肾上腺皮质嗜酸细胞肿瘤7例临床分析

Clinical analysis of 7 cases with adrenocortical oncocytic neoplasms

目的探讨肾上腺皮质嗜酸细胞肿瘤的临床和病理学特点。方法回顾性分析7例肾上腺嗜酸细胞肿瘤的临床资料。结果 7例患者中,1例表现为女性男性化,2例表现为皮质醇增多症,4例无特异表现,肿瘤大小1.5 cm×1.5 cm×2 cm～8 cm×8cm×9 cm,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。3例免疫组化NSE(+)、VIM(+)。7例均诊断为良性肿瘤,手术切除后未见肿瘤复发和转移。结论肾上腺嗜酸细胞肿瘤有其自身的特点,大多是没有功能的,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 features of adrenocortical oncocytic neoplasms. Methods The clinical data of 7 cases with adrenocotical oncocytic neoplasms were retrospectively analyzed and discussed with literature reviewed. Results In these 7 cases, one case developed gynandria, two showed Cushing＇s syndrome and the others were atypical. The tumorsize was 1.5 cm× 1.5 cm× 2 cm-8 cm× 8 cm× 9 cm. The capsule of tumor was integrated, and not adhere to the adjacent tissue. The cut surface was yellow. Under light microscopy, the neoplastic cells were exclusively oncocytes, having abundant eosinophilic cytoplasm with granules and almost no mitosis. The immunohistochemical staining of three cases was positive for NSE and VIM. All 7 cases were benign with no recurrence and metastasis found after operation. Conclusion Most adrenocortical oncocytic neoplasms have no function and the size is great when it is found. The distinguishability of carcinoma should accord to pathologic features and follow-up.