肾上腺囊肿23例临床与病理分析

目的：探讨肾上腺囊肿的临床诊断与病理分型。方法：收集2005年-2010年手术切除的23例肾上腺囊肿标本,10%的福尔马林固定、石蜡包埋、切片、HE染色、显微镜观察诊断并复习相关文献。结果：23例标本中,最大直径2.5cm-8cm,上皮性囊肿2例占8.7%（2/23）、内皮性囊肿8例占34.8%（8/23）,假性囊肿12例占52.2%（12/23）,寄生虫性囊肿1例占4.3%（1/23）。结论：肾上腺囊肿的病理分型以假性囊肿比例较高,其次为内皮性囊肿。影像学具有很高的诊断参考价值,但确诊仍需病理检查。     

超声检查诊断卵巢良恶性肿瘤的临床价值分析

目的探究超声检查诊断卵巢良恶性肿瘤的临床价值。方法选取2013年3月至2016年3月间琼中黎族苗族自治县人民医院收治的90例卵巢肿瘤患者,按照检测方法不同分为观察组与对照组,每组45例。观察组采用超声检查,对照组采用X线检查,结合病理检查对照,观察分析两组患者卵巢肿瘤良恶性诊断符合率和良恶性病变类型。结果观察组患者超声检测出恶性肿瘤患者23例,符合率为100.0%(23/23),良性肿瘤患者22例,符合率为95.5%(21/22)。观察组中良性肿瘤病理诊断病变类型有卵巢囊肿4例,浆液性囊肿腺瘤3例,黏液性囊肿腺瘤2例,输卵管炎症3例,闭锁黄体3例,红体1例,黄体囊肿2例,副输卵管囊肿2例,子宫内膜异位症1例;恶性肿瘤病理诊断病变类型有腺癌2例,卵巢癌6例,透明细胞癌3例,子宫内膜样癌2例,成熟囊性畸胎瘤3例,乳头状癌2例,梭形细胞肿瘤3例,浆液性囊腺癌2例。对照组患者X线片检测出的恶性肿瘤符合率为80.0%(16/20),良性肿瘤符合率为76.0%(19/25),其良恶性肿瘤的病变类型未有明确辨别,两组患者的良恶性诊断符合率和病变类型差异均有统计学意义(均P<0.05)。结论采用超声检查对卵巢肿瘤患者进行诊断,可较好地提高卵巢肿瘤患者的诊断符合率,对临床诊断和治疗具有较大意义。     

异位嗜铬细胞瘤17例

目的:总结异住嗜铬细胞瘤的临床特点,以增进对本病的认识,提高诊断和治疗水平.方法:回顾性分析本院1975年至2008年共17例经病理证实为异位嗜铬细胞瘤患者的临床资料.结果:17例中,良性者占70.59%(12/17),恶性者占29.41%(5/17).单发者占88.24%(15/17),多发者占11.76%(2/17).血压正常者占52.94%(9/17),伴有高血压病史者占47.06%(8/17).17例患者中检测24小时尿3-甲氧基4羟基苦杏仁酸(VMA)共11例,其中7例高于正常,VMA异常升高阳性率为63.64%(7/11).17例中1例发生于膀胱,余16例均发生于腹部:腹主动脉旁41.18%(7/17)、下腔静脉旁17.65%(3/17)、肾门附近11.76%(2/17),邻近胰头、降结肠、十二指肠水平部、骶骨前各5.88%(1/17).位于脊柱左侧占52.94%(9/17),位于脊柱右侧占41.18%(7/17),位于脊柱中央占5.88%(1/17).病灶最大直径>5cm者占82.35%(14/17),<5cm者占17.65%(3/17).17例中手术治疗者占94.12%(16/17),根治性切除肿瘤者占70.59%(12/17),姑息性切除肿瘤者占5.88%(1/17),无法切除仅行病理学检查明确病理者占17.65%(3/17).开腹手术中触摸或挤压肿物时,46.67%(7/15)出现血压明显增高.结论:异位嗜铬细胞瘤很少见,早期诊断较困难.其恶性发病率较发生在肾上腺的嗜铬细胞瘤高;病理学检查不是恶性嗜铬细胞瘤诊断的金标准.患者常伴高血压病史;病灶多邻近腹主动脉、下腔静脉、肾门;单发者较多;就诊时肿瘤最大直径常在5 cm以上:检测24小时尿VMA是诊断的重要生化指标;手术切除是唯一的根治性治疗手段,术中触摸或挤压肿物时易出现血压明显增高.根治性切除预后良好;手术成败关键之一是良好的术前扩容准备.     

结直肠癌及肝和区域淋巴结转移灶CXCR4表达临床意义分析

目的:观察CXCR4在结直肠癌及肝和区域淋巴结转移灶中的表达,分析其与结直肠癌临床病理因素的关系。方法:应用SP免疫组化方法检测48例结直肠癌组织、48例癌旁正常组织、15例肝转移灶和23例区域淋巴结转移灶中CX-CR4的表达。结果:48例癌组织中CXCR4表达占95.83%(46/48),弱阳性表达占16.67%(8/48),阳性表达占29.17%(14/48),强阳性表达占50.00%(24/48);48例癌旁正常组织中CXCR4的表达率为16.67%(8/48),均为弱阳性表达。CX-CR4在结直肠癌组织中的表达率(95.83%)明显高于癌旁正常组织(16.67%),χ2=72.38,P<0.01。在伴有肝和区域淋巴结转移的病例中,15例可切除肝转移标本中CXCR4的表达率为100.00%(15/15),其中阳性表达率为20.00%(3/15),强阳性表达率为80%(12/15);23例淋巴结转移标本中CXCR4的表达率为100.00%(23/23),阳性表达率为26.09%(6/23),强阳性表达率为73.91%(17/23)。CXCR4在转移灶中的表达率(100.00%,100.00%)与原发灶中的表达率(95.83%)差异无统计学意义,χ2=1.62,P>0.05;CXCR4高表达与结直肠癌患者的年龄、性别、部位、组织学类型及大体类型无关,P>0.05;而与肝(r=0.43,P<0.05)和区域淋巴结转移(r=0.53,P<0.05)呈正相关。结论:CXCR4在结直肠癌中的表达与肝和区域淋巴结转移呈正相关,检测癌组织CXCR4的表达有助于对结直肠癌患者预后的分析。     

41例垂体Rathke囊肿的诊断和手术治疗

目的:分析和讨论垂体Rathke(拉克氏)囊肿的诊断和手术治疗.方法:回顾分析41例经手术和病理证实的垂体Rathke囊肿的病例,男性16例,女性25例;年龄13～67岁,平均32.8岁,平均病程为20.6个月.主要临床表现:头痛26例(63.4%)、垂体功能紊乱23例(56.1%)、视功能障碍13例(31.7%),CT及MRI检查发现鞍区囊性肿物.39例采用经口鼻蝶窦入路显微外科手术,2例采用开颅手术,切除部分囊壁,敞开囊腔,清除囊肿内容物.结果:术前正确诊断为垂体Rathke囊肿的仅为7例,术后随诊3个月至8年,头痛患者的症状全部缓解,垂体功能紊乱患者(13/23)56.5%得到改善,视功能障碍患者(10/13)76.9%得到改善.41例患者术后均无复发.结论:垂体Rathke囊肿术前较难明确诊断,MRI检查信号呈多样性,无特异性.经口鼻蝶窦入路显微外科手术可以明确诊断,缓解症状,患者预后良好,是治疗垂体Rathke囊肿的有效方法.     

肾上腺肿块的影像学诊断

本文报道X线造影,B超,CT对43例肾上腺肿块的诊断,并与手术结果对照研究。其中肾上腺癌3例,转移癌4例(7个癌灶),肾上腺腺瘤12例,嗜铬细胞瘤15例(16个瘤).肾上腺囊肿4例,肾上腺髓质脂肪瘤和髓质出血各1例,肾上腺皮质增生肥大3例。X线腹膜后空气造影、X线肾盂造影、B超、CT诊断正确率分别为40％(2/5)、28.6％(2/7)、79.1％(34/43)、93％(40/43)。B超和CT联合诊断率为95.3％.我们认为,B超和CT是目前诊断肾上腺疾病的首选方法,两者结合诊断可提高术前诊断正确率与诊断水平。     

单纯放射治疗阴茎癌的远期效果——附44例临床分析

本文回顾性分析我院1958年到1984年底单纯放射治疗阴茎癌44例的远期效果。 材料与方法 患者年龄:23～67岁,平均年龄40.2岁。 患者病程1个月～15年,发病1年以内就诊者占73％(32/44)。患者中包茎、包皮过长者91％(40/44)。包皮龟头炎占57％(25/44)。肿瘤位于龟头者占43％(19/44),冠状沟30％(13/44),包皮内板27％(12/44)。 病理诊断:全组中鳞癌38例(86％),癌末分型2例,无病理4例,均为晚期病例,其中T_4N_33     

经阴道彩色多普勒超声诊断卵巢肿瘤

本文采用经阴道彩色多普勒超声探测卵巢肿瘤实质及表面的血流,评价动脉波型与恶性卵巢肿瘤关系,并与CA125、二维超声图像分型的诊断进行了比较.24例卵巢肿瘤均经组织学确诊,其中恶性9例,包括原发性卵巢肿瘤4例,低度恶性囊腺瘤2例,转移性卵巢瘤1例,颗粒细胞瘤和腹膜后恶性神经鞘瘤各1例;良性病变15例,包括卵巢巧克力囊肿8例,囊性畸胎瘤和粘蛋白囊腺瘤各2例,泡膜细胞瘤、卵巢冠囊肿和卵泡囊肿各1例.脉动指数(PI)=收缩期峰值流速一舒张末期速度/平均速度,其倒数为1/PI.探及动脉波型共11/24例(45.8%),其中良性3/15例(20.0%),恶性8/9例(88.9%).     

前纵隔肿瘤的影像学与临床病理对照分析

目的:探讨前纵隔常见肿瘤的临床、病理及影像学特点。方法:回顾性分析经手术、穿刺活检病理证实的前纵隔肿瘤48例,并结合临床、病理资料进行对照分析。结果:胸腺瘤占50%(24例),均位于前上纵膈,11例可见囊变、坏死区或钙化,增强后呈轻度或不均匀强化。畸胎瘤占23%(11例),前上纵隔5例,前下纵隔6例,以囊实性为主,其内可见软组织、液体、脂肪及钙化成份,囊壁及实性成份呈轻中度强化。淋巴瘤17%(8例),可见多个结节样软组织融合呈团块状肿物,2例见坏死、囊变区,呈轻度强化或无强化。胸内甲状腺肿6%（3例）。心包囊肿4%（2例）。结论:依据前纵隔常见肿瘤发病部位、密度以及周围组织结构的关系,结合患者年龄伴随体征等特征,可提高前纵隔肿瘤的诊断与鉴别诊断准确率。     

KLK10和VEGF在卵巢癌组织中的表达及其临床意义

目的：分析激肽释放酶10（kallikrein 10,KLK10）和血管内皮生长因子（vascular endothelial growth factor,VEGF）在卵巢癌组织中的表达,探讨两者在卵巢癌临床诊断、治疗及预后中的意义。方法：收集2004年1月至2009年1月在南通大学附属医院妇科收治的45例卵巢癌、10例良性和12例交界性卵巢肿瘤组织石蜡切片标本,应用免疫组化法检测标本中KLK10蛋白和VEGF的表达,并分析两者表达的相关性及与卵巢癌各临床病理指标和预后的关系。结果：KLK10 \[86.7%(39/45) vs 10.0%(1/10)、58.3%(7/12), P <0.05\]和VEGF\[（82.2%(37/45) vs 20.0%(2/10)、41.4%(5/12), P <0.05\]在卵巢癌组织中的阳性表达率均明显高于卵巢良性、交界性肿瘤组织。KLK10和VEGF表达阳性率分别与分期、肿瘤分化、淋巴结转移、5年生存率有关（ P <0.05）,与患者年龄、病理分型、血清CA125水平、腹水及残余肿瘤直径无关（ P >0.05）;KLK10和VEGF蛋白在卵巢癌中的表达呈正相关性（ r =0.5279, P =0.043）。结论：KLK10和VEGF蛋白在卵巢癌中均为高表达,两者表达呈正相关,两者均似可作为卵巢癌诊断、治疗及预后的标志物。     

穿刺加三苯氧胺治疗乳腺囊肿的疗效观察(附36例)

目的：比较乳腺可扪及囊肿穿刺抽液后服用三苯氧胺和单纯穿刺抽液两种治疗方法的疗效.方法：将临床可扪及乳腺囊肿根据乳腺B超检查结果入组68例,随机分为穿刺抽液治疗组32例和穿刺抽液后服三苯氧胺治疗组36例,两组患者穿刺抽液后中位随访13个月观察疗效.结果：68例可扪及乳腺单纯囊肿,平均囊肿大小23mm,36例穿刺服三苯氧胺组复发率13.89%（5/36）,32例穿刺抽液组复发率37.50%（12/32）,两组相比较（P＜0.05）有显著性差异.乳腺囊肿病史＞1年的患者,穿刺服三苯氧胺组和穿刺组复发率分别是36.36%（4/11）和77.78%（7/9）,两组相比较（P＜0.05）差异有显著性.对单个囊肿,多发囊肿,囊肿病史＜1年患者,两种治疗方法不影响复发率（P＞0.05）.结论：临床可扪及乳腺单纯囊肿可根据B超检查筛选适合穿刺患者,穿刺抽液加服三苯氧胺治疗可减少复发,囊肿病史＞1年者复发率较高.     

Endoscopic ultrasound-guided fine-needle aspiration in 179 cases: the M. D. Anderson Cancer Center experience

BACKGROUND: Recently, endoscopic ultrasound-guided fine-needle aspiration (EUS-FNA) has emerged as a diagnostic adjunct for small pancreatic lesions and abdominal and mediastinal lymph node diseases.DESIGN: During a 21-month period, we performed 179 EUS-FNAs in 166 consecutive patients; these data are the subject of this study. An average of 2.6 needle passes were obtained and aspiration was performed most commonly in the pancreas (162 cases, 91%). The FNA smears were reviewed using six diagnostic categories (negative for malignancy/nondiagnostic [NND], atypia, suspicious for malignancy, benign tumor/cyst, neuroendocrine neoplasm [NEN], and carcinoma). The review diagnosis was correlated with the histologic diagnosis made on resection or surgical biopsy specimens in 70 cases. Up to 17 months of clinical follow-up were sought for the cases with a negative or inconclusive FNA diagnosis and no diagnostic tissue confirmation (81 cases).RESULTS: The review FNA diagnoses were as follows: NND (49 cases), atypia (17 cases), suspicious for malignancy (12 cases), benign tumor/cyst excluding NEN (10 cases), NEN (6 cases), carcinoma (85 cases). Follow-up methods included resection (49 cases), surgical biopsy (21 cases), repeat FNA or brushing cytology (28 cases), and clinical follow-up only (81 cases). Of the 49 NND cases, 23 (47%) had positive follow-up results (i.e., false-negative diagnosis) that were confirmed by tissue diagnosis (resection/surgical biopsy in 11 cases [48%] and repeat FNA/brushing in 12 cases [52%]). These included pancreatic/ampullary adenocarcinoma in 20 cases, esophageal squamous carcinoma in 1 case, and NEN in 2 cases. Follow-up also revealed carcinoma in all 12 suspicious cases and 13 pancreatic adenocarcinomas and 1 microcystic adenoma in 14 of the 17 atypical cases. Overall, repeat computed tomography (CT)-guided FNA samples yielded a definite diagnosis in four atypical and seven NND cases, whereas EUS-FNA results provided a definite diagnosis in three cases in which CT-guided FNA failed and in two cases in which ampullary biopsy failed. No false-positive cases were identified. The false-negative rate due to inadequate sampling was 13.2%. Sensitivity (including cases with inadequate cellularity and nondiagnostic aspirates) was 81.7% and specificity was 100%. None of the factors evaluated (lesion characteristics, aspiration site, and tumor type) significantly influenced diagnostic results.CONCLUSION: EUS-FNA is a valuable diagnostic and staging tool with high specificity and sensitivity. Negative or nondiagnostic cases on EUS-FNA require further diagnostic work for a definitive diagnosis when clinical or radiographic findings do not correlate with the FNA results.     

Serous cystadenoma of the pancreas: limitations and pitfalls of endoscopic ultrasound-guided fine-needle aspiration biopsy

BACKGROUND: Expectant management of serous cystadenoma (SCA) of the pancreas requires an accurate preoperative diagnosis. Previously published cytologic diagnostic sensitivities have ranged widely, from 10% to 100%. In the current study, the authors evaluated the diagnostic sensitivity of endoscopic ultrasound (EUS)-guided fine-needle aspiration biopsy (FNAB) and cross-sectional imaging for SCA. METHODS: Group I consisted of 21 histologically confirmed SCAs. Group II (n = 7 lesions) lacked histologic confirmation and was defined by EUS findings that were consistent with SCA and a cyst fluid carcinoembryonic antigen (CEA) level <5 ng/mL. Group III was comprised of 2 nonserous and potentially malignant cysts of the pancreas for which a preoperative diagnosis of SCA was considered. Cross-sectional imaging data were recorded. The smears were evaluated for the presence of serous lining epithelium, gastrointestinal-contaminating epithelium, and inflammatory cells including hemosiderin-laden macrophages. The authors also evaluated the presence of hemosiderin-laden macrophages in a series of 110 FNA specimens from histologically confirmed neoplastic mucinous cysts of the pancreas and 45 pseudocysts of the pancreas. RESULTS: Prospectively among Group I lesions, the appearance on computed tomography (CT) was considered definitive for SCA in 3 of 12 cases (25%). The histologically confirmed SCA cases had CEA levels of <5 ng/mL, except for 1 case for which the CEA level was 176.5 ng/mL. A cytologic diagnosis of SCA was made prospectively in only 1 CT-guided case. Retrospectively, 3 intraoperative FNAs and 1 additional CT-guided aspirate contained rare epithelial cells of a SCA. None of the EUS-guided aspirates demonstrated serous epithelium. Among Group II aspiration specimens, only 1 contained serous epithelial cells. Approximately 52% of the EUS-guided aspirates demonstrated gastrointestinal contamination. This glandular epithelium was categorized as atypical in 2 cases. Hemosiderin-laden macrophages were identified in 43% of the SCAs. Conversely, only 2% of neoplastic mucinous cysts and 9% of pseudocysts produced hemosiderin-laden macrophages in aspirate fluid. CONCLUSIONS: In the current study, serous epithelial cells were identified in <20% of cases. Gastrointestinal-contaminating epithelium, often observed in EUS-guided aspirates, further contributes to difficulties in interpretation. The presence of hemosiderin-laden macrophages as a surrogate marker for SCA requires further study. A preoperative diagnosis of SCA remains a challenge, and an EUS-guided FNAB is unlikely to provide the high level of diagnostic accuracy necessary to permit a nonoperative approach.     

成人支气管囊肿的CT诊断

目的:探讨CT扫描对支气管囊肿的诊断价值.方法:回顾性分析13例经手术和病理证实的成人支气管囊肿患者的CT表现.结果:纵隔型支气管囊肿3例,直径4～13cm,1例呈囊性,2例为软组织密度肿块,增强后其囊内容物及囊壁均未见强化,显示为高密度囊肿.肺内型支气管囊肿10例,直径0.5～6.0cm,含气和含液囊肿分别为2例和3例,均为边界清楚的圆形或卵圆形病灶,囊壁有强化,囊内容物未见强化;软组织肿块5例,1例合并肺段隔离症,1例边缘有环形钙化,3例为边缘模糊的不规则肿块.结论:CT平扫和增强对含气和含液支气管囊肿的诊断有特异性,对软组织密度支气管囊肿的鉴别诊断较困难,增强CT扫描有助于高密度囊肿的诊断.     

Interphase fluorescence in situ hybridization analysis of chromosome 12p abnormalities is useful for distinguishing epidermoid cysts of the testis from pure mature teratoma.

PURPOSE: The distinction of epidermoid cyst of the testis from teratoma is of critical importance because the former is benign and the latter is a malignant tumor that may have associated metastasis of either teratomatous or non-teratomatous germ cell tumor types. Chromosome 12p abnormalities are seen in the vast majority of testicular germ cell tumors of adults and are present in all histologic subtypes. In this study, we investigated the clinical utility of interphase fluorescence in situ hybridization (FISH) analysis of chromosome 12p abnormalities for distinguishing epidermoid cysts of the testis from pure mature teratoma. EXPERIMENTAL DESIGN: Sixteen testicular epidermoid cysts and 17 testicular teratomas were investigated for isochromosome 12p [i(12p)] and 12p overrepresentation using interphase FISH analysis. RESULTS: Neither i(12p) nor 12p overrepresentation were observed in 16 epidermoid cyst cases, whereas i(12p) was detected in 76% of teratomas and 12p overrepresentation was identified in 29% of teratomas. Overall, 88% of testicular teratomas had chromosome 12p abnormalities. CONCLUSIONS: FISH identification of i(12p) and/or 12p overrepresentation in routinely processed surgical specimens is a useful ancillary diagnostic tool in distinguishing testicular epidermoid cysts from teratoma.     

Epidermoid Cysts in Head and Neck: Our Experiences,with Review of Literature

Epidermoid cysts are benign lesions, characterized by cystic spaces lined by simple squamous epithelium (epidermoid cyst), containing skin adnexa (“true” dermoid cyst) or tissues of all three germ layers (teratoid cyst). Head and neck constitute ~7% of all cases of epidermoid and dermoid cysts. There is often a diagnostic dilemma with the more common cystic lesions of this region. A retrospective case-series study of histologically proved epidermoid cysts in the head–neck region, from February 2008 to January 2011, in the Department of Otorhinolaryngology and Head-Neck Surgery of a tertiary Government teaching hospital in eastern India. The diagnosis was reached by fine needle aspiration cytology FNAC and subsequent histopathology where feasible. Necessary imaging was done for evaluation and management. A total of 28 cases were analyzed. 5 were female, with a male: female ratio of 4.6. Age range was from 2 to 60 years (mean = 30). Excision was the preferred treatment in 20 cases (71.4%). Various sites like the submandibular region (5), pinna (5), sublingual region (1), periorbital (6), suprasternal (6), along the anterior border of sternocleidomastoid (1) and glabella (3) were involved, along with an iatrogenic implantation epidermoid cyst in a tracheostomy scar. Some of the interesting cases presenting with clinical dilemma have been emphasized. Epidermoid cysts are relatively less common in the head–neck region, hence are liable to be misdiagnosed. In this case-series, few cases presenting with enough elements of confusion and dilemma are discussed with overall analysis and review of the related literature.     

Molecular analysis of pancreatic cyst fluid

BACKGROUND:

The management of patients with pancreatic cysts is based on the preoperative distinction of nonmucinous and mucinous cysts in general and of benign and malignant cysts in particular. An accurate diagnosis is challenging, because endoscopic ultrasound (EUS) and cyst fluid analysis for carcinoembryonic antigen (CEA) and cytology have low sensitivity and specificity. Currently, molecular analysis is a commercially available test that promises an accurate diagnosis. The objective of the current study was to correlate a commercially provided molecular diagnosis (MDx) with a clinical consensus diagnosis (CCD) in the general categories of malignant, benign mucinous, and benign nonmucinous pancreatic cysts.

METHODS:

Pancreatic cysts that had aspirated fluid submitted for a commercially available molecular test (PathFinderTG) were reviewed. The CCD, defined by histology, malignant cytology, or 2 concordant tests (such as EUS, cytology, or CEA ≥192 ng/mL for mucinous cysts), was categorized as malignant, benign mucinous, or benign nonmucinous cyst in 35 patients. Their MDx, based on the PathFinderTG report, including analysis of k‐ras mutation, loss of heterozygosity, and quantity/quality of DNA, also was classified as malignant, benign mucinous, or benign nonmucinous cyst. These 2 diagnoses were compared and correlated.

RESULTS:

The concordance between CCD and MDx was 5 of 6 (83%), 13 of 15 (87%), and 13 of 14 (93%), respectively, for malignant, benign mucinous, and benign nonmucinous cysts, with an overall Cohen kappa statistic of 0.816. The sensitivity, specificity, and positive predictive value of the MDx were 83%, 100%, and 100%, respectively, for a malignant cyst and 86%, 93%, and 95%, respectively for a benign mucinous cyst.

CONCLUSIONS:

Molecular analysis of pancreatic cyst fluid adds diagnostic value to the preoperative diagnosis with high sensitivity, specificity, and positive predictive value for the diagnosis of malignant and benign mucinous pancreatic cysts. Cancer (Cancer Cytopathol) 2009. © 2009 American Cancer Society.     

肾上腺淋巴管瘤临床特征分析

目的:探讨肾上腺淋巴管瘤的临床特征,提高对该病的认识。方法:回顾性分析我院2015年05月至2021年05月术后经病理证实为肾上腺淋巴管瘤患者的临床资料。结果:本组病例共11例（左侧4例、右侧7例）,男性3例、女性8例;患者年龄范围为22~54岁,中位年龄39岁。体检发现肾上腺占位7例,以血压升高就诊2例,因肾盂积水入院检查发现肾上腺占位1例,间歇性颜面潮红伴腹泻1例。超声示病灶为无回声包块;CT平扫示病灶呈囊性低密度影,边界清楚,部分可见分隔及钙化,增强后无强化或边缘及分隔轻度强化;MRI检查示肿块呈长T1、长T2信号影,增强扫描未见明显强化或可见囊壁及分隔轻度强化。所有患者均行手术治疗,术后病理均诊断为淋巴管瘤;病理示病灶质软、色灰黄,直径范围约0.1~7.0 cm,镜下见病灶由许多扩张的淋巴管构成,管腔内覆以扁平内皮细胞,无明显核分裂象;免疫组织化学染色示CD31阳性率100%（8/8）,CD34阳性率88.9%（8/9）,D2-40阳性率75.0%（6/8）。结论:淋巴管瘤是一种罕见的淋巴系统疾病,当位于肾上腺时,好发于右侧,以女性为主,临床表现无特异性,多为偶然发现,影像学表现具有一定特征,但最后确诊依赖于病理学及免疫组织化学染色检查,推荐个体化治疗。