Flattet A, Hedinger C
Schweiz Med Wochenschr. 1980 Sep 6;110(36):1300-6.
Histological slides of the adrenals of 54 patients who underwent uni- or bilateral adrenalectomy for Cushing's syndrome at the Zürich University Hospital Department of urology between 1960 and 1977 were reexamined. In 29 patients (53.7%) Cushing's disease was due to diffuse bilateral adrenocortical hyperplasia, in 4 (7.4%) to micronodular cortical hyperplasia and in 3 (5.6%) to macronodular cortical hyperplasia and in 3 (5.6%) to macronodular hyperplasia. Two patients (3.7%) presented with primary bilateral nodular cortical dysplasia (so-called microadenomatosis). In 12 cases of Cushing's syndrome (22.2%) the basic lesion was a cortical adenoma and in 4 cases (7.4%) a cortical carcinoma. The histologic diagnoses corresponded well with biochemical findings, clinical diagnoses and further development of the disease. Histopathologic diagnosis of diffuse and micronodular hyperplasia presents no difficulties. Differential diagnosis of macronodular hyperplasia, cortical dysplasia, adenoma, and carcinoma may, however, be somewhat more problematic.
对1960年至1977年间在苏黎世大学医院泌尿外科因库欣综合征接受单侧或双侧肾上腺切除术的54例患者的肾上腺组织切片进行了重新检查。29例患者（53.7%）的库欣病是由双侧肾上腺皮质弥漫性增生引起的，4例（7.4%）是由微结节性皮质增生引起的，3例（5.6%）是由大结节性皮质增生引起的，3例（5.6%）是由大结节性增生引起的。2例患者（3.7%）表现为原发性双侧结节性皮质发育异常（所谓的微腺瘤病）。在12例库欣综合征患者（22.2%）中，基本病变是皮质腺瘤，4例（7.4%）是皮质癌。组织学诊断与生化检查结果、临床诊断及疾病的进一步发展情况吻合良好。弥漫性和微结节性增生的组织病理学诊断并不困难。然而，大结节性增生、皮质发育异常、腺瘤和癌的鉴别诊断可能会有些问题。
