PDF(Pubmed)
Abstract：
UNASSIGNED: The aetiologies in unilateral and bilateral adrenal lesions can be different with different clinical implications and management guidelines, the latter having aetiologies like hyperplasia, infections, infiltrative lesions and neoplasia. Bilateral tumours are more likely to have hereditary/syndromic associations. There is limited data on the clinical and pathological profile of bilateral adrenal lesions.
UNASSIGNED: This was a retrospective study where patients with bilateral adrenal lesions were selected from a total of 266 patients with adrenal lesions who presented to our institute between January 2016 and August 2022. The demographic, laboratory and imaging data were retrieved from the Hospital Information System and patient case files.
UNASSIGNED: The study included 51 patients; the mean age at presentation was 51.15 years (range 14 to 82 years). Forty-eight patients (94.1%) were symptomatic at presentation with an average duration of symptoms being 10.68 months (range 10 days to 1 year). The most common presentation was adrenal insufficiency in 18 cases (38%), followed by fever in 17 cases (36%). The commonest aetiology, as revealed on histopathology, was histoplasmosis (n = 22, 43%), followed by pheochromocytoma (n = 11, 21.5%), metastases (n = 6, 11.7%), adrenal hyperplasia (n = 5, 9.8%), adrenocortical adenoma (n = 1, 1.9%), lymphoma (n = 3, 5.8%), neuroblastoma (n = 1, 1.9%), myelolipoma (n = 1, 1.9%) and tuberculosis (n = 1, 1.9%). Histoplasmosis and metastatic lesions were commonly seen in older people, and pheochromocytoma was associated with young age. 6/11 patients with a diagnosis of bilateral pheochromocytoma were associated with family history, genetic mutation and extra-adrenal involvement.
UNASSIGNED: The approach to bilateral adrenal lesions differs from that of unilateral lesions due to differences in aetiologies and the more significant role of genetics in some bilateral tumours. The age at presentation, presenting symptoms, lesion size and biochemical features help delineate varied underlying aetiologies.
UNASSIGNED: This was a retrospective study where patients with bilateral adrenal lesions were selected from a total of 266 patients with adrenal lesions who presented to our institute between January 2016 and August 2022. The demographic, laboratory and imaging data were retrieved from the Hospital Information System and patient case files.
UNASSIGNED: The study included 51 patients; the mean age at presentation was 51.15 years (range 14 to 82 years). Forty-eight patients (94.1%) were symptomatic at presentation with an average duration of symptoms being 10.68 months (range 10 days to 1 year). The most common presentation was adrenal insufficiency in 18 cases (38%), followed by fever in 17 cases (36%). The commonest aetiology, as revealed on histopathology, was histoplasmosis (n = 22, 43%), followed by pheochromocytoma (n = 11, 21.5%), metastases (n = 6, 11.7%), adrenal hyperplasia (n = 5, 9.8%), adrenocortical adenoma (n = 1, 1.9%), lymphoma (n = 3, 5.8%), neuroblastoma (n = 1, 1.9%), myelolipoma (n = 1, 1.9%) and tuberculosis (n = 1, 1.9%). Histoplasmosis and metastatic lesions were commonly seen in older people, and pheochromocytoma was associated with young age. 6/11 patients with a diagnosis of bilateral pheochromocytoma were associated with family history, genetic mutation and extra-adrenal involvement.
UNASSIGNED: The approach to bilateral adrenal lesions differs from that of unilateral lesions due to differences in aetiologies and the more significant role of genetics in some bilateral tumours. The age at presentation, presenting symptoms, lesion size and biochemical features help delineate varied underlying aetiologies.
摘要：
■单侧和双侧肾上腺病变的病因可能不同，具有不同的临床意义和管理指南，后者有增生等病因，感染,浸润性病变和瘤形成。双侧肿瘤更有可能具有遗传性/综合征性关联。关于双侧肾上腺病变的临床和病理特征的数据有限。
■这是一项回顾性研究，从2016年1月至2022年8月到我们研究所就诊的266例肾上腺病变患者中选择双侧肾上腺病变患者。人口统计，从医院信息系统和患者病例档案中检索实验室和影像学数据.
■该研究包括51名患者；就诊时的平均年龄为51.15岁（范围为14至82岁）。48例患者（94.1％）出现症状，症状平均持续时间为10.68个月（范围为10天至1年）。最常见的表现是肾上腺功能不全18例（38％），其次是发热17例(36%)。最常见的病因，正如在组织病理学上所揭示的，是组织胞浆菌病（n=22，43%），其次是嗜铬细胞瘤（n=11，21.5%），转移（n=6，11.7%），肾上腺增生（n=5，9.8%），肾上腺皮质腺瘤（n=1，1.9%），淋巴瘤（n=3，5.8%），神经母细胞瘤（n=1，1.9%），骨髓脂肪瘤（n=1，1.9％）和结核（n=1，1.9％）。组织胞浆菌病和转移性病变常见于老年人，嗜铬细胞瘤与年轻有关。6/11诊断为双侧嗜铬细胞瘤的患者与家族史有关，基因突变和肾上腺外受累。
■双侧肾上腺病变的方法与单侧病变的方法不同，原因是病因不同，遗传学在某些双侧肿瘤中的作用更重要。演讲的年龄，出现症状，病变大小和生化特征有助于描绘各种潜在的病因。
■这是一项回顾性研究，从2016年1月至2022年8月到我们研究所就诊的266例肾上腺病变患者中选择双侧肾上腺病变患者。人口统计，从医院信息系统和患者病例档案中检索实验室和影像学数据.
■该研究包括51名患者；就诊时的平均年龄为51.15岁（范围为14至82岁）。48例患者（94.1％）出现症状，症状平均持续时间为10.68个月（范围为10天至1年）。最常见的表现是肾上腺功能不全18例（38％），其次是发热17例(36%)。最常见的病因，正如在组织病理学上所揭示的，是组织胞浆菌病（n=22，43%），其次是嗜铬细胞瘤（n=11，21.5%），转移（n=6，11.7%），肾上腺增生（n=5，9.8%），肾上腺皮质腺瘤（n=1，1.9%），淋巴瘤（n=3，5.8%），神经母细胞瘤（n=1，1.9%），骨髓脂肪瘤（n=1，1.9％）和结核（n=1，1.9％）。组织胞浆菌病和转移性病变常见于老年人，嗜铬细胞瘤与年轻有关。6/11诊断为双侧嗜铬细胞瘤的患者与家族史有关，基因突变和肾上腺外受累。
■双侧肾上腺病变的方法与单侧病变的方法不同，原因是病因不同，遗传学在某些双侧肿瘤中的作用更重要。演讲的年龄，出现症状，病变大小和生化特征有助于描绘各种潜在的病因。
