肾上腺皮质嗜酸细胞瘤的诊断及治疗(附2例报告)

Diagnosis and therapy of adrenocortical oncocytic neoplasms

目的探讨肾上腺皮质嗜酸细胞瘤的临床和病理学特点及治疗方法。方法回顾性分析2例肾上腺皮质嗜酸细胞瘤患者的临床资料。结果1例没有特异表现,1例表现为高血压病。肿瘤大小分别为13 cm×12cm×10 cm和8.0 cm×6.0 cm×5.5cm。肿瘤包膜完整,与周围无粘连。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。2例免疫组化Inhibin-α、Melan-A、CgA均阳性。1例诊断为良性肿瘤,1例诊断为恶性潜能。行患侧肾上腺全切术后均随访9个月,未见肿瘤复发和转移。结论肾上腺嗜酸细胞肿瘤多无功能。肿瘤生长迅速。可行患侧肾上腺全切术,预后好。

Objective To investigate the clinical and pathologic feature and treatment of adrenocortical oncocytic neoplasms.Methods The clinical data of 2 cases with adrenocofical oneocytic neoplasms were retrospectively analyzed. Results The clinical feature of 1 case were atypical. The principal symptom of the other case was hypertension The tumor＇ size was 13 cm× 12 cm× 10 cm and 8 cm × 6 cm × 5.5 cm respectively. The capsule of tumor was integrated, and not adhere to the adjacent tissue. The cut surface was yellow. Observated with light microscopy, the neoplastic cells were exclusively oncocytes, with abundant eosinophilic cytoplasm with granules, and almost had no mitosis. The immunohistoehcmical staining of these two eases was positive for Inhibin-α and Melan-A, and CgA. 1 case was diagnosed being benign, and l case was diagnosed being potential malignancy. They were followed 9 months respectively after operation , no recurrence and metastasis were found. Conclusions Most of adrenocortical oncocytic neoplasms have no function and the size is great when it was found. The main treatment is the all resection ot the affected adrenal and need to follow up after operation. The patients with this disease have better prognosis.