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正常肾上腺经几家医院的CT、B超检查,均误诊为肾上腺腺癌的病例罕见,我们遇到1例,为总结经验教训,报告如下。患者女,36岁,病案号(24413)。进行性肥胖伴高血压9年,加重半年入院。1980年1月始感体重增加,伴乏力、失眼,经过症治疗好转。1985年出现下肢浮肿,体重由原来49公斤,增加至90公斤。1986年B超肾上腺检查:左腺上腺腺癌。CT检查:左肾上腺有1cm大阴影,CT值20HU,考虑肾上腺腺癌。查体:血压17/12kPa,体重91公斤,重度肥胖,类似“满月脸”,腹,背、臀部及大腿脂肪堆积。心肺检查无异常,肝肾功能及血生化检查无异常。血清皮质醇含量正常。地塞米松大抑制试验:抑制前9.4ug/dl,抑制后<1ug/dl。24小时尿17—KS及17—OH值均正常。X线胸、腰及头颅片检
The CT scan and B-ultrasound of normal adrenal glands in several hospitals are rare cases of misdiagnosis of adrenal adenocarcinoma. We encountered one case. To summarize the lessons learned, the report is as follows. Female patient, 36 years old, medical record number (24413). Progressive obesity with hypertension for 9 years, an increase of six months admission. In January 1980, he began to experience weight gain, with fatigue, loss of eyes, and improved after treatment. In 1985, lower extremity edema appeared. The body weight increased from 49 kg to 90 kg. B-adrenal examination in 1986: left glandular adenocarcinoma. CT examination: The left adrenal gland has a shadow of 1cm, CT value 20HU, consider adrenal gland cancer. Examination: blood pressure 17/12kPa, weight 91 kg, severe obesity, similar to the “full moon face”, abdominal, back, buttocks and thigh fat accumulation. There was no abnormality in cardiopulmonary examination, and there was no abnormality in liver and kidney function and blood biochemical examination. Serum cortisol levels are normal. Dexamethasone inhibition test: inhibition of the former 9.4ug/dl, after inhibition <1ug/dl. 24-hour urine 17-KS and 17-OH values were normal. X-ray chest, waist and cranial examination