Jedrzejowski Maciej, Grzesiuk Wiesław, Pawlik-Pachucka Eliza, Jankowski Mieczysław, Lewandowska Katarzyna, Krasnodebski Wojciech, Bar-Andziak Ewa
Akademia Medyczna w Warszawie, Katedra i Klinika Chorób Wewnetrznych i Endokrynologii.
Pol Merkur Lekarski. 2005 Aug;19(110):193-5.
Adrenal tuberculosis is relatively infrequent cause of primary adrenocortical insufficiency in developed countries. Adrenal involvement is most often the result of hematogenous spread of the pulmonary tuberculosis. Isolated adrenal tuberculosis, especially with enlargement of adrenal glands can cause diagnostic problems and requires differentiation from primary or secondary neoplastic disease. In this paper we present a case of 61-year-old man with several months history of adrenocortical insufficiency without signs of pulmonary tuberculosis. Computed tomography scan revealed asymmetrical mass-like enlargement in adrenal glands. Despite of consecutive investigations, the diagnosis remained uncertain. Because of the possibility of neoplastic process of unknown origin, the patient was qualified for surgical exploration during which both enlarged glands were removed. The diagnosis of tuberculosis was made on microscopic examination.
在发达国家,肾上腺结核是原发性肾上腺皮质功能不全相对少见的病因。肾上腺受累通常是肺结核血行播散的结果。孤立性肾上腺结核,尤其是伴有肾上腺增大时,可导致诊断困难,需要与原发性或继发性肿瘤性疾病相鉴别。本文报告一例61岁男性,有几个月肾上腺皮质功能不全病史,无肺结核体征。计算机断层扫描显示肾上腺呈不对称的肿块样增大。尽管进行了一系列检查,诊断仍不明确。由于存在不明来源肿瘤性病变的可能性,该患者接受了手术探查,术中切除了双侧增大的肾上腺。经显微镜检查确诊为结核。