Adrenal Glands

肾上腺
  • 文章类型: Case Reports
    UNASSIGNED: Adrenal gland cysts are a rare entity, with a reported incidence in post-mortem series of 0.06-0.18%. However, the incidence seems to be increasing in recent years. The presentation of adrenal gland cysts is usually asymptomatic, but those cases in which symptoms are present are usually non-specific, which makes adrenal cysts generally recognized as incidentalomas. The finding is mainly made by computed tomography. The main objective of this article was to describe the clinical course of a patient with an adrenal gland pseudocyst, which is accompanied by symptoms of compression and persistent pain of long evolution in the left flank.
    UNASSIGNED: A 65-year-old female patient attended the emergency room of a second-level hospital due to an increase in volume of the abdominal region with a sensation of fullness, heartburn, vomiting and pain. Computed tomography was performed, which reported a cystic mass and, later, exploratory laparotomy plus adrenalectomy were carried out. The pathology analysis reported a diagnosis of a 10 x 15 x 14 cm solid, cystic, and adherent tumor, coinciding with a pseudocyst of the adrenal gland.
    UNASSIGNED: Adrenal gland cysts are rare. Computed tomography is recommended for its diagnosis and the standard of treatment is surgical intervention in the presence of symptoms.
    UNASSIGNED: los quistes de glándula suprarrenal son una entidad rara, con un reporte en la incidencia de series post mortem de 0.06-0.18%. Sin embargo, la incidencia parece ir en aumento en los últimos años. La presentación de los quistes de glándula suprarrenal es habitualmente asintomática, pero en aquellos casos en que se presentan síntomas, estos suelen ser inespecíficos, lo cual hace que los quistes suprarrenales generalmente sean reconocidos como incidentalomas. El hallazgo se hace principalmente mediante tomografía computarizada. El objetivo principal de este artículo fue describir el curso clínico de una paciente con un pseudoquiste de glándula suprarrenal, que se acompaña de síntomas de compresión y dolor persistente de larga evolución en el flanco izquierdo.
    UNASSIGNED: mujer de 65 años que acudió a urgencias de un hospital de segundo nivel por aumento de volumen de región abdominal con sensación de plenitud, pirosis, vómito y dolor. Se realizó tomografía computarizada que reportó masa quística; posteriormente se realizó laparotomía exploradora y adrenalectomía. El análisis de patología reportó diagnóstico de tumor de 10 x 15 x 14 cm, sólido, quístico y adherido, coincidente con pseudoquiste de glándula suprarrenal.
    UNASSIGNED: los quistes de glándula suprarrenal son raros. Para su diagnóstico se recomienda realizar tomografía computarizada y el estándar de tratamiento es la intervención quirúrgica ante la presencia de sintomatología.
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  • 文章类型: Case Reports
    背景:肾上腺梗塞(AI)是一种罕见的肾上腺损害,这在系统性红斑狼疮中相对常见,抗磷脂抗体综合征(APS)和妊娠。AI的诊断主要通过计算机断层扫描(CT)和磁共振成像,但很容易与其他肾上腺疾病混淆。因此,这份报告详细介绍了系统性红斑狼疮的AI状况,APS并从影像学上做出了鉴别诊断。
    方法:我们报告了一例55岁的女性,她的窝腋窝和腹股沟区疼痛。然后CT扫描显示双侧肾上腺疾病,病人被诊断为系统性红斑狼疮,附加自身免疫检查后的APS和AI。
    方法:患者诊断为系统性红斑狼疮合并狼疮性肾炎,血液学损伤和门脑炎,APS,AI和继发性凝血障碍。
    方法:患者接受甲基强的松龙治疗,羟氯喹和低分子肝素。
    结果:患者在治疗1年后病情缓解并保持健康。
    AI可以分为出血性和非出血性,以双侧病变多见。在我们的案例中,人工智能是双边的,部分受累且非出血性,“截止符号”最早是在CT中提出的,这可能有助于诊断。
    BACKGROUND: Adrenal infarction (AI) is a rare type of adrenal damage, which is relatively common in systemic lupus erythematosus, antiphospholipid antibody syndrome (APS) and pregnancy. The diagnosis of AI is mainly by computed tomography (CT) and magnetic resonance imaging, but is easily confused with other adrenal disease. Hence, this report details a condition of AI with systemic lupus erythematosus, APS and made a differential diagnosis from imaging.
    METHODS: We report a case of a 55-year-old woman with pain in her fossa axillaries and inguinal regions. Then CT scan disclosed bilateral adrenal diseases, and the patient was diagnosed with systemic lupus erythematosus, APS and AI after additional autoimmune examinations.
    METHODS: The patient was diagnosed as systemic lupus erythematosus with lupus nephritis, hematological damage and oromeningitis, APS, AI and secondary blood coagulation disorders.
    METHODS: The patient was treated with methylprednisolone, hydroxychloroquine and low molecular heparin.
    RESULTS: The patient relieves and remains well 1 year after treatment.
    UNASSIGNED: AI can be divided hemorrhagic and non-hemorrhagic, with bilateral lesions more common. In our case, the AI was bilateral, partially involved and non-hemorrhagic, and the \"cutoff sign\" was first put forward in CT, which might assist the diagnosis.
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  • 文章类型: Case Reports
    背景:大多数肾上腺肿瘤是良性的,原发性肾上腺恶性肿瘤相对罕见。原发性肾上腺淋巴瘤(PAL)是一种非常罕见且高度侵袭性的恶性肿瘤,病因不明,不典型的临床症状,非特异性影像学表现,疾病诊断困难,预后差。
    方法:本病例报道了一名42岁女性,因1岁双侧肾上腺肿块和1个月大的左上腹痛入院。腹部增强CT示:右侧肾上腺结节,左侧肾上腺区大面积占位,嗜铬细胞瘤的可能性很高。术中,在左肾上腺区发现了一个约12*12*10厘米的巨大肿瘤,浸润左肾,脾脏和胰尾。术后病理:肾包膜及包膜下可见淋巴细胞,在胰腺中发现淋巴细胞;在脾脏中发现淋巴细胞。考虑淋巴造血系统的肿瘤,可能是淋巴瘤.
    结论:该病例表明原发性肾上腺弥漫性大B细胞淋巴瘤(PADLBCL)具有高度侵袭性,预后不良,容易复发,治疗效果不佳,而且很难诊断.临床医生在遇到巨大的肾上腺占位性病变时应考虑PADLBCL的可能性,并在手术前考虑化疗。手术前缩小肿瘤大小是一种更有利的治疗方法,从而延长患者生命,提高生存质量。
    BACKGROUND: Most adrenal tumors are benign and primary adrenal malignancies are relatively rare. Primary adrenal lymphoma (PAL) is a very rare and highly aggressive malignant tumor with unknown etiology, atypical clinical symptoms, nonspecific imaging manifestations, difficult disease diagnosis and poor prognosis.
    METHODS: This case report details a 42-year-old woman who was admitted to the hospital with a 1-year-old bilateral adrenal mass and 1-month-old left upper abdominal pain. Enhanced CT of the abdomen showed a right adrenal nodule and a large occupying lesion in the left adrenal region, with a high probability of pheochromocytoma. Intraoperatively, a huge tumor measuring about 12*12*10 cm was found in the left adrenal region, infiltrating the left kidney, spleen and pancreatic tail. Postoperative pathology: lymphocytes were found in the renal capsule and subcapsule, lymphocytes were found in the pancreas; lymphocytes were found in the spleen. Consider a tumor of the lymphohematopoietic system, possibly lymphoma.
    CONCLUSIONS: This case demonstrates that primary adrenal diffuse large B-cell lymphoma (PADLBCL) is highly aggressive, has a poor prognosis, is prone to recurrence, has poor therapeutic outcomes, and is difficult to diagnose. Clinicians should consider the possibility of PADLBCL when encountering huge adrenal-occupying lesions and consider chemotherapy before surgery. Reducing the tumor size before surgery is a more favorable therapeutic approach, thus prolonging the patient life and improving the quality of survival.
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  • 文章类型: Case Reports
    一名63岁的妇女出现低钾血症,高血压,体重增加,肢体水肿,和颤抖。她被诊断出患有库欣综合征,24小时尿皮质醇水平为41,013nmol/天。研究显示2级胰腺神经内分泌肿瘤伴有广泛的肝转移。由于她的疾病产生过多的促肾上腺皮质激素,尽管酮康唑,她的皮质醇血症和库欣症状恶化,生长抑素类似物,肝右叶化疗栓塞术.对她的双侧肾上腺进行了三个部分的39Gy剂量的立体定向放射治疗(SBRT),以期降低皮质醇水平并改善症状。她的24小时尿皮质醇水平在SBRT后下降,但不够快;她的临床状况继续恶化,治疗21天后死亡.SBRT在这种情况下作为紧急干预并不有效;可能需要更大的延迟来实现响应。
    A 63-year-old woman presented with hypokalemia, hypertension, weight gain, limb edema, and tremors. She was diagnosed with Cushing syndrome, with a 24-hour urine cortisol level of 41,013 nmol/day. Investigations revealed a grade 2 pancreatic neuroendocrine tumor with extensive hepatic metastases. Owing to excessive adrenocorticotropic hormone production from her disease, her hypercortisolemia and Cushing symptoms worsened despite ketoconazole, somatostatin analogs, and right liver lobe chemoembolization. Stereotactic body radiotherapy (SBRT) at a dose of 39 Gy in three fractions was administered to her bilateral adrenal glands in the hope of reducing her cortisol levels and improving her symptoms. Her 24-hour urine cortisol levels decreased following SBRT, but not rapidly enough; her clinical condition continued to deteriorate, and she died 21 days after treatment. SBRT was not effective as an urgent intervention in this setting; a greater latency to realize a response is likely necessary.
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  • 文章类型: Case Reports
    Primary aldosteronism is a group of disorders in which the autonomous secretion of aldosterone is associated with hypertension and hypokalemia. It is crucial to determine the laterality of aldosterone hypersecretion because treatment options differ accordingly. Adrenal venous sampling (AVS) is considered the most reliable method for assessing the laterality of primary aldosteronism. This procedure is often technically challenging because of the small size and varied locations of the adrenal veins. A better understanding of anatomical variations and careful review of imaging studies would improve sampling success. This report presents three cases of anatomical variations encountered during AVS.
    원발성 알도스테론증은 자율신경계에 의한 알도스테론 분비조절의 장애로 고혈압 및 저칼륨혈증과 관련이 있다. 원발성 알도스테론증에서 편측성을 결정하는 것이 매우 중요한 이유는 그에 따라 치료 방법이 달라지기 때문이다. 부신정맥채혈술은 원발성 알도스테론증에서 편측성을 평가하는 가장 신뢰성 있는 방법으로 알려져 있다. 부신정맥채혈술은 부신 정맥이 크기가 매우 작으며 그 해부학적 위치가 다양하기 때문에 기술적으로 어려운 시술이다. 따라서 성공적인 시술을 위해서는 해부학적 변이를 잘 이해하고 시술 전 영상 검사를 면밀히 검토하는 것이 중요하다. 부신정맥채혈술 중에 발견된 세 가지 해부학적 변이를 보고하고자 한다.
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  • 文章类型: Case Reports
    原发性糖皮质激素抵抗(OMIM615962)是一种罕见的内分泌疾病,由人类糖皮质激素受体(hGR)对糖皮质激素(GR)的抵抗引起,其特征是靶器官对GK的普遍或部分不敏感。下丘脑-垂体-肾轴的代偿激活导致由肾上腺过度刺激引起的各种病理状况的发展。临床范围可从无症状病例到盐皮质激素和/或雄激素过量的严重病例。目前,原发性全身性糖皮质激素耐药仅与NR3C1基因缺陷相关。这里,我们提供了一例青少年患者的病例报告,该患者的临床表现为糖皮质激素耐药,经详细的内分泌评估证实,但未证实NR3C1基因突变.
    Primary glucocorticoid resistance (OMIM 615962) is a rare endocrinologic condition caused by resistance of the human glucocorticoid receptor (hGR) to glucocorticoids (GR) and characterised by general or partial insensitivity of target organs to GK. Compensatory activation of hypothalamic-pituitary-andrenal axis results in development of a various pathological conditions caused by overstimulation of adrenal glands. Clinical spectrum may range from asymptomatic cases to severe cases of mineralocorticoid and/or androgen excess. At present time, primary generalized glucocorticoid resistance has been exclusively associated with defects in the NR3C1 gene. Here, we present a case report of an adolescent patient with clinical presentation of glucocorticoid resistance confirmed by detailed endocrinologic evaluation but no confirmed mutations in the NR3C1 gene.
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  • 文章类型: Case Reports
    异位脑组织很少见,尚未见报道。我们中心做了第一份报告。4岁零2个月大的女孩在右上腹痛2周后出现右肾上腺囊性肿块。手术成功了,经术后病理证实。手术后6个月,切口愈合良好,无复发。该病例报告有详细的诊治过程和满意的检查结果。为临床HBT的诊治提供参考,降低误诊误治风险。
    Heterotopic brain tissue is rare and has not been reported. Our center made the first report. 4 years and 2 months old Girl presented with a cystic mass in the right adrenal gland 2 weeks after right upper abdominal pain. The operation was successful, and the diagnosis was confirmed by postoperative pathology. 6 months after the procedure, the incision healed well without recurrence. This case report has a detailed diagnosis and treatment process and satisfactory examination results. It can provide a reference for diagnosing and treating clinical HBT and reduce the risk of misdiagnosis and mistreatment.
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  • 文章类型: Review
    背景:肾-肾上腺融合是一种罕见的实体,由肾上腺和肾脏的不完全包裹引起。迄今为止,英语文献中仅报道了18例。
    方法:我们的患者是一名77岁的非裔美国女性,收缩压为200mmHg。计算机断层扫描显示左肾脏前部和内侧有9×6cm的肿块增强。患者接受了左肾上腺切除术和部分肾切除术。大体和组织学检查显示肾上腺皮质腺瘤和肾-肾上腺融合。
    结论:肾-肾上腺融合可能构成诊断挑战,特别是当并发肾上腺腺瘤时。重要的是要意识到这种罕见的异常,以避免误诊和过度治疗。
    BACKGROUND: Renal-adrenal fusion is a rare entity resulting from incomplete encapsulation of the adrenal gland and kidney. Only 18 cases have been reported in English literature to date.
    METHODS: Our patient is a 77-year-old African American female who presented with a systolic blood pressure of 200 mmHg. Computed tomography showed an enhancing 9 × 6 cm mass anterior and medial to the left kidney. The patient underwent a left adrenalectomy with partial nephrectomy. Gross and histologic examinations revealed an adrenal cortical adenoma and renal-adrenal fusion.
    CONCLUSIONS: Renal-adrenal fusion may pose a diagnostic challenge, particularly when there is a concurrent adrenal adenoma. It is important to be aware of this uncommon anomaly to avoid misdiagnosis and overtreatment.
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  • 文章类型: Review
    背景:腺瘤样瘤是罕见的良性肿瘤,主要涉及生殖道,如男性的附睾和女性的子宫和输卵管。然而,少数病例可发生在生殖道外。在这里,我们报道了一例罕见的原发性肾上腺腺瘤样瘤。
    方法:一名50岁男子接受了超声检查,发现右肾上腺肿块无血压升高,疲劳后的虚弱,频繁的夜间尿急,疼痛,或者血尿史.患者的一般健康状况正常。计算机断层扫描显示右肾上腺区多囊混合密度病变,大小约7.3×4.5厘米。
    方法:根据临床信息,形态特征,和免疫组织化学结果,病理诊断为原发性肾上腺腺瘤样瘤。
    方法:通过11根肋骨切除右肾上腺和肿瘤。
    结果:患者术后进展顺利。
    结论:防止腺瘤样瘤与其他类型肾上腺肿瘤或转移性肿瘤的误诊势在必行。形态学和免疫组织化学特征可以帮助诊断原发性肾上腺腺瘤样瘤。
    BACKGROUND: Adenomatoid tumors are rare benign tumors, mainly involving the reproductive tract, such as the epididymis in men and the uterus and fallopian tubes in women. However, a few cases can occur outside the reproductive tract. Herein, we report a rare case of a primary adenomatoid tumor of the adrenal gland.
    METHODS: A 50-year-old man underwent ultrasound examination and was found to have a right adrenal mass without elevated blood pressure, weakness after fatigue, frequent nocturnal urination urgency, pain, or a history of hematuria. The patient\'s general health was normal. Computed tomography revealed a polycystic mixed-density lesion in the right adrenal region, approximately 7.3 × 4.5 cm in size.
    METHODS: Based on the clinical information, morphological features, and immunohistochemistry results, a pathological diagnosis of primary adenomatoid tumor of the adrenal gland was made.
    METHODS: Excision of the right adrenal gland and tumor through the 11 ribs.
    RESULTS: The patient\'s postoperative course was uneventful.
    CONCLUSIONS: Preventing misdiagnosis adenomatoid tumors with other types of adrenal gland tumors or metastatic tumors is imperative. Morphological and immunohistochemical features can help diagnose primary adenomatoid tumors of the adrenal gland.
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  • 文章类型: Case Reports
    Adrenal gland trauma is uncommon and is diagnosed at an increasing frequency using CT scans. However, owing to the rarity of this injury and its diverse clinical presentations and prognoses, there is no consensus on its management. In this case report, a 73-year-old male patient experienced recurrent bleeding in the right adrenal gland due to an in-car traffic accident, which was treated with repeated transcatheter arterial embolization.
    외상성 부신 손상은 드물게 나타난다고 알려져 있으며, 최근 외상 환자에서 컴퓨터단층촬영 사용 빈도가 증가함에 따라 그 발견 빈도가 증가하고 있다. 그러나 손상의 희귀성, 임상적 표현과 예후의 다양성으로 인하여 부신 외상의 치료에 대한 명확한 지침은 형성되지 않았다. 본 증례 보고에서는 차량 사고로 인하여 재발성 우측 부신 출혈을 경험하였으며 이에 대하여 반복적인 경카테터 동맥 색전술을 이용하여 치료한 73세 남성 환자에 대하여 보고하고자 한다.
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