Stenger A M, Frilling A, Schröder S, Odensaas C, Broelsch C E
Abteilung für Allgemeinchirurgie, Universität Hamburg.
Chirurg. 1996 Apr;67(4):448-50.
Sporadic adrenomedullary hyperplasia (AMH) is characterized by a clinical history of hypertension, increased plasma and/or urinary catecholamine levels and histomorphometric evidence of increased adrenal medullary mass in the absence of MEN 2 syndrome. The case of a 42-year-old female patient is reported who presented with typical clinical and laboratory findings of episodic hypertension and elevated plasma and urinary catecholamines. Sonography and computed tomography revealed no abnormality, but 131I-metaiodobenzylguanidine (131I-MIBG) scintigraphy showed increased uptake in the right adrenal. Transabdominal unilateral adrenalectomy was performed. The right adrenal gland was macroscopically inconspicuous. Upon histomorphometry, however, an increased adrenal medullary cell mass was shown, thus confirming AMH. Two years following surgery the patient is asymptomatic and normotensive.
散发性肾上腺髓质增生(AMH)的特征是有高血压的临床病史、血浆和/或尿儿茶酚胺水平升高,以及在无MEN 2综合征的情况下肾上腺髓质质量增加的组织形态计量学证据。本文报告了一例42岁女性患者,其表现出发作性高血压以及血浆和尿儿茶酚胺升高的典型临床和实验室检查结果。超声检查和计算机断层扫描未发现异常,但131I-间碘苄胍(131I-MIBG)闪烁显像显示右侧肾上腺摄取增加。遂行经腹单侧肾上腺切除术。右侧肾上腺在大体上不明显。然而,组织形态计量学显示肾上腺髓质细胞质量增加,从而确诊为AMH。术后两年,患者无症状且血压正常。