肾上腺皮质嗜酸细胞肿瘤的临床诊治（附5例报告）

Clinical diagnosis and treatment of adrenal cortical eosinophil tumor （ 5 cases report）

目的探讨肾上腺皮质嗜酸细胞肿瘤的临床、病理学特征及治疗方法。方法回顾性分析5例肾上腺嗜酸细胞肿瘤的临床资料。结果5例患者中，1例表现为女性男性化，1例皮质醇节律异常表现为皮质醇增多症合并表现库欣综合征，3例无特异表现，肿瘤大小为13cm×12cm×10cm到8．0cm×6．0cm×5．5cm。术中发现包膜完整，与周围组织没有粘连，切面为灰黄色。光镜下细胞质内含丰富的嗜酸颗粒，细胞核大并有轻度异型，核分裂相罕见。2例免疫组化NSE（＋）、VIM（＋）。治疗上行患侧肾上腺全切术，切除后随访未见肿瘤复发和转移。结论肾上腺皮质嗜酸细胞肿瘤临床罕见，大部分为偶发瘤。发现时一般肿瘤体积比较大，良性肿瘤多见，肿瘤生长迅速。可行患侧肾上腺全切术，手术切除肿瘤为首选治疗，预后良好。术后需要随访。

Objective To study the clinical and pathological features and treatment method of adrenal cortical eosinophil tumor. Methods Retrospective analysis was made on the clinical data of 5 cases with adrenal cortical eosinophic tumor. Results Among the 5 cases, 1 case looked female male-driven, 1 case demonstrated cortisol dysrhythmias with cortisol increase combined Cushing syndrome, 3 cases of no specific demonstrations, tumor sized 13 cm × 12 cm × 10 cm to 8.0 cm × 6.0 cm × 5.5 cm. Capsule was found complete, and no adhesion. Incision cut appeared gray, trypan-blue and cytoplasm contained rich acidophilus grain, the nuclei were large with a mild alien, fission were rare. Two cases were found immunohistochemical NSE （ ＋ ）, VIM （ ＋ ）. No relapse and metastasis were found after tumor resection. Conclusions Adrenal cortical eosinophil tumor is clinically rare, mostly being the occasional tumors. In general the tumor size is larger, more being benign tumor, growing quickly. Surgical resection is the first choice for the treatment of the disease, with good prognosis. Postoperative follow-up is needed.