肾上腺皮质腺瘤合并髓脂肪瘤的临床病理学特征  

Myelolipoma within adrenocortical adenoma:a clinicopathologic study

作　　者：缑向楠 马亚琪[1] 赵泽坤 王辅林[1] GOU Xiang-nan;MA Ya-qi;ZHAO Ze-kun;WANG Fu-lin(Department of Pathology,the First Medical Center of PLA General Hospital,Beijing 100853,China)

机构地区：[1]解放军总医院第一医学中心病理科,北京100853

出　　处：《诊断病理学杂志》2022年第8期749-752,共4页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨肾上腺皮质腺瘤合并髓脂肪瘤的临床病理学特征。方法收集26例肾上腺皮质腺瘤合并髓脂肪瘤的病例,观察总结其临床病理学特征、免疫组化染色结果,并进行相关文献复习。结果26例患者中包括男性11例,女性15例,年围17~67岁,平均47.8岁,中位年龄51.5岁。19例患者有高血压病史,10例有库欣综合征表现,1例有原发性醛固酮增多症。1例患者同时合并双侧肾透明细胞癌。髓脂肪瘤成分由成熟脂肪组织与造血细胞岛构成,在皮质腺瘤内呈单灶分布8例,多灶18例。2例肿瘤出现大片出血及纤维素样坏死区域。26例肿瘤均经手术切除,随访1~169个月,目前患者术后情况良好,尚未发现肿瘤复发或转移。结论肾上腺皮质腺瘤合并髓脂肪瘤发生机制尚不清楚,可能涉及多种因素,经手术切除肿瘤及激素替代治疗后恢复良好。但是当肾上腺皮质肿瘤出现预后不良或恶性的病理学特征,需要引起关注。Objective To investigate the clinicopathological features of myelolipoma within adrenocortical adenoma.Methods Twenty-six cases diagnosed as myelolipoma within adrenocortical adenoma were collected,their clinicopathological features and immunohistochemical staining results were observed and summarized,and relevant literature was reviewed.Results Eleven of the 26 patients were male and fifteen were female,aged 17-67 years,with an average of 47.8 years and median age of 51.5 years.Nineteen patients had a history of hypertension,ten had manifestations of Cushing’s syndrome,and one had primary aldosteronism.One patient had bilateral clear cell carcinoma of the kidney.Myelolipoma was composed of mature adipose tissue and island of hematopoietic cells.8 cases presented single foci and 18 cases presented multiple foci in adrenocortical adenoma.Two cases had extensive hemorrhage and fibrinoid necrosis.All the 26 patients were surgically removed and followed up for 1-169 months.At present,the postoperative condition of the patients was good,and no tumor recurrence or metastasis was found.Conclusion The mechanism of myelolipoma within adrenocortical adenoma is not clear,which may involve many factors.After surgical resection of the tumors and hormone replacement therapy,the patients recover well.However,when adrenocortical tumors show poor prognosis or malignant pathological features,we should pay attention to them.

关 键 词：肾上腺 皮质腺瘤 髓脂肪瘤 

分 类 号：R736.6[医药卫生—肿瘤]