肾上腺皮质癌6例临床病理分析

Clinical pathological analysis of six cases of adrenal cortical carcinoma

目的:分析肾上腺皮质癌的临床与病理组织学特点。方法:收集6例肾上腺皮质癌患者的临床及病理检查资料。结果:6例患者中库兴综合征、高血压各2例。实验室检查17-羟皮质类固醇及17-酮类固醇增高1例。肿瘤直径全部≥6cm,最大15cm,内部均有出血坏死;切片镜检:肿瘤细胞核异型明显,核分裂象多见,嗜酸细胞>70%,血管及周围组织浸润,4例远处转移。结论:对于肾上腺皮质癌的诊断与鉴别诊断,应将临床特点和镜下组织细胞形态学主要特征及肿瘤是否浸润、转移等表现相结合,免疫组织化学染色可协助鉴别诊断。

Objective. To analyze the clinical and histologic features of adrenal cortical carcinoma （ACC） for obtaining the correct diagnosis and differential diagnosis of ACC. Methods： Clinical and pathological examination data of 6 cases of ACC patients were collected. Results： Of the 6 patients with ACC, 2 suffered from Cushing＇s syndrome and 2 from high blood pressure. Laboratory examination results showed that 1 case＇s 17-hydroxycorticosteroid and 17-ketosteroid increased. All the tumor diameters were equal to or larger than 6 cm, the largest was 15 cm. Besides, the interior have bleeding necrosis. The microscopic examination of the biopsy found that the tumor cell nuclei deformed, nuclear fission phenomenon was more common, acidophil was more than 70%, the blood vessels and the surrounding tissues were infiltrated, 4 cases occured distant metastasis. Conclusion： For the diagnosis and differential diagnosis of adrenal cortical carcinoma, clinical manifestation characteristics should be combined with such performances as the main characteristics of microscopic organiz staining can help ation cell morphology, tumor invasion and metastasis. Immunohistochemistry the differential diagnosis.