肾上腺皮质嗜酸细胞肿瘤(附2例报告及文献复习)

Adrenocortical oncocytic neoplasms (Report of 2 cases and review of literature)

目的:探讨肾上腺皮质嗜酸细胞肿瘤的临床和病理学特点。方法:回顾分析2例肾上腺嗜酸细胞肿瘤的临床资料。结果:2例病例在临床上没有特异表现,肿瘤大小分别为8.0cm×6.0cm×5.5cm和8.0cm×9.5cm×7.0cm,包膜完整,与周围没有粘连。切面为灰黄色,光镜下胞质内含丰富的嗜酸颗粒,细胞无明显异型性和核分裂相。电镜下胞质内见大量线粒体。1例免疫组化NSE(+)、VIM(+)、MIB1<1%(+)。2例均诊断为良性肿瘤。手术切除后分别随访11个月和26个月,未见肿瘤复发和转移。结论:大多肾上腺嗜酸细胞肿瘤是没有功能的,发现时一般肿瘤体积比较大,应该根据肿瘤的病理学特征进行良恶性鉴别,术后需要随访。

Objective：To investigate the clinical and pathologic feature of adrenocortical oncocytic neoplasms. Methods：The clinical data of 2 cases with adrenocotical oncocytic neoplasms were retrospectively analyzed and discussed with literature reviewed. Results：The clinical feature of these 2 cases were atypical. The tumor＇size was 8cm× 6cm×5.5cm and 8cm×9.5cm×7cm respectively. The capsule of tumor was integrated, and not adhere to the adjacent tissue. The cut surface was yellow. On light microscopy, the neoplastic cells were exclusively oncocytes, with abundant eosinophilic cytoplasm with granules, and almost had no mitosis. Enormous mitochondria were noted on electorn microscopy. The immunohistochemical staining of one case was positive for NSE and VIM, and MIB1〈1%（ ＋ ）. These 2cases were all diagnosed being benign, and were followed 11 and 26 months respectively after operation, no recurrence and metastasis were found. Conclusions：The most of adrenocortical oncocytic neoplasms had no function and the size was great when it was found. The distinguishability of carcinoma should accord to pathologic feature and need to follow up after operation.