目的 探討腎上腺髓脂瘤的CT 特征及其病理基礎(chǔ),以提高其CT診斷水平。
方法 對(duì)12例經(jīng)手術(shù)及病理學(xué)檢查證實(shí)的腎上腺髓脂瘤患者的臨床及影像學(xué)資料進(jìn)行回顧性分析。在CT 圖像上,觀察病變的位置、大小、形態(tài)、密度、內(nèi)部結(jié)構(gòu)及其與周圍結(jié)構(gòu)的關(guān)系,并結(jié)合病理學(xué)特征進(jìn)行分析。
結(jié)果 12例腎上腺髓脂瘤發(fā)生在左側(cè)2例,右側(cè)9例,雙側(cè)1例。CT特征表現(xiàn)為以脂肪密度為主的混雜密度腫塊。病理學(xué)檢查顯示腫瘤由成熟脂肪細(xì)胞和骨髓造血細(xì)胞組成。術(shù)前CT診斷與術(shù)后病理學(xué)檢查結(jié)果符合者為11/12例。
結(jié)論 腎上腺髓脂瘤雖然較為少見(jiàn),但其病理成分特殊,CT表現(xiàn)極具特征性,結(jié)合臨床和化驗(yàn)檢查,術(shù)前完全能夠正確診斷。
引用本文: 張麗芝,曾涵江,黃子星,宋彬. 腎上腺髓脂瘤的CT表現(xiàn)及其病理基礎(chǔ). 中國(guó)普外基礎(chǔ)與臨床雜志, 2013, 20(4): 458-461. doi: 復(fù)制
1. | Schaeffer EM, Kavoussi LR. Adrenal myelolipoma[J]. J Urol, 2005, 173(5):1760. |
2. | Wagnerová H, Lazúrová I, Bober J, et al. Adrenal myelolipoma. 6 cases and a review of the literature[J] . Neoplasma, 2004, 51(4) :300-305. |
3. | Porcaro AB, Novella G, Ficarra V, et al. Incidentally discovered adrenal myelolipoma. Report on 3 operated patients and update of the literature[J]. Arch Ital Urol Androl, 2002, 74(3):146-151. |
4. | 田偉, 馮毓正, 普平. 腎上腺間質(zhì)組織腫瘤的CT 和MRI 表現(xiàn)[J]. 中華放射學(xué)雜志, 1999, 33(1):54-56. |
5. | 鄭敏文, 宦怡, 葛雅麗. 腎上腺少見(jiàn)腫瘤的CT 診斷[J]. 實(shí)用放射學(xué)雜志, 2002, 18 (9):781-782. |
6. | Segura Martín M, Lorenzo Romero JG, Salinas Sánchez AA, et al. Bilateral adrenal myelolipoma[J]. Urol Int, 1999, 62(4):226-228. |
7. | Dunnick NR. Hanson lecture. Adrenal imaging:current status[J]. AJR Am J Roentgenol, 1990, 154(5):927-936. |
8. | EI-Mekresh MM, Abdel-Gawad M, EI-baz M, et al. Clinical, radiological and histological features of adrenal myelolipoma:review and experience with a further eight cases[J]. Br J Urol, 1996, 78(3):345-350. |
9. | Bednarek Tupikowska G, Tupikowski K, Akinpelumi BF. Adrenal myelolipma[J]. Pol Merkur Lekarski, 2005, 18(103):107-110. |
10. | Wrightson WR, Hahm TX, Hutchinson JR, et al. Bilateral giantadrenal myelolipomas:a case report[J]. Am Surg, 2002, 68(6):588-589. |
11. | Francis IR, Gross MD, Shapiro B, et al. Intgrated imaging of adrenal disease[J]. Radiology, 1992, 184(1):1-13. |
12. | Nakajo M, Onohara S, Shinmura K, et al. Embolization for spontaneous retroperitoneal hemorrhage from adrenal myelolipoma[J]. Radiat Med, 2003, 21(5):214-219. |
13. | Robbani L, Shah L, Shoh OJ, et al. Diagnosis of adrenal myeloli-poma by imaging and guided biopsy[J]. Ceylon Med J, 2003, 48(1):24-25. |
14. | 郭應(yīng)坤, 楊志剛, 張梅, 等. 腎上腺少見(jiàn)腫瘤的CT 表現(xiàn)及其病理基礎(chǔ)[J]. 臨床放射學(xué)雜志, 2005, 24(1):46-49. |
15. | Khong PL, Lam KY, Ooi CG, et al. Muture teratomas of the adrenal gland:imaging features[J]. Abdom Imaging, 2002, 27(3):347-350. |
16. | Radin R, David CL, Goldfarb H, et al. Adrenal and extra-adrenal retroperitoneal ganglioneuroma:imaging findings in 13 adults[J]. Radiology, 1997, 202(3):703-707. |
17. | Johnson GL, Hruban RH, Marshall FF, et al. Primary adrenal ganglioneuroma:CT fingings in four patients[J]. AJR Am J Roentgenol, 1997, 169(1):169-171. |
18. | Serrano S, Tejedor L, Carcia B, et al. Addisonian crisis as the presenting feature of bilateral primary adrenal lymphoma[J]. Cancer, 1993, 71(12):4030-4033. |
19. | Harris GJ, Tio FO, Von hoff DD. Primary adrenal lymphoma[J]. Cancer, 1989, 63(4):799-803. |
20. | Elsayes KM, Mukundan G, Narra VR. Adrenal masses:MR imaging features with pathologic correlation[J] . Radiographics, 2004, 24(Suppl 1):S73- S 86. |
21. | 楊志剛, 閔鵬秋, 余建群, 等. 腹部惡性淋巴瘤螺旋CT 表現(xiàn)特征[J]. 臨床放射學(xué)雜志, 2003, 22(8):680-683. |
22. | Andreu J, Alegret X, Perez C, et al. Cystic schwanoma mimic-king adrenal tumor[J]. Comput Med Imaging Graph, 1988,12(3):. |
23. | 程傳明, 馬志軍, 劉小妹, 等. 腎上腺腫瘤的CT 征象及鑒別診斷[J]. 醫(yī)學(xué)影像學(xué)雜志, 2005, 15(11):974-977. |
24. | Rozenblit A, Morehouse HT, Amis ES. Cystic adrenal lesions:CT features[J]. Radiology, 1996, 201(1):541-548. |
25. | 劉宏霞, 楊有萬(wàn), 臧任麗, 等. 腎上腺腫瘤的螺旋CT 診斷及鑒別診斷[J]. 醫(yī)學(xué)影像學(xué)雜志, 2009, 19(5):558-560. |
26. | -185. |
- 1. Schaeffer EM, Kavoussi LR. Adrenal myelolipoma[J]. J Urol, 2005, 173(5):1760.
- 2. Wagnerová H, Lazúrová I, Bober J, et al. Adrenal myelolipoma. 6 cases and a review of the literature[J] . Neoplasma, 2004, 51(4) :300-305.
- 3. Porcaro AB, Novella G, Ficarra V, et al. Incidentally discovered adrenal myelolipoma. Report on 3 operated patients and update of the literature[J]. Arch Ital Urol Androl, 2002, 74(3):146-151.
- 4. 田偉, 馮毓正, 普平. 腎上腺間質(zhì)組織腫瘤的CT 和MRI 表現(xiàn)[J]. 中華放射學(xué)雜志, 1999, 33(1):54-56.
- 5. 鄭敏文, 宦怡, 葛雅麗. 腎上腺少見(jiàn)腫瘤的CT 診斷[J]. 實(shí)用放射學(xué)雜志, 2002, 18 (9):781-782.
- 6. Segura Martín M, Lorenzo Romero JG, Salinas Sánchez AA, et al. Bilateral adrenal myelolipoma[J]. Urol Int, 1999, 62(4):226-228.
- 7. Dunnick NR. Hanson lecture. Adrenal imaging:current status[J]. AJR Am J Roentgenol, 1990, 154(5):927-936.
- 8. EI-Mekresh MM, Abdel-Gawad M, EI-baz M, et al. Clinical, radiological and histological features of adrenal myelolipoma:review and experience with a further eight cases[J]. Br J Urol, 1996, 78(3):345-350.
- 9. Bednarek Tupikowska G, Tupikowski K, Akinpelumi BF. Adrenal myelolipma[J]. Pol Merkur Lekarski, 2005, 18(103):107-110.
- 10. Wrightson WR, Hahm TX, Hutchinson JR, et al. Bilateral giantadrenal myelolipomas:a case report[J]. Am Surg, 2002, 68(6):588-589.
- 11. Francis IR, Gross MD, Shapiro B, et al. Intgrated imaging of adrenal disease[J]. Radiology, 1992, 184(1):1-13.
- 12. Nakajo M, Onohara S, Shinmura K, et al. Embolization for spontaneous retroperitoneal hemorrhage from adrenal myelolipoma[J]. Radiat Med, 2003, 21(5):214-219.
- 13. Robbani L, Shah L, Shoh OJ, et al. Diagnosis of adrenal myeloli-poma by imaging and guided biopsy[J]. Ceylon Med J, 2003, 48(1):24-25.
- 14. 郭應(yīng)坤, 楊志剛, 張梅, 等. 腎上腺少見(jiàn)腫瘤的CT 表現(xiàn)及其病理基礎(chǔ)[J]. 臨床放射學(xué)雜志, 2005, 24(1):46-49.
- 15. Khong PL, Lam KY, Ooi CG, et al. Muture teratomas of the adrenal gland:imaging features[J]. Abdom Imaging, 2002, 27(3):347-350.
- 16. Radin R, David CL, Goldfarb H, et al. Adrenal and extra-adrenal retroperitoneal ganglioneuroma:imaging findings in 13 adults[J]. Radiology, 1997, 202(3):703-707.
- 17. Johnson GL, Hruban RH, Marshall FF, et al. Primary adrenal ganglioneuroma:CT fingings in four patients[J]. AJR Am J Roentgenol, 1997, 169(1):169-171.
- 18. Serrano S, Tejedor L, Carcia B, et al. Addisonian crisis as the presenting feature of bilateral primary adrenal lymphoma[J]. Cancer, 1993, 71(12):4030-4033.
- 19. Harris GJ, Tio FO, Von hoff DD. Primary adrenal lymphoma[J]. Cancer, 1989, 63(4):799-803.
- 20. Elsayes KM, Mukundan G, Narra VR. Adrenal masses:MR imaging features with pathologic correlation[J] . Radiographics, 2004, 24(Suppl 1):S73- S 86.
- 21. 楊志剛, 閔鵬秋, 余建群, 等. 腹部惡性淋巴瘤螺旋CT 表現(xiàn)特征[J]. 臨床放射學(xué)雜志, 2003, 22(8):680-683.
- 22. Andreu J, Alegret X, Perez C, et al. Cystic schwanoma mimic-king adrenal tumor[J]. Comput Med Imaging Graph, 1988,12(3):.
- 23. 程傳明, 馬志軍, 劉小妹, 等. 腎上腺腫瘤的CT 征象及鑒別診斷[J]. 醫(yī)學(xué)影像學(xué)雜志, 2005, 15(11):974-977.
- 24. Rozenblit A, Morehouse HT, Amis ES. Cystic adrenal lesions:CT features[J]. Radiology, 1996, 201(1):541-548.
- 25. 劉宏霞, 楊有萬(wàn), 臧任麗, 等. 腎上腺腫瘤的螺旋CT 診斷及鑒別診斷[J]. 醫(yī)學(xué)影像學(xué)雜志, 2009, 19(5):558-560.
- 26. -185.