左肾上腺区占位误诊报告1例并文献复习  

Misdiagnosis of left adrenal gland occupying was reported in one case and literature review

作　　者：宝诗琪 易发现[1] 任超 BAO Shiqi;YI Faxian;REN Chao(Department of Urinary Surgery,Affiliated Hospital of Inner Mongolia Medical University,Inner Mongolia Autonomous Region,Hohhot010000,China)

机构地区：[1]内蒙古医科大学附属医院泌尿外科,内蒙古呼和浩特010000

出　　处：《中国医药导报》2021年第27期186-188,196,共4页China Medical Herald

基　　金：内蒙古自治区应用技术研究与开发资金计划项目(1505015)。

摘　　要：为探讨左肾上腺区占位性病变的误诊原因及防范措施,提高诊疗水平,开阔诊断思路。本文回顾性分析就诊于内蒙古医科大学附属医院泌尿外科的1例左肾上腺区占位患者临床资料,通过分析患者术前血清皮质醇、醛固酮、肾上腺增强CT及超声等相关检查检验,并复习参考相关文献,为左肾上腺区占位性病变提供临床诊疗经验。本病例中患者术前将左肾上腺区副脾误诊为左侧肾上腺腺瘤,腹腔镜手术过程中发现左肾上腺区副脾,术中行左侧肾上腺切除,未行副脾切除,术后病理回报为左肾上腺皮质结节状增生。肾上腺区副脾与肾上腺结节性增生作为肾上腺腺瘤的鉴别诊断,临床罕见,但应当引起高度关注,通过综合患者临床症状及合理应用影像学评估方案仔细推敲,可以减少误诊,规范诊疗。To explore the reasons for misdiagnosis and preventive measures of space-occupying lesions in the left adrenal gland area,improve the level of diagnosis and treatment,and broaden the diagnosis ideas.This article retrospectively analyzes the clinical data of a patient with left adrenal area occupying in the Department of Urology,Affiliated Hospital of Inner Mongolia Medical University,preoperative serum cortisol,aldosterone,adrenal enhanced CT and ultrasound were analyzed,and relevant literature was reviewed and referenced.To provide clinical diagnosis and treatment experience for left adrenal space occupying lesions.In this case,the left adrenal accessory spleen was misdiagnosed as a left adrenal adenoma before the operation,and the left adrenal accessory spleen was found during laparoscopic surgery.The left adrenal gland was resected during the operation and the accessory splenectomy was not performed.The postoperative pathological report was nodular hyperplasia of the left adrenal cortex.As the differential diagnosis of adrenal adenoma,accessory spleen and adrenal nodularhyperplasia in the adrenal area is clinically rare,but it should cause high attention.Through comprehensive patient clinical symptoms and rational application of imaging evaluation programs,careful consideration can reduce misdiagnosis and standardize diagnosis and treatment.

关 键 词：肾上腺肿瘤 肾上腺结节性增生 副脾 肾上腺增强CT 误诊 

分 类 号：R736[医药卫生—肿瘤]