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[肾上腺肿瘤的病理解剖]

[Pathologic anatomy of adrenal tumors].

作者信息

Richter H J

出版信息

Radiologe. 1980 Apr;20(4):149-57.

PMID:7413971
Abstract

Review of the pathology of benign and malignant tumors of the adrenal gland. Generally, all neoplasms of the adrenal gland may show endocrine activity with respective clinical syndromes. Such syndromes may give first clues for the important differential diagnosis between hyperplasia and neoplasia. There is no correlation between morphology and function of the various tumors. Cancers of the adrenal cortex are extremely rare. They occur at any age. At infancy, neoplasms of the adrenal cortex are almost always hormonally active and malignant. Adenomas and carcinomas of the adrenal cortex are discussed with special reference to the difficulty of differential diagnosis. The prognosis of carcinomas of the adrenal cortex is poor. The five years' survival rate amounts to 10--25%. The dignity of phaeochromocytoma can hardly be established by morphology alone. Most of them are benign. Metastases of these tumors are the only certain criterion of malignancy. Neuroblastoma metastasizes very early and--in case of bone marrow involvement--must be separated from lymphosarcoma, Ewing's sarcoma, and from undifferentiated leukemias. Cysts of the adrenal gland are very rare but they are important in the differential diagnosis of adrenal masses. Finally, tumors like myelolipoma are briefly discussed.

摘要

肾上腺良恶性肿瘤的病理学综述。一般来说,肾上腺的所有肿瘤都可能表现出内分泌活性并伴有相应的临床综合征。这些综合征可能为增生和肿瘤之间重要的鉴别诊断提供最初线索。各种肿瘤的形态与功能之间没有相关性。肾上腺皮质癌极为罕见。其可发生于任何年龄。在婴儿期,肾上腺皮质肿瘤几乎总是具有激素活性且为恶性。本文特别参照鉴别诊断的难点,对肾上腺皮质腺瘤和癌进行了讨论。肾上腺皮质癌的预后很差。五年生存率为10%至25%。仅靠形态学很难确定嗜铬细胞瘤的良恶性。它们大多是良性的。这些肿瘤的转移是恶性的唯一确切标准。神经母细胞瘤很早就会发生转移,并且在骨髓受累的情况下,必须与淋巴肉瘤、尤因肉瘤以及未分化白血病相鉴别。肾上腺囊肿非常罕见,但在肾上腺肿块的鉴别诊断中很重要。最后,对诸如肾上腺髓质脂肪瘤等肿瘤进行了简要讨论。

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