基础医学与临床 ›› 2007, Vol. 27 ›› Issue (5): 577-579.

• 临床园地 • 上一篇    下一篇

肾上腺节细胞神经瘤与嗜铬细胞瘤的临床鉴别诊断及治疗

石冰冰 樊华 荣石 李汉忠   

  1. 北京协和医院泌尿外科 北京协和医院泌尿外科
  • 收稿日期:2006-04-29 修回日期:2006-12-01 出版日期:2007-05-25 发布日期:2007-05-25
  • 通讯作者: 石冰冰

Diagnosis and treatment for adrenal pheochromocytoma and adrenal ganglioneucoma

  

  • Received:2006-04-29 Revised:2006-12-01 Online:2007-05-25 Published:2007-05-25

摘要: 目的 探讨肾上腺节细胞神经瘤与嗜铬细胞瘤的临床特点,诊断、鉴别诊断及治疗。方法 回顾性分析1999-2005北京协和医院14例节细胞神经瘤及32例嗜铬细胞瘤患者的临床资料。节细胞神经瘤组男8例,女6例;年龄16∽63岁;肿瘤直径2.5∽15cm 。嗜铬细胞瘤组男14例,女18例;年龄19∽74岁;肿瘤直径2∽16cm。全部患者均行手术疗切除肿瘤并经病理证实。结果 节细胞神经瘤患者多无临床症状,查体时偶然发现肾上腺区占位;CT多表现为形态规则的圆形或类圆形低密度影,边界光滑,质地均一,增强扫描强化不明显; 24h尿儿茶酚胺在正常水平; 131I-MIBG检测大部分阴性。嗜铬细胞瘤患者就诊时多有典型的阵发或持续性高血压症状;CT表现多为形态欠规则的实性、囊实性或单纯囊性占位,密度不均,增强后呈不规则明显强化;嗜铬细胞瘤内分泌功能活跃,24h尿儿茶酚胺检查显著升高; 131I-MIBG检测大部分呈阳性,浓聚区域与占位病变位置相同。结论 肾上腺节细胞神经瘤与嗜铬细胞瘤在临床表现、影像学、内分泌检查和131I-MIBG等均有显著差异。通过仔细询问病史,正确的实验室及辅助检查,术前基本能鉴别诊断。行开放或腹腔镜手术切除可取得良好的治疗效果。

Abstract: To evaluate the clinical characteristics, diagnosis and treatment procedures for adrenal pheochromocytoma and adrenal ganglioneucoma.. Methods: 32 cases of adrenal pheochromocytoma and 14 cases of adrenal ganglioneucoma surgical treated between 1999-2005 are analysed, The mean age of ganglioneucoma was 39 years old (16~63). tumor size ranged from 2.5cmcm to 15cm. The mean age of pheochromocytoma was 42 years old (19~74), tumor size ranged from 2cm to 16cm. Tumor locations in the adrenal area. All cases accept surgical operation and are confirmed by pathology. Results: Most cases of adrenal ganglioneucoma do not have any symptom but are founded incidentally. Differential are obviously between ganglioneucoma and pheochromocytoma. Conclusions: Both of adrenal ganglioneucoma and pheochromocytoma are rare diseases .CT 、urinary CA and 131I-MIBG are good methods for diagnosis .The final diagnosis depend on pathology, surgical resection of tumor is the preferred choice.