Department of Medicine, John A. Burns School of Medicine, University of Hawaii, Honolulu, Hawaii 96813, USA.
Am J Med Sci. 2010 Nov;340(5):424-6. doi: 10.1097/MAJ.0b013e3181ee9599.
The authors describe a patient in whom pararenal splenosis nodules were initially interpreted as probable pheochromocytoma. A 22-year-old man with chronic glomerulonephritis, hypertension and a childhood history of splenectomy was hospitalized for a hypertensive emergency. He did not improve with aggressive antihypertensive therapy. A pheochromocytoma was suspected, and a renal ultrasound and a magnetic resonance imaging showed 2 left pararenal masses. Laboratory evaluation for pheochromocytoma and aldosteronoma were negative. Biopsies of the masses were planned, but the masses were subsequently shown to be splenic tissue by a (99m)technnetium heat-damaged red blood cell scan. Ectopic splenic masses, eg, splenosis or accessory spleens, should be considered in patients with undiagnosed abdominal or kidney masses and a history of splenectomy.
作者描述了一位患者，最初将其肾旁脾结节解释为可能的嗜铬细胞瘤。一名 22 岁的男性，患有慢性肾小球肾炎、高血压和儿童时期脾切除术病史，因高血压急症住院。尽管进行了积极的降压治疗，但他的病情并未改善。怀疑为嗜铬细胞瘤，肾脏超声和磁共振成像显示左肾旁有 2 个肿块。进行了嗜铬细胞瘤和醛固酮瘤的实验室检查，但均为阴性。计划对肿块进行活检，但随后 (99m)锝热损伤红细胞扫描显示肿块为脾组织。对于有未确诊的腹部或肾脏肿块和脾切除术病史的患者，应考虑异位脾组织，如脾组织内转移或副脾。
