Charbonnel B, Chatal J F, Ozanne P
J Nucl Med. 1981 Dec;22(12):1059-61.
An adrenal tumor was discovered fortuitously in a patient with no clinical features of Cushing's syndrome. On adrenal imaging, there was good uptake in the nodule but no visualization of the contralateral adrenal. The latter was seen, however, in a second scan performed under ACTH treatment. In the hormone assessment, basal cortisol and 17-hydroxycorticoids were normal and cortisol diurnal variation was near normal, but a dexamethasone suppression test and ACTH responses to metyrapone and insulin hypoglycemia were abnormal. Eight months after excision of a spongiocytic-type adenoma, the remaining adrenal was visible on scintigram and the hormonal tests were normal. This pattern suggests that the clinical Cushing's syndrome but enough to suppress partially ACTH and, consequently, visualization of the contralateral gland.
在一名无库欣综合征临床特征的患者中偶然发现了肾上腺肿瘤。肾上腺成像显示，结节摄取良好，但对侧肾上腺未显影。然而，在促肾上腺皮质激素（ACTH）治疗下进行的第二次扫描中可见对侧肾上腺。在激素评估中，基础皮质醇和17-羟皮质类固醇正常，皮质醇昼夜变化接近正常，但地塞米松抑制试验以及ACTH对甲吡酮和胰岛素低血糖的反应异常。切除海绵状细胞瘤型腺瘤8个月后，闪烁扫描可见剩余肾上腺，激素检测正常。这种模式表明，临床上虽无库欣综合征，但足以部分抑制ACTH，从而导致对侧肾上腺不显影。
