Schwerk W B, Görg C, Görg K, Restrepo I K
Department of Internal Medicine, Philipps University, Marburg, Germany.
J Ultrasound Med. 1994 Jul;13(7):517-21. doi: 10.7863/jum.1994.13.7.517.
Sonographic findings in 19 patients with proved adrenal pheochromocytomas observed over a 10 year period were evaluated retrospectively. Adrenal tumors were analyzed by number, size, echogenicity, internal echogenicity, and biologic behavior. There were 16 benign and 3 malignant pheochromocytomas, all of which were well marginated or encapsulated and ranged from 1.4 to 11 cm in greatest diameter (mean, 4.8 +/- 2.2 cm). A broad spectrum of sonographic appearances has been noted, including purely solid tumors (68%), complex masses (16%), and cystic lesions (16%). Compared with renal parenchyma as a reference tissue, 10 (77%) of 13 solid pheochromocytomas were isoechoic or hypoechoic, whereas three (23%) were hyperechoic. Six (46%) of the solid tumors were homogeneously echogenic, and seven (54%) were heterogeneous. Ultrasonic discrimination between benign and malignant pheochromocytoma on the basis of acoustic features alone has proved impossible. Abdominal sonography, however, provided evidence of malignancy in all three patients with malignant tumors by disclosing regional or distant metastases. In conclusion, rather than showing a specific uniform ultrasonographic appearance, pheochromocytoma is associated with a broad spectrum of possible sonographic presentations.
回顾性评估了10年间观察到的19例经证实的肾上腺嗜铬细胞瘤患者的超声检查结果。对肾上腺肿瘤的数量、大小、回声性、内部回声及生物学行为进行了分析。其中有16例良性和3例恶性嗜铬细胞瘤，所有肿瘤边界清晰或有包膜，最大直径为1.4至11厘米（平均4.8±2.2厘米）。已注意到超声表现范围广泛，包括纯实性肿瘤（68%）、混合性肿块（16%）和囊性病变（16%）。以肾实质作为参照组织，13例实性嗜铬细胞瘤中有10例（77%）等回声或低回声，而3例（23%）为高回声。6例（46%）实性肿瘤回声均匀，7例（54%）回声不均匀。仅根据声学特征对良性和恶性嗜铬细胞瘤进行超声鉴别是不可能的。然而，腹部超声检查通过发现局部或远处转移，为所有3例恶性肿瘤患者提供了恶性证据。总之，嗜铬细胞瘤并非呈现特定一致的超声表现，而是与多种可能的超声表现相关。
