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1、上海交通大学学报(医学版)56JournalofShanghaiJiaotongUniversity(MedicalScience)Vo.l31No.1Jan.2011[文章编号]16748115(2011)01005604论著非肿瘤性肾上腺囊性病变的临床分析12111111孙福康,金晓龙,周文龙,黄欣,戴军,祝宇,吴瑜璇,沈周俊(上海交通大学医学院附属瑞金医院1.泌尿外科,2.病理科,上海200025)[摘要]目的分析肾上腺囊肿和血肿等非肿瘤性囊性病变的临床特点。方法回顾性分析2000
2、年1月2009年10月在上海交通大学医学院附属瑞金医院泌尿外科经过手术切除的肾上腺肿块标本共1250例,收集其中46例(3.68%)经过病理检查证实的单纯性肾上腺囊肿和血肿的病例进行重点分析。术前患者均进行了内分泌功能检查和影像学(B超、CT、MRI和腹部平片加静脉肾盂造影)检查,术后进行病理诊断。结果46例患者术前内分泌功能检查均无异常。术前影像学诊断30例(65.2%)为肾上腺囊肿,16例(34.7%)肿块性质不能确定。术中显示,肿块大小3.0cm2.5cm~7.6cm8.7cm;其中单纯肿块切除41例,肿块加肾上
3、腺部分切除5例。所有患者术后随访8个月~9.5年,均未见复发。结论单纯性肾上腺囊肿经临床、影像学和实验室检查后大多可明确诊断,但部分肾上腺囊肿和肾上腺血肿易误诊为肾上腺实性肿瘤。具有症状的肾上腺囊肿或者性质不明的囊性肿块应行探查;无法明确病变性质的囊性肿块,需按静止性嗜铬细胞瘤做术前准备。[关键词]肾上腺;非肿瘤性囊性病变;囊肿;血肿[DOI]10.3969/.jissn.16748115.2011.01.013[中图分类号]R699.3[文献标志码]AClinicalanalysisofnonneopla
4、sticadrenalcysticlesions1211111SUNFukang,JINXiaolong,ZHOUWenlong,HUANGXin,DAIJun,ZHUYu,WUYuxuan,1SHENZhoujun(1.DepartmentofUrology,2.DepartmentofPathology,RuijinHospital,ShanghaiJiaotongUniversitySchoolofMedicine,Shanghai200025,China)[Abstract]ObjectiveToexpl
5、oretheclinicalcharacteristicsofnonneoplasticcysticlesionssuchasadrenalcystsandhematomas.MethodsOnethousandtwohundredandfiftysamplesofadrenalmassesresectedbyDepartmentofUrology,RuijinHospita,lShanghaiJiaotongUniversitySchoolofMedicinebetweenJanuary2000andOctober20
6、09wereretrospectivelyanalysed,and46(3.68%)ofthecaseswereconfirmedassmipleadrenalcystsorhematomasbypathologicalexaminations,andwerefurtheranalysed.AllpatientsunderwentendocrinalexaminationsandmiagingexaminationssuchasBultrasound,CT,MRIandplainabdominalradiographplus
7、intravenouspyelographybeforeoperation,andpathologicaldiagnosiswasmadeafteroperation.ResultsTherewerenoabnormalfindingsinendocrinalexaminationsbeforeoperationin46patients.Thirtycases(65.2%)werediagnosedasadrenalcystsbymiagingdiagnosisbeforeoperation,whiletheother1
8、6caseswereundetermined.Thesizeofmassesrangedbetween3.0cm2.5cmto7.6cm8.7cm.Fortyonepatientsunderwentsmiplemassresection,and5patientsexperienced