Medlej R, Nasser S, Abadjian G, Gedeon E, Chalouhy E, Halaby G
Service d'endocrinologie, Hôtel-Dieu de France, Beyrouth, Liban.
J Med Liban. 1993;41(3):155-9.
The wider application of increasingly sensitive ultrasonography and CT scanning has created a new problem for clinical management: the incidental discovery of asymptomatic adrenal lesions. These lesions, also called "incidentalomas" may be due to a large variety of etiologies, and although most of them prove to be benign cortical adenomas, diagnostic confirmation is frequently impossible preoperatively. For this reason, a general approach, based on the relative prevalence of benign and malignant, clinically silent adrenal masses, has been defined. This same approach is usually needed in the case of myelolipoma, a rare form of benign and silent adrenal neoplasms, containing hematopoietic and fatty elements. Actually, computed tomographic aspect of such tumors is very evocative but not pathognomonic, so it doesn't eliminate the possibility of malignant lesions, especially in the presence of heterogeneities. Because of these limitations and awaiting the development of more specific diagnostic procedures, it seems cautious to approach these tumors like incidentalomas in general.
日益灵敏的超声检查和CT扫描的广泛应用给临床管理带来了一个新问题:偶然发现无症状肾上腺病变。这些病变也称为“偶发瘤”,可能由多种病因引起,尽管其中大多数被证明是良性皮质腺瘤,但术前往往无法确诊。因此,基于良性和恶性临床无症状肾上腺肿块的相对患病率,已确定了一种通用方法。对于肾上腺髓质脂肪瘤这种罕见的良性无症状肾上腺肿瘤(含有造血和脂肪成分),通常也需要采用同样的方法。实际上,此类肿瘤的计算机断层扫描表现很有提示性,但并非特异性表现,因此不能排除恶性病变的可能性,尤其是存在异质性时。由于这些局限性,在更特异的诊断方法出现之前,总体上像对待偶发瘤一样处理这些肿瘤似乎较为谨慎。