肾上腺皮质腺瘤30例病理分析  

ADRENAL CORTICAL ADENOMA: PATHOLOGIC ANALYSIS OF 30 CASES

作　　者：王学丽[1] 陈青[1] 郝青[1] 

机构地区：[1]滨州市中心医院病理科,山东滨州251700

出　　处：《齐鲁医学杂志》2013年第1期35-36,共2页Medical Journal of Qilu

摘　　要：目的探讨肾上腺皮质腺瘤特别是导致肾上腺生殖器综合征的皮质腺瘤的诊断与鉴别诊断。方法对30例肾上腺皮质腺瘤的临床病理资料进行回顾性分析,显微镜下观察标本组织学形态、细胞异型程度及核分裂象,并随访部分病人生存情况。结果光镜下,28例肾上腺皮质腺瘤由占较大比例的胞浆透亮的细胞和少量的胞浆嗜酸性细胞构成,其中3例可见脂肪瘤样和髓脂肪瘤样化生,1例可见奇异核,但核分裂象罕见。随访10例病人均生存良好。伴肾上腺生殖器综合征的2例病人光镜下均出现了明显的核异型,伴奇异核细胞及多核瘤巨细胞出现,可见较多的核分裂象,甚至病理性核分裂象;随访此2例病人均未见复发。结论伴肾上腺生殖器综合征的肾上腺皮质腺瘤有较高程度的异质性,应重视其鉴别诊断。Objective To investigate the diagnosis and differential diagnosis of adrenal cortical adenoma （ACA）, espe- cially of that leading to adrenogenital syndrome （AGS）. Methods A retrospective analysis was done in 30 cases of ACA. The histological appearance, cellular atypia and karyokinesis of the specimens were examined microscopically. A follow up of survival was conducted in some of them. Results Microscopically, 28 tumors were constituted by cells with more transparent cytoplasm and less oxyphil ceils, of which, lipoma- and myelolipoma-like metaplasia could be seen in three cases, and heterocaryosis in one. Karyokinesis was seldom seen. Of the 10 patients followed were well survived. In two patients with AGS, significant nuclear aty pia with strange heterokaryocyte and polynuclear tumor giant cells appeared, more with caryomitosis, even of pathological feature, could be seen. No recurrence was found in these two patients during the follow-up. Conclusion Adrenal cortical adenoma with AGS is more frequently accompanied with cell heterogeneity. A differential diagnosis of this condition should be thought highly.

关 键 词：肾上腺皮质腺瘤 病理学 临床 诊断 鉴别 

分 类 号：R736.6[医药卫生—肿瘤]