肾上腺髓质脂肪瘤(附15例报告)  

Adrenal myelolipoma(report of 15 cases)

作　　者：李泽良[1] 孔垂泽[1] 刘同才[1] 温强[1] 王毅[1] 王刚[1] 冯景路[2] 徐彪[3] 

机构地区：[1]中国医科大学第一临床学院泌尿外科,沈阳110001 [2]中国医科大学第一临床学院超声中心,沈阳110001 [3]沈阳医学院附属第二医院泌尿外科

出　　处：《中华泌尿外科杂志》2000年第11期645-647,共3页Chinese Journal of Urology

摘　　要：目的　总结肾上腺髓质脂肪瘤的临床特征、诊断和治疗方法。　方法　回顾性研究 15例 (16侧 )肾上腺髓质脂肪瘤患者的临床资料。 10例有腰背部疼痛症状 ,其中 5例合并高血压 ;5例无任何自觉症状。 15例行B超检查示腹膜后或肾上腺区团块状回声 ,周边见包膜 ,内部回声不均匀。15例行CT检查 ,13例诊断为肾上腺髓质脂肪瘤 ,1例疑为肾癌 ,1例疑为肾血管平滑肌脂肪瘤。 11例行IVU检查 ,6例示肾脏受压移位 ,5例为正常肾盂肾盏形态。 6例行MRI检查确诊 (包括 1例CT误诊为肾癌者 )。　结果　 12例行肾上腺及肿瘤切除术 ,4例 (其中 1例为双侧之左侧 )未手术。镜下见肿瘤由成熟脂肪细胞和类似骨髓的造血成分按不同比例混合构成。术后 14例获随访 0 .5～ 10 .5年 ,12例手术者术后 8例腰腹痛症状消失 ,4例血压降至正常。未手术者复查CT示肿瘤增大不明显。　结论　肾上腺髓质脂肪瘤的诊断需靠CT、MRI检查 ,对较大肿瘤及有潜在出血危险者应予手术治疗。Objective To study the clinical features, the treatment and diagnosis of adrenal myelolipoma. Methods A retrospective review of 15 cases of adrenal myelolipoma was performed. Results Of the 15 patients,10 presented with abdominal or flank pain, 3 with abdominal mass. 5 presented with hypertension and one had Cushing's syndrome. Microscopic examination revealed a mixture of mature fat cells and hematopoietic elements.12 patients underwent surgery due to abdominal pain, Cushing's syndrome and large tumor size. 4 patients ( one was bilateral) were treated conservatively. 14 patients were followed up ranging from 0.5～10.5 years. Conclusions CT and MRI can be used for diagnosis and fine needle aspiration biopsy may be used to confirm the diagnosis. Because of the risk of hemorrhage and the potential for further growth, elective removal of large adrenal myelolipomas might still be considered.

关 键 词：肾上腺肿瘤 肾上腺髓质脂肪瘤 诊断 治疗 

分 类 号：R736[医药卫生—肿瘤]