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患者男,78岁,因“食欲不振、消瘦3周”入院,无畏寒、发热,无腹痛、腹泻或黑便。血压115/60mmHg。腹部触诊未及明显异常。实验室检查各项指标均在正常范围内。CT表现:平扫右侧肾上腺区见一大小约8.5 cm×11.5 cm×12.5 cm的软组织密度肿块,内见大片囊变坏死区,病灶边缘光整,周围脂肪间隙见索条影(图1),注射对比剂后病灶实质部分轻度强化,其内见较多粗大肿瘤血管,囊变坏死区无强化(图2)。冠状位重组图像示肝脏、右肾、右肾静脉及下腔静脉均受压移位(图3)。拟诊:右侧肾上腺皮质腺癌。
Male patient, 78 years old, due to “loss of appetite, weight loss 3 weeks ” admission, no chills, fever, no abdominal pain, diarrhea or melena. Blood pressure 115 / 60mmHg. Abdominal palpation was not as obvious. Laboratory tests are within the normal range of indicators. CT manifestations: plain right adrenal area to see a size of about 8.5 cm × 11.5 cm × 12.5 cm soft tissue mass, see the large necrosis of cystic lesions, the edge of the edge of the whole body around the fat gap see cable strip (Figure 1) After injection of contrast agent, the parenchyma of the lesion was mildly enhanced, and more coarse tumor vessels were found in the lesion. There was no enhancement of the cystic necrosis area (Fig. 2). Coronal images showed the liver, right kidney, right renal vein and inferior vena cava were pressure shift (Figure 3). To be diagnosed: right adrenal gland adenocarcinoma.