治疗可能很困难,有时只能通过死后的组织病理学检查来诊断。在这种无法解释进化的情况下,尸检是非常有用的。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Unusual case of infrarenal pheochromocytoma developed on ectopic adrenal tissue: An autopsy case report
Abstract Introduction: Pheochromocytomas are catecholamine-secreting tumors arising from the chromaffin cells of the adrenal medulla. We describe an unusual case of pheochromocytoma located in the infrarenal area and associated with bilateral adrenal hyperplasia. Case presentation: A 70-year-old patient was admitted for syncope, diaphoresis, and high blood pressure. Computed tomography showed a 73×70×72 mm retroperitoneal mass of the left infrarenal area. High levels of metanephrine and noradrenaline were found in the urine. A tumor resection was performed. A few days after surgery, the blood pressure suddenly decreased and could not be restored, resulting in the death of the patient. Histopathological examination of the surgical specimen revealed a proliferation of monotonous cells, with eosinophilic cytoplasm, round nuclei with prominent nucleoli arranged in clusters, and capsular and vascular invasion. The tumor cells expressed synaptophysin and chromogranin, without positivity for inhibin A or S100 protein. At the autopsy, both adrenal glands showed hyperplasia but unrelated to the tumor mass. The histological aspect, location, and immunophenotype indicated an ectopic infrarenal pheochromocytoma. Conclusions: In patients with pheochromocytoma developed on ectopic adrenal tissue, clinical management might be difficult, and diagnosis can be sometimes established only based on post-mortem histopathological examination. Autopsy can be extremely useful in such cases with unexplained evolution.
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来源期刊
Acta Marisiensis - Seria Medica
Acta Marisiensis - Seria Medica Pharmacology, Toxicology and Pharmaceutics-Pharmacology, Toxicology and Pharmaceutics (all)
CiteScore
0.40
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24 weeks
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