以头痛为首发症状的嗜铬细胞瘤1例报告并文献复习  

Pheochromocytoma with headache as first symptom:A case report and literature review

作　　者：徐丽斯 何金婷[1] 莽靖[1] 王学菊[2] 王丽萍[2] 那万里[3] 邵延坤[1] 徐忠信[1] 

机构地区：[1]吉林大学中日联谊医院神经内科,吉林长春130033 [2]吉林大学中日联谊医院病理科,吉林长春130033 [3]吉林大学中日联谊医院泌尿外科,吉林长春130033

出　　处：《吉林大学学报（医学版）》2015年第5期1027-1031,I0004,共6页Journal of Jilin University：Medicine Edition

基　　金：吉林省科技厅科技发展计划项目资助课题(20130206045SF)

摘　　要：目的:探讨1例以头痛为首发症状的嗜铬细胞瘤患者的临床表现和诊断方法。方法:记录患者临床症状,利用放射免疫法动态检测患者活性肾素;化学发光法检测患者血中醛固酮水平;高效液相色谱法检测患者血中肾上腺素和去甲肾上腺素水平;CT检查患者肾上腺影像;手术取肾上腺肿瘤行病理学活检和HE染色检测。结果:该嗜铬细胞瘤患者剧烈头痛发作时常伴血压、活性肾素和醛固酮水平明显升高;肾上腺CT扫描可见左肾上腺1个类圆形低密度影,肾上腺CT增强扫描可见该肿块动脉期呈不均匀强化;病理活检HE染色检测,透明和嗜酸性细胞呈巢状及束状排列,出血、坏死明显,部分细胞有异型。结论:嗜铬细胞瘤是一种分泌儿茶酚胺的内分泌肿瘤,应主要结合临床症状、生化、影像和病理确诊。Objective To study the clinical manifestation and the diagnosis methods of one case of pheochromocytoma with headache as the first clinical feature.Methods The clinical symptoms were recorded;radio immunoassay was used to detect the active renin of the patient;chemiluminescence was used to detect the aldosterone level of the patient;high performance liquid chromatography was used to detect the levels of blood adrenaline and noradrenaline;CT was used to detect the adrenal gland;the tumor tissue was taken by operation and pathological examination and HE staining were performed.Results When the patient suffered serious headache,the levels of active renin,aldosterone and blood pressure were increased obviously.The CT results showed that the patient＇s left adrenal gland had a quasi-circular low density.On the CT enhanced scan image,the tumor appeared inhomogeneous enhancement on artery phase.There were transparent and eosinophil cells arranged in a prominent nesting pattern and bundles with obvious bleeding and necrosis and also there were some heterocysts.Conclusion Pheochromocytoma is a catecholamine-producing endocrine tumor and a reliable diagnosis can be made by combining the clinical information,biochemical testing,imaging examination and pathology.

关 键 词：嗜铬细胞瘤 头痛 高血压 

分 类 号：R739.41[医药卫生—肿瘤]