不同大小嗜铬细胞瘤的超声表现及病理分析  

Ultrasound findings of different sizes of pheochromocytoma and pathology of pheochromocytoma

作　　者：田艳[1] 郭丹丹[1] 马姣姣[1] 牛云[2] 武敬平[1] 宋雪妮[1] 刘健[1] 黄炎[1] 郑敏[1] 

机构地区：[1]中日友好医院超声科,北京100029 [2]中日友好医院病理科,北京100029

出　　处：《中日友好医院学报》2016年第2期73-76,F0003,F0004,共6页Journal of China-Japan Friendship Hospital

摘　　要：目的：探讨不同大小嗜铬细胞瘤的超声表现,通过与病理对照分析提高对本病的超声诊断水平.方法：分析手术后经病理证实的24例患者嗜铬细胞瘤的超声诊断资料.按嗜铬细胞瘤的最大直径分为3组,即直径＜4.0cm组,4.0～6.0cm组及＞6.0cm组,分析病灶内部回声、周边及内部血流和边界的情况.结果：24例患者中3例为双侧发病,嗜铬细胞瘤病灶共27个：其中5个病灶为异位嗜铬细胞瘤（3个位于肾门部,2个位于腹主动脉或下腔静脉前方）,10病灶个位于右侧肾上腺,12个病灶位于左侧肾上腺.27个病灶中有2个为恶性.不同大小病灶组之间内部回声及病灶血流情况,均具有显著性差异（P＜0.05,P＜0.01）.但病灶边界情况与病灶大小无关,3组之间无显著性差异（P＞0.05）.术后病理大体标本多数肿瘤界限清楚有完整包膜,切面灰褐色或棕黄色,常有出血、坏死和囊性变.镜下肿瘤细胞排列呈巢状,有富含血管的纤维组织或薄壁血窦分隔,瘤细胞多数为多角形,胞浆丰富、嗜碱性.免疫组化瘤细胞CgA（＋）、肿瘤巢周支持细胞均为S-100（＋）.结论：随嗜铬细胞瘤肿物大小不同超声图像有所不同,嗜铬细胞瘤病理结构决定超声图像有一定的特点.Objective：To investigate the ultrasound of different sizes of pheochromocytoma and compare them with pathology diagnosis to improve the accuracy of the diagnosis.Methods ：To analyze the ultrasonographic di- agnosis in 24 cases of pheochromocytoma confirmed by operation and pathology.According to the maximum di- ameter of pheochromoeytoma divided into three groups, that is, the diameter of 4.0cm group,diameter〈4.0cm- 6.0cm group and diameter〉6.0cm group,and analyze the internal echo,peripheral and internal blood flow and boundary conditions.Results：Five lesions were abdominal ectopic pheochromocytorna,ten lesions were located in the right adrenal gland and twelve lesions in th6 left.There were 3 cases on bilateral side.The echo of differ- ent size of lesion and the blood flow of the lesion were statistically significant （P〈0.05,P〈0.01）.But the boundary was not related to the size of the lesion,the difference between the three groups was not statistically significant （P〉0.05）.Postoperative pathology was most tumors were well circumscribed with complete capsule, section gray brown or brown,often with hemorrhage ,necrosis and cystic degeneration.The tumor cells were ar- ranged in nests,fibrous tissue rich in blood vessels into the parenchyma blood sinus tumor cells were separat- ed.The tumor cells were mostly polygonal,contained abundant basophilic cytoplasm.The results of the immuno- histochemistry were CgA （＋）,tumor nest week support cells were S-100 （＋）.Conclusion：With the size of pheochromoeytoma ultrasound images are different, pathological structure determines the certain characteristics of ultrasound image.

关 键 词：嗜铬细胞瘤 超声 病理 

分 类 号：R445.1[医药卫生—影像医学与核医学]