Babin J P, Allain D, Demarquez J L, Bondonny J M, Leger H, Martin C
Arch Fr Pediatr. 1977 Feb;34(2):130-42.
Cysts of the adrenal gland are very rare in the neonatal period and are always diagnosed either at surgery or at autopsy. Two patients are reported. One is an infant born at term in whom a mass in the left loin was discovered on the 3rd day of life. At surgery a suprarenal tumour was discovered and a polycystic adrenal was removed: recovery was uneventful. Histology showed a cystic haemangioma in the adrenocortical tissue. The diagnosis made was that of a cystic haemangioma. The other patient is an infant born at 38 weeks gestation who became jaundiced and developed a haemolytic streptococcal septicaemia. A mass was found in the right lumbar region on the 3rd day. The calcified egg-shell appearance, renal arteriography and an intravenous pyelogram demonstrated the cystic appearance of the adrenal. The cystic mass and the adrenal gland were removed and the patient recovered. Histological examination suggested that a pseudocyst had arisen secondary to a haemorrhagic infarct caused by a septic embolus. Adrenal cysts are classified as true cysts and pseudocysts (which must be distinguished from unilateral haematomas). The histological appearances are reviewed. These patients may be added to the 11 neonatal case reports in the literature (9 haemorrhagic pseudocysts, only 2 true cysts). To our knowledge cystic haemangioma has not previously been reported.
肾上腺囊肿在新生儿期非常罕见,通常在手术时或尸检时才被诊断出来。本文报告了两例患者。一例是足月出生的婴儿,出生后第3天发现左腰部有一肿块。手术时发现一个肾上腺肿瘤,切除了一个多囊性肾上腺:术后恢复顺利。组织学检查显示肾上腺皮质组织中有一个囊性血管瘤。诊断为囊性血管瘤。另一例患者是一名孕38周出生的婴儿,出现黄疸并发展为溶血性链球菌败血症。出生后第3天在右腰部发现一个肿块。蛋壳样钙化、肾动脉造影和静脉肾盂造影显示肾上腺呈囊性。切除了囊性肿块和肾上腺,患者康复。组织学检查提示,假性囊肿继发于败血症栓子引起的出血性梗死。肾上腺囊肿分为真性囊肿和假性囊肿(必须与单侧血肿相鉴别)。本文对其组织学表现进行了综述。这两例患者可补充到文献中已报道的11例新生儿病例(9例出血性假性囊肿,仅2例真性囊肿)。据我们所知,此前尚未有囊性血管瘤的报道。