PDF(Pubmed)
Abstract：
Bilateral adrenal hyperplasia associated with primary lung cancer may arise from either an adrenocorticotropic hormone (ACTH)-dependent paraneoplastic syndrome or metastatic hyperplasia. Ectopic Cushing\'s syndrome manifests as a paraneoplastic syndrome characterized by the secretion of ACTH from malignant cells. This secretion can in turn overstimulate the adrenal cortex, resulting in adrenal cortical hyperplasia followed by hypercortisolism. Though rare, lung cancer can metastasize to the adrenal glands bilaterally, occasionally resulting in hemorrhage causing a rapid increase in size. This cadaveric report aims to delineate an unusual case of metastatic lung cancer, presenting with bilateral adrenal hyperplasia and two abdominal aortic aneurysms (AAA). An 84-year-old white male cadaver was dissected during routine coursework. Dissection of the right lung revealed a pale-yellow mass measuring 10.0 x 7.4 x 7.0cm. An irregularly defined, necrotic, ulcerated lesion measuring 5.5 x 4.5 x 3.3cm was evident on the lateral surface of the left shoulder, consistent with a history of metastatic lung carcinoma. Upon abdominal dissection, bilaterally enlarged adrenal glands and two AAAs were observed. These AAAs measured 6.0cm and 11.0cm at their respective widest transverse diameters. The right and left adrenal glands measured 10.0 x 6.5 x 4.5cm and 7.3 x 4.7 x 3.5cm, respectively. We aim to discuss the possible pathophysiological correlation of these unusual findings in this cadaver.
摘要：
与原发性肺癌相关的双侧肾上腺增生可能起因于促肾上腺皮质激素（ACTH）依赖性副肿瘤综合征或转移性增生。异位库欣综合征表现为以恶性细胞分泌促肾上腺皮质激素为特征的副肿瘤综合征。这种分泌反过来会过度刺激肾上腺皮质，导致肾上腺皮质增生，然后是皮质醇增多症。虽然罕见，肺癌可以转移到双侧肾上腺，偶尔导致出血，导致大小迅速增加。这份尸体报告旨在描绘一个不寻常的转移性肺癌病例，表现为双侧肾上腺增生和两个腹主动脉瘤（AAA）。在例行课程中解剖了一名84岁的白人男性尸体。右肺解剖显示浅黄色肿块，大小为10.0x7.4x7.0cm。一个不规则的定义，坏死,测量5.5x4.5x3.3cm的溃疡病变在左肩的侧面是明显的，与转移性肺癌病史一致。在腹部解剖时，观察到双侧肾上腺增大和两个AAAs。这些AAAs在其各自最宽的横向直径处测得6.0cm和11.0cm。左右肾上腺测量10.0x6.5x4.5cm和7.3x4.7x3.5cm，分别。我们旨在讨论该尸体中这些异常发现的可能病理生理相关性。
