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肾上腺皮质髓质混合瘤

Corticomedullary mixed tumor of the adrenal gland.

作者信息

Wieneke J A, Thompson L D, Heffess C S

机构信息

Department of Endocrine and Otorhinolaryngic-Head & Neck Pathology, Armed Forces Institute of Pathology, 6825 16th St NW, Washington, DC 20306-6000, USA..

出版信息

Ann Diagn Pathol. 2001 Oct;5(5):304-8. doi: 10.1053/adpa.2001.28297.

Abstract

Corticomedullary mixed tumors of the adrenal gland are quite rare, with only five well-documented cases reported in the literature.(1-4) Herein, we report the light microscopic and immunohistochemical features of two cases of this rare tumor. Patient 1 is a 34-year-old woman who presented with hypertension, hair loss, and amenorrhea of 1-year duration. Patient 2 is a 52-year-old woman who presented with flank pain and what appeared to be a renal mass on arteriogram with no history of hypertension, Cushing's syndrome, or other endocrine abnormalities. At surgery, the tumor was noted to arise from the adrenal gland rather than the kidney and adrenalectomy was performed. In both cases, the surgically resected specimens consisted of a well-circumscribed, single adrenal mass surrounded by a rim of uninvolved adrenal cortical tissue. The tumors were composed of adrenal cortical cells intimately admixed with pheochromocytes. Immunohistochemical studies highlighted these two cellular components. The pheochromocytes were strongly reactive with chromogranin and the sustentacular cells with S-100 protein, whereas the adrenal cortical cells reacted specifically with inhibin. Thus, we report two additional cases of mixed corticomedullary tumor of the adrenal gland. Ann Diagn Pathol 5:304-308, 2001. This is a US government work. There are no restrictions on its use.

摘要

肾上腺皮质髓质混合瘤十分罕见,文献中仅报道过5例有充分记录的病例。(1 - 4)在此,我们报告2例这种罕见肿瘤的光镜和免疫组化特征。病例1是一名34岁女性,有1年高血压、脱发和闭经病史。病例2是一名52岁女性,表现为胁腹痛,动脉造影显示有一个似乎是肾肿块,无高血压、库欣综合征或其他内分泌异常病史。手术时发现肿瘤起源于肾上腺而非肾脏,遂行肾上腺切除术。在这两个病例中,手术切除的标本均为一个边界清楚的单个肾上腺肿块,周围是未受累的肾上腺皮质组织边缘。肿瘤由肾上腺皮质细胞与嗜铬细胞紧密混合组成。免疫组化研究突出了这两种细胞成分。嗜铬细胞对嗜铬粒蛋白呈强反应,支持细胞对S - 100蛋白呈强反应,而肾上腺皮质细胞对抑制素呈特异性反应。因此,我们报告另外2例肾上腺皮质髓质混合瘤。《诊断病理学杂志》5:304 - 308,2001年。这是美国政府的作品。其使用不受限制。

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