Babinska Anna, Peksa Rafał, Sworczak Krzysztof
Department of Endocrinology and Internal Medicine, Medical University of Gdansk, ul. Dębinki 7, 80-288, Gdańsk, Poland.
Department of Pathology, Medical University of Gdansk, ul. Dębinki 7, 80-288, Gdańsk, Poland.
World J Surg Oncol. 2015 Sep 30;13:289. doi: 10.1186/s12957-015-0711-6.
An increased number of adrenal tumors are now diagnosed due to the increased number of abdominal CT scans being performed. We present the first case of malignant lymphoma combined with clinically "silent" pheochromocytoma in the same adrenal gland. An abdominal CT scan demonstrates unilateral adrenal lesion which suggests pheochromocytoma or adrenal carcinoma. Laboratory examinations revealed a slight increase of 24-h urine vanillylmandelic acid and 24-h urinary methanephrine excretion. Histological examination revealed two intermingled tumor cell proliferations-diffuse B cell lymphoma and pheochromocytoma.Unexpected coexistence of catecholamine-producing tumor with the other adrenal lesion can lead to serious complications of diagnosis and treatment. The adequate preparation for surgery can protect patient from threatening catecholamine crisis.
由于腹部CT扫描数量的增加，现在诊断出的肾上腺肿瘤数量有所增多。我们报告首例同一肾上腺内恶性淋巴瘤合并临床“无症状”嗜铬细胞瘤的病例。腹部CT扫描显示单侧肾上腺病变，提示嗜铬细胞瘤或肾上腺癌。实验室检查显示24小时尿香草扁桃酸和24小时尿甲氧基肾上腺素排泄量略有增加。组织学检查显示两种肿瘤细胞增殖相互交织——弥漫性B细胞淋巴瘤和嗜铬细胞瘤。产生儿茶酚胺的肿瘤与其他肾上腺病变意外并存可导致诊断和治疗的严重并发症。充分的手术准备可保护患者免受危及生命的儿茶酚胺危象。
