肾上腺碰撞瘤的临床病理学特征  

Adrenal collision tumors:a clinicopathological analysis of twelve cases

作　　者：户燕姣[1] 张伟 姜天娇[3] 计晓彬[1] 李玉军[1] 林东亮[1] HU Yan-jiao;ZHANG Wei;JIANG Tian-jao;JI Xiao-bin;LI Yu-jun;LIN Dong-liang(Department of Pathology,the Affiliated Hospital of Qingdao University,Qingdao 266003,China;Department of Pathology,971 Hospital of PLA Nary,Qingdao 266071,China;Department of Radiology,the Afiliated Hospital of Qingdao University,Qingdao 266003,China)

机构地区：[1]青岛大学附属医院病理科,青岛266003 [2]海军第九七一医院病理科,青岛266071 [3]青岛大学附属医院放射科,青岛266003

出　　处：《诊断病理学杂志》2021年第8期639-642,647,共5页Chinese Journal of Diagnostic Pathology

摘　　要：目的探讨肾上腺碰撞瘤(ACTs)的临床病理特征,进一步认识此类病变。方法回顾性分析青岛大学附属医院及海军第九七一医院2009-2019年手术切除标本诊断ACTS 12例.采用HE观察组织形态学及免疫表型,并进行随访及复习相关文献。结果12例ACTS者中,男7例,女5例,发病年龄44~73岁(中位年龄58岁)。9例无症状,为体检时CT偶然发现,2例有高血压病史,1例有糖尿病病史。影像学检查均提示肾上腺占位。组织学上,11例为肾上腺皮质腺瘤分别合并髓脂肪瘤(7例)嗜铬细胞瘤(3例)、血管瘤(1例),1例为髓脂肪瘤并节细胞神经瘤。12例患者均行肿物手术切除,术后随访4~120个月,均无复发、转移。结论ACTs少见,临床和影像学检查无特异性。大多为肾上腺皮质腺瘤和其他不同组织类型的良性肿瘤的混合,以皮质腺瘤合并髓脂肪瘤最多见,手术完整切除后,预后良好。Objective To investigate the clinicopathological characteristics of adrenal collision tumors(ACTs), and to make further understanding of such lesions. Methods The clinicopathological and follow-up data of 12 cases of ACTs from 2009 to 2019 in the Affiliated Hospital of Qingdao University were retrospectively analyzed. Immunohistochemical staining was performed. Results There were seven males and five females, and they aged from 44 to 73 years(median, 58 years). Nine patients were asymptomatic and detected incidentally by CT scan, two patients had a history of hypertension, and one patient had a history of diabetes. Imaging studies suggested an adrenal nodule in all patients. Histologically, eleven cases had an adrenocortical adenoma component, and the other components were myelolipoma(7 cases), pheochromocytoma(3 cases), and hemangioma(1 case), respectively. One case was composed of myelolipoma and ganglioneuroma. Surgical resection was performed in all patients. The follow-up ranged from 4 to 120 months, and none of the patients experienced local recurrence or distant metastasis. Conclusion ACTs are rare tumors, and they lack specific clinical or radiographic characteristics. Most cases are composed of adrenocortical adenoma and other benign components, and adrenocortical adenoma accompanied with myelolipoma is the most common one. The prognosis of ACTs is good after complete surgical resection.

关 键 词：肾上腺肿瘤 碰撞瘤 皮质腺瘤 嗜铬细胞瘤 免疫组织化学 

分 类 号：R736.6[医药卫生—肿瘤]