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[间碘苄胍闪烁扫描阴性的嗜铬细胞瘤危象:一例报告]

[PHEOCHROMOCYTOMA CRISIS WITH MIBG SCINTIGRAPHY NEGATIVE: A CASE REPORT].

作者信息

Katsumata Yuki, Takai Yuki, Kuromoto Akito, Morozumi Kento, Hoshi Senji, Numahata Kenji, Sasano Kiminobu

机构信息

The Department of Urology, Yamagata Prefectural Central Hospital.

The Department of Pathology, Tohoku University School of Medicine.

出版信息

Nihon Hinyokika Gakkai Zasshi. 2019;110(3):206-210. doi: 10.5980/jpnjurol.110.206.

Abstract

We report a case of pheochromocytoma crisis with negative MIBG scintigraphy. A 48-year-old man was admitted for hypertension crisis. Computed tomographic scan revealed a 60 mm right adrenal mass. The MIBG scintigraphy was negative, but we diagnosed pheochromocytoma crisis because of high blood catecholamine levels. We successfully managed the patient's hemodynamics through medical treatment and the patient was able to recover from the crisis. After appropriate preparation, the tumor was removed via laparotomy. SDHB mutation, related to the negative MIBG scintigraphy, was also denied pathologically by immunostaining procedures. Histopathologically, it showed a wide range of necrotic images. So the cause of the crisis was thought to be the release of a large amount of catecholamine from necrotic tumor cells. It was thought that scintigraphy became negative due to the decreased MIBG uptake of tumor cells with extensive necrosis.

摘要

我们报告一例MIBG闪烁扫描呈阴性的嗜铬细胞瘤危象病例。一名48岁男性因高血压危象入院。计算机断层扫描显示右侧肾上腺有一个60毫米的肿块。MIBG闪烁扫描呈阴性,但由于血儿茶酚胺水平升高,我们诊断为嗜铬细胞瘤危象。我们通过药物治疗成功控制了患者的血流动力学,患者得以从危象中康复。经过适当准备后,通过剖腹手术切除了肿瘤。免疫染色程序在病理上也排除了与MIBG闪烁扫描阴性相关的SDHB突变。组织病理学显示有广泛的坏死图像。因此,认为危象的原因是坏死肿瘤细胞释放大量儿茶酚胺。据认为,由于广泛坏死的肿瘤细胞对MIBG摄取减少,闪烁扫描呈阴性。

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