肾上腺皮质腺瘤合并髓脂肪瘤的临床病理分析  

Clinicopathological analysis of myelolipoma within adrenocortical adenoma

作　　者：仇玮[1,2] 洪烨[3] 章如松[1] 魏雪[1] 陆珍凤[1] 石群立[1] 马捷[1] 

机构地区：[1]南京军区南京总医院病理科,南京210002 [2]南京市江宁医院 [3]南京医科大学病理学系,南京211166

出　　处：《医学研究生学报》2017年第6期637-640,共4页Journal of Medical Postgraduates

摘　　要：目的肾上腺皮质腺瘤合并髓脂肪瘤国内外鲜有报道。文中探讨该肿瘤的临床病理特征,为正确诊断和治疗提供更多依据。方法回顾性分析2005年6月1日至2016年6月30日间南京总医院与南京江宁医院11例诊断为肾上腺皮质腺瘤合并髓脂肪瘤患者的组织学及临床资料,并结合结果与相关文献进行比较。结果 11例肾上腺皮质腺瘤合并髓脂肪瘤患者中,男4例、女7例,平均年龄(49.0±9.5)岁。其中3例患者出现Cushing’s综合征,1例反复发作头昏伴高血压十余年,其余7例均为体检偶然发现。影像学检查发现肾上腺占位。光镜下见髓脂肪瘤呈孤立性结节状分布和/或混杂分布于皮质腺瘤中,髓脂肪瘤由成熟脂肪组织和不同比例的造血细胞构成。11例患者均行肿物手术切除,术后随访2个月~11年均无肿块复发。结论肾上腺皮质腺瘤合并髓脂肪瘤临床少见,女性多见,患者可出现Cushing’s综合征、高血压或无明显临床症状,手术切除预后良好。Objective At present, there are few studies about myelolipoma within adrenal cortical adenoma. Our aim was to provide more basis for correct diagnosis and treatment by investigation into its clinical and pathological features. Methods The clini- cal and pathological data were retrospectively reviewed in 11 patients of myelolipoma within adrenal cortical adenoma, along with rela- tive literature reviews. Results The median age of 11 patients （7 females, 4 males） was 49± 9.5 years, among whom 3 patients presented Cushing＇s syndrome, 1 patient with more than 10 years recurrent dizzy with hypertension, other 7 patients were found coinci- dently by routine examination. Adrenal mass were found by imaging examination. Pathologically, myelolipomas were in solitary nodule distribution and/or admixed with adrenal cortical adenomas. Myelolipomas were composed of variable admixture of mature adipose tissue and hematopoietic elements. Surgical treatment was performed for all 11 patients, and no relapse was found in 2 months to 11 years follow-up. Conclusion Myelolipoma within adrenal cortical adenoma is extremely rare, which is common in females. The patients may present with Cushing＇s syndrome, hypertension or without obvious clinical syndrome. All the patients are in favorable prognosis af- ter surgical resection.

关 键 词：肾上腺 皮质腺瘤 髓脂肪瘤 临床 病理 

分 类 号：R736.6[医药卫生—肿瘤]