肾上腺髓性脂肪瘤30例临床病理分析

目的：分析肾上腺髓性脂肪瘤的临床病理特点。方法：回顾性分析本科1980年—2002年30例肾上腺髓性脂肪瘤患者的临床、CT和病理资料。结果：肾上腺髓性脂肪瘤的发生占同期本院肾上腺原发肿瘤住院病例的2．58％(30／1166)。临床上多数患者无特殊表现，少数病例因肿瘤体积大而造成腹部隐痛和扪及腹部包块。本组中4例伴有高血压，3例同时伴有皮质腺瘤，2例库欣综合征，1例为肥胖多毛。大体检查：肿瘤切面淡黄色，夹杂灰白色斑块。3例大肿瘤有出血、坏死、囊性变和钙化。镜下肿瘤由成熟的脂肪组织和成熟的髓性造血细胞岛共同组成。结论：肾上腺髓性脂肪瘤是中年人中的少见病，男女之间发病率无差异，肿瘤的发生可能与内分泌紊乱有一定关系。该病预后较好，治疗应根据肿瘤大小和有无伴随肾上腺疾病而决定。

Clinicopathological Analysis of Adrenal Myelolipoma: A Report of 30 Cases

To study the clinicopathological features of adrenal myelolipoma.Methods:The clinical,CT,and patho-logical data of30adrenal myelolipoma(1980to2002)were retrospectively analyzed.Results:The incidence of adrenal myelolipoma was2.58%(30/1166)among all the primary adrenal tumors.Most patients had no specific symptoms,but few had tenderness and palpable abdominal mass.In this group,there were4patients with hypertension,3with adrenocortical adenoma,2with Cushing's syndrome,and1with centric obesity and hirsutism.The tumor section was white-gray with yellowish background.Three large tumor had hemorrhage,necrosis,cystic degeneration and calcification.The tumor was composed of mature adipose tissue and mature hematopoietic cell islands.Conclusion:Adrenal myelolipoma,uncommon in adults,is related to endocrine disorders with no incidence difference between male and female.The prognosis is good and the treatment should be carried out according to the tumor size and the existence of other adrenal diseases.