1,111 Patients with adrenal incidentalomas observed at a single endocrinological center - Incidence of chromaffin tumors
1,111 Patients with adrenal incidentalomas observed at a single endocrinological center - Incidence of chromaffin tumors
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DOI：
10.1196/annals.1353.004
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发表时间：
2006-01-01
期刊：
影响因子：
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通讯作者：
Eisenhofer, Graeme
中科院分区：
文献类型：
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作者：
Kasperlik-Zaluska, Anna A.;Roslonowska, Elzbieta;Eisenhofer, Graeme
大多数偶然发现的肾上腺肿瘤源自肾上腺皮质。我们研究的目的是评估 1,111 名肾上腺偶发瘤患者中嗜铬瘤的发生率。该群体中有 803 名女性和 308 名男性，年龄 1087 岁。采用临床检查、影像学检查（必要时超声扫描、CT和MRI）和激素测定（血液中的皮质醇、ACTH和雄激素，地塞米松抑制试验，尿中17-OHCS、醛固酮和17-KS排泄，以及高血压患者和CT密度超过20 HU的患者的PRA/醛固酮刺激试验和变肾上腺素）。对380例接受手术（主要是腹腔镜手术）的患者进行了组织学和免疫细胞化学检查。临床检查显示 25% 的研究患者患有高血压。 43 例患者中发现嗜铬瘤，其中 33 名女性和 10 名男性，年龄 20-75 岁：嗜铬细胞瘤 36 例（3 例恶性）； 2.嗜铬细胞增生；副神经节瘤 3;神经节神经母细胞瘤 1;神经节神经瘤 1; 2. 注射造影剂前，肿瘤直径为1.1～20.0 cm，密度为25 Hounsfield 单位（HU）或以上。其中 53% 的患者患有高血压。在进行测定的 38 名患者中，有 31 名患者的尿变肾上腺素排泄量升高。在 1,111 名肾上腺偶发瘤患者中，4% 检出嗜铬细胞瘤（3% 为嗜铬细胞瘤）。 43 名嗜铬瘤患者中，9% 存在恶性肿瘤。 CT高密度对于偶然发现的髓样肿瘤是一个非常重要的诊断发现。
A majority of incidentally found adrenal tumors derive from the adrenal cortex. The aim of our study was evaluation of the incidence of chromaffin tumors in a group of 1,111 patients with adrenal inciden-talomas. In this group there were 803 women and 308 men, aged 1087 years. Clinical examination, imaging studies (ultrasound scans, CT, and MRI if necessary), and hormonal determinations (cortisol, ACTH and androgens in the blood, dexamethasone suppression test, urinary excretion of 17-OHCS, aldosterone and 17-KS, as well as PRA/aldosterone stimulation test and metanephrines in hypertensive patients and those with density in CT over 20 HU) were used. In 380 patients treated by surgery (mainly by laparoscopic approach), histological and immunocytochemical examinations were performed. Clinical examination revealed hypertension in 25% of the patients under study. Chromaffin tumors were detected in 43 patients, 33 women, and 10 men aged 20-75 years: pheochromocytoma in 36 (malignant in 3); chromaffin cells hyperplasia in 2; paraganglioma in 3; ganglioneuroblastoma in 1; ganglioneuroma in 1; and schwannoma in 2. The tumors' diameter ranged between 1.1 and 20.0 cm, density = 25 Hounsfield units (HU) or more before contrast medium injection. Hypertension was present in 53% of these patients. The urinary metanephrines excretion was elevated in 31 of 38 patients, in whom the determinations were done. Chromaffin tumors were detected in 4% (pheochromocytomas in 3%) of 1,111 patients with adrenal incidentalomas. Malignancy was present in 9% of 43 patients with chromaffin tumors. High density in CT was a very important diagnostic finding in the incidentally found medullary tumors.