原发性肾上腺神经节细胞瘤1例

患者,男,43岁,高血压阵发性加剧,伴头晕10年。B超发现左侧肾上腺占位性病变,CT扫描示:左侧肾上腺区肿瘤,7 cm×7.5 cm×8 cm,伴部分囊性变。10年前高血压130~160/85~100 mmHg间,发作时血压高达180/110 mmHg,伴头痛、眩晕、出冷汗、心慌,对症处理可缓解。近年来发作较频繁。体检、血压140/90 mmHg,余无异常发现。血电解质、肝肾功能无异常,24 h尿醛固酮、17-羟、17-酮正常;VMA 147.97μmoL/L、CA 1 347.48 nmol/L、E 1 135.68 nmol/L、NE 211.80 nmol/L。术前诊断左侧肾上腺嗜铬细胞瘤,全麻下行经腹手术完整切除肿瘤,囊内抽出70 m l…     

巨大肾上腺肿瘤1例报告

1 临床资料 病史:患者陈某,女,29岁,以"发现右侧肾上腺占位1年"入院.1年前,无明显诱因出现全身乏力、心悸、多汗,伴气短、烦躁易怒,不思饮食、恶心呕吐等,无腹痛及腹泻,以"甲状腺功能亢进"收治于内分泌科.既往有"高血压病史5年".病史中体重增加15 kg,入院查体血压170/110 mmHg,体型肥胖,甲状腺无肿大.辅助检查:空腹血糖19.84 mmol/L,电解质K+3.8 mmol/L,Na+133.4 mmol/L,尿常规:尿糖(3+),酮体(2+),血常规正常.     

巨大肾上腺肿瘤1例报告

1临床资料病史:患者陈某,女,29岁,以"发现右侧肾上腺占位1年"入院。1年前,无明显诱因出现全身乏力、心悸、多汗,伴气短、烦躁易怒,不思饮食、恶心呕吐等,无腹痛及腹泻,以"甲状腺功能亢进"收治于内分泌科。既往有"高血压病史5年"。病史中体重增加15 kg,入院查体血压     

肾上腺原始神经外胚层瘤1例

<正>女,64岁,外院体检发现左侧肾上腺占位性病变3d入院。查体:双肾区对称,无隆起,无叩痛。血压:110/70mmHg(1mmHg=0.133kPa),心率80次/min。化验室检查:尿VMA(-),血儿茶酚胺、皮质醇、肾素-醛固酮值均正常。肿瘤标志物CA19-9、CEA均在正常范围。CT平扫示左肾上腺区见一巨大实性肿块,最大截面积     

双侧肾上腺非霍奇金淋巴瘤CT诊断一例

患者女,65岁。高血压、高血糖5年,腹痛、腹胀6个月,并发热2周。空腹血糖11.87mmol/L,血压190/90mmHg(1mmHg=0.133kPa),多饮,多食,T38.3℃。当地医院诊断为“Ⅱ型糖尿病,高血压”。外院CT示:双侧肾上腺区肿块(左2.9cm×2.5cm,右4.5cm×3.0cm)。本院辅助检查:放射免疫结果:皮质醇     

131I-MIBG肾上腺髓质显像胆囊显影二例

例1　患者女,32岁,因反复头晕、胸闷、心悸、消瘦、腹痛6个月,加重1个月余入院。患者于2003年3月20日在外院住院后血压呈阵发性升高,发作时血压>160110mmHg(1mmHg=0.133kPa),立基丁试验阳性,予以对症、支持治疗。4月24日在本科行131I间碘苄胍(MIBG)肾上腺髓质断层 同机CT融合显像,示双肾上腺阴性,胆囊放射性明显浓集。临床拟诊“异位嗜铬细胞瘤”。入院后血压在100～11065～85mmHg波动,有时无诱因出现腹痛、呕吐,发作时血压140105mmHg,服苯苄胺控制不佳。患者24h尿香草基扁桃酸(VMA)正常,血压升高时查5h尿VMA肌酐(Cr)比值轻度升高。…     

无功能肾上腺偶发瘤切除对血压的影响

 目的 探讨应用后腹腔镜切除无功能肾上腺偶发瘤对血压的影响。方法 选取2012-10至2014-10肾上腺瘤合并高血压,并行后腹腔镜瘤切除92例,并进行最长2年的随访观察,观察术前至术后完成随访的血压变化情况,以及手术相关并发症发生的情况。结果 共计78例完成随访。术后至完成随访期间共有69例(88.5%)高血压情况得到改善,收缩压水平由术前(167.2±5.2)mmHg降至术后随访终点(122.1±3.7)mmHg,舒张压(100.3±4.6)mmHg降至术后(79.9±2.4)mmHg,差异有统计学意义(P＜0.001);初始血压为高血压3、2、1级的患者术后血压总体改善率分别为93.1%、88.9%、 88.1%,差异无统计学意义;共发生手术并发症11例(14.1%),均无需特殊处理。结论 后腹腔镜切除肾上腺瘤能够改善一部分患者的血压水平,且手术风险较低。     

孤立性肾上腺髓脂肪瘤1例

病人 ,女 ,6 6岁。体验偶尔发现右肾上腺肿物 ,患者自感无不适。体检 :血压 139/ 90ｍｍＨｇ(1ｍｍＨｇ =0 .1333ｋｐａ) ,心、肺、肝、脾均无异常。辅助检查 :血糖、醛固酮、血游离皮质醇及 2 4ｈ尿 17-ＯＨＣＳ ,17-ＫＳ均正常。彩超示右肾上极后缘 4 .5ｃｍ× 4ｃｍ较强回声光团。轮廓清 ,内部回声均匀。ＣＴ示右肾上腺类圆形混杂密度影 ,边界清晰。临床拟诊 :右肾上腺肿物 ,行右肾上腺肿物切除 ,手术所见为右肾上腺有一类圆形肿物 ,表面光滑 ,与周围组织无粘连。病理标本大体检查为一椭圆形肿物 ,表面光滑 ,并有散在的黄斑。切面红褐色 …     

单侧肾上腺皮质增生误诊为嗜铬细胞瘤1例

患者男,45岁。因一过性血压升高,近来加重就诊。患者5年前无明显诱因出现血压短暂升高,呈一过性。自服降压药治疗效果欠佳,近几个月血压升高明显,心跳加快,无心慌。门诊怀疑肾上腺嗜铬细胞瘤收治入院。入院后查体:一般情况可,心肺无异常,血压120/90mmHg,腹部未触及也块。超声检查左肾上腺区探及34mm×16mm低回声区,边界清,欠规整,内回声均质(图1)。CDFI:其内未见明显血流信号。右肾上腺未见异常。B超诊断:左肾上腺实性占位。CT扫描:左肾上腺见低密度影,强化扫描内见点状强化。CT诊断:左肾上腺占位可能性大,增生不能除外,随后进行尿液检…     

右侧肾上腺血管瘤1例CT动态增强分析并文献复习

患者 男,69岁,外院体检发现右肾上腺区占位后入本院。站立位-卧位血浆血管紧张素水平正常,血浆儿茶酚氨水平正常,血压140 mmHg/90 mmHg(1 mmHg=0.133 kPa)。彩超检查：右肾上腺区可见一大小约为13.8 cm×10.0 cm 囊实混合性包块,边界清晰,内回声不均。CDFI：其内可见彩流信号。诊断：右肾上腺区囊实性占位。     

Overview of adrenal imaging/adrenal CT

CT is the imaging procedure of choice for the detection of most suspected adrenal masses. But except for some patients with acute adrenal hemorrhage or fat-containing myelolipoma, the precise histologic nature of an adrenal mass is not apparent from the CT image. MIBG radionuclide scanning is useful in some patients with pheochromocytoma, whereas bilateral adrenal venous sampling for hormone assay is necessary for correct lateralization in some patients with a small aldosterone-producing adenoma. The potential value of MR imaging in the characterization of adrenal masses, especially to distinguish benign adrenal cortical adenomas from metastatic disease, is now under investigation. Currently percutaneous aspiration biopsy is still necessary to make this distinction in patients with an adrenal mass and a known extra-adrenal primary neoplasm.     

Overview of adrenal imaging/adrenal CT

CT is the imaging procedure of choice for the detection of most suspected adrenal masses. But except for some patients with acute adrenal hemorrhage or fat-containing myelolipoma, the precise histologic nature of an adrenal mass is not apparent from the CT image. MIBG radionuclide scanning is useful in some patients with pheochromocytoma, whereas bilateral adrenal venous sampling for hormone assay is necessary for correct lateralization in some patients with a small aldosterone-producing adenoma. The potential value of MR imaging in the characterization of adrenal masses, especially to distinguish benign adrenal cortical adenomas from metastatic disease, is now under investigation. Currently percutaneous aspiration biopsy is still necessary to make this distinction in patients with an adrenal mass and a known extraadrenal primary neoplasm.     

Paraovarian adrenal rest with MRI features characteristic of an adrenal adenoma

We report MR and sonographic imaging features of an incidentally detected paraovarian adrenal rest in a 44-year-old woman who was being evaluated for menorrhagia. This is the first report of chemical shift imaging identifying the presence of lipid within an adrenal rest as well as rapid washout of contrast. Both of these MR characteristics are typically seen with an adrenal adenoma.     

CT of the adrenal gland: the many faces of adrenal hemorrhage

Adrenal hemorrhage is rarely suspected clinically, exhibits no specific clinical symptoms or laboratory findings, and yet is immediately life-threatening when bilateral. Recognition of adrenal hematomas is complicated by the variable appearance of these lesions. We survey the ways in which adrenal hematomas can appear on CT and provide strategies for differentiating hematomas from other adrenal pathologies.     

Diagnosis of adrenal disorders

This article considers the various imaging modalities that can be used in the diagnosis of adrenal disorders and their relative role in the evaluation of specific adrenal disorders. Modalities discussed include abdominal radiography, nephrotomography, ultrasound, computed tomography, arteriography, venography, adrenal venous sampling, radioisotope scanning, and nuclear magnetic resonance. Disorders dealt with include Cushing's disease, pheochromocytoma, primary aldosteronism, neuroblastoma, ganglioneuroma, sympathogonioma, and nonfunctioning adrenal tumors.