Yotsuyanagi S, Maeda Y, Fuse H, Hirano S
Department of Urology, Kouseiren Takaoka Hospital.
Hinyokika Kiyo. 2001 Jan;47(1):23-5.
A 75-year-old man was admitted to our hospital for closer examination of a left mass. Warfarin and calcium-antagonist for arrhythmia and hypertension had been administered for about 2 months before admission to our ward. Abdominal ultrasonography revealed a left adrenal mass 5 cm in diameter. Only serum noradrenalin was slightly elevated in endocrinological studies. In 131I-MIBG scintigraphy, uptake of radio-isotope at the adrenal gland was not revealed. Computed-tomographic (CT) scan showed left adrenal mass with a low density in the central area and iso-density in the peripheral area. The enhanced CT scan revealed enhancement in only the peripheral area of the left adrenal gland. Magnetic resonance imaging (MRI) showed a different intensity in the central area or peripheral area. Only the peripheral area of the mass was enhanced on dynamic MRI. Left adrenalectomy was performed. Histopathological examination revealed an old hematoma in the adrenal medulla without neoplasmic cells or vascular lesions.
一名75岁男性因对左侧肿块进行进一步检查而入住我院。入院前约2个月,患者一直在服用华法林以及用于治疗心律失常和高血压的钙拮抗剂。腹部超声检查发现一个直径5厘米的左侧肾上腺肿块。在内分泌学检查中,仅血清去甲肾上腺素略有升高。在131I-MIBG闪烁扫描中,未发现肾上腺有放射性同位素摄取。计算机断层扫描(CT)显示左侧肾上腺肿块中央区域密度低,周边区域等密度。增强CT扫描显示仅左侧肾上腺周边区域有强化。磁共振成像(MRI)显示中央区域和周边区域信号强度不同。动态MRI显示肿块仅周边区域有强化。遂行左侧肾上腺切除术。组织病理学检查显示肾上腺髓质有陈旧性血肿,无肿瘤细胞或血管病变。