肾上腺血管淋巴管瘤8例诊治分析并文献复习  

Clinical analysis of 8 cases of adrenal hemolymphangioma and literature review

作　　者：徐楚潇 潘大猛 贺慧颖[2] 马潞林[1] 张树栋[1] XU Chuxiao;PAN Dameng;HE Huiying;MA Lulin;ZHANG Shudong(Department of Urology,Peking University Third Hospital,Beijing 100191,China;Department of Pathology,Peking University Third Hospital,Beijing 100191,China)

机构地区：[1]北京大学第三医院泌尿外科,北京100191 [2]北京大学第三医院病理科,北京100191

出　　处：《现代泌尿外科杂志》2025年第3期207-211,共5页Journal of Modern Urology

摘　　要：目的探讨肾上腺血管淋巴管瘤的临床病理特征和手术治疗效果,为临床认识该疾病提供参考。方法回顾性分析2013年1月—2022年12月北京大学第三医院泌尿外科收治的8例肾上腺血管淋巴管瘤患者的临床、病理资料并复习相关文献。结果患者中男性5例,女性3例,中位年龄54(25~75)岁。所有患者均经体检发现,无明显症状,其中4例有高血压病史。肾上腺功能学检查结果无明显异常,影像学检查共查出肿瘤9处,1例单侧多发2处瘤灶、7例单侧单发,中位肿瘤直径3.6(1.0~5.4)cm。7例行后腹腔镜肾上腺肿瘤切除术,1例行机器人辅助腹腔镜肾上腺肿瘤切除术,均完整切除肿瘤。中位手术时间77(53~115)min、术中中位失血量7.5(2.0~20.0)mL、术后中位住院时间4(1~7)d。术后病理显示:囊性肿瘤内畸形扩张的血管和淋巴管相互交织,内含大量淋巴液、淋巴细胞和红细胞,管壁间可见慢性淋巴细胞浸润;囊腔部分相通,内衬以扁平内皮细胞,病理诊断为肾上腺血管淋巴管瘤。8例中位随访时间53.5(12.0~106.8)个月,术后患者恢复良好,血压稳定,未见肿瘤复发或转移。结论肾上腺血管淋巴管瘤多无特异性临床症状,肾上腺功能学检测亦无明显异常,确诊需依靠病理学检查。采用后腹腔镜/机器人辅助腹腔镜肾上腺肿瘤切除术疗效确切且预后良好。Objective To investigate the clinicopathological characteristics and surgical outcomes of adrenal hemolymphangioma,so as to enhance the understanding of this disease.Methods Clinical and pathological data of 8 patients with adrenal hemolymphangioma admitted to the Department of Urology of our hospital during Jan.2013 and Dec.2022 were retrospectively analyzed,and relevant literature was reviewed.Results The patients included 5 males and 3 female,median age 54(25-75)years.Adrenal hemolymphangioma was detected in all patients in physical examinations without obvious symptoms.And 4 of the patients had a history of hypertension.Adrenal function test results showed no abnormalities.A total of 9 tumors were identified by imaging examination,including 1 unilateral multiple and 7 unilateral solitary tumors,with a median diameter of 3.6(1.0-5.4)cm.Posterior laparoscopic adrenal tumor resection was performed in 7 cases and robot-assisted laparoscopic adrenal tumor resection in 1 case;all of the tumors were completely removed.The median operation time was 77(53-115)min,median intraoperative blood loss 7.5(2.0-20.0)mL,and median postoperative hospital stay 4(1-7)d.Postoperative pathology showed interwoven deformed and dilated blood vessels and lymphatic vessels in the cystic tumors,with a large amount of lymphoid fluid,lymphocytes and red blood cells.Chronic lymphocyte infiltration was visible between the tube walls.The cystic cavity was partially connected,with flat endothelial cells lining.The pathological diagnosis was adrenal hemolymphangioma.During the median follow-up of 53.5(12.0-106.8)months,all patients recovered well,with stable blood pressure and no tumor recurrence or metastasis.Conclusion Adrenal hemolymphangioma has no specific clinical symptoms.As adrenal functional tests show no obvious abnormalities,the diagnosis depends on pathological examinations.Popsterior laparoscopic or robot-assisted laparoscopic resection has good efficacy and prognosis.

关 键 词：肾上腺肿瘤 血管淋巴管瘤 后腹腔镜肾上腺肿瘤切除术 机器人辅助腹腔镜肾上腺肿瘤切除术 

分 类 号：R736.6[医药卫生—肿瘤]