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目的分析肾上腺大腺瘤的CT征象,对比大、小腺瘤的病理特征,提高对肾上腺大腺瘤的认识。方法分析经手术病理证实的14例肾上腺大腺瘤的CT征象及30例小腺瘤的病理征象。按照肿瘤细胞构成、瘤内囊变、出血发生率3方面对比大、小腺瘤的病理特征。结果CT征象:14例单侧单发;3例边界欠清楚,11例边界清楚;14例形态较规则;大小介于5 cm×5.5 cm～18 cm×20 cm之间;平扫密度不均匀,3例瘤内见钙化,6例瘤内见囊变;增强扫描大部分呈中度不均匀强化。病理特征:小腺瘤细胞构成以透明细胞为主,大腺瘤则致密细胞为主型和透明细胞、致密细胞兼有的比例相当;3例小腺瘤和6例大腺瘤瘤内发生囊变;5例小腺瘤和4例大腺瘤瘤内出血;统计学分析,大、小腺瘤的细胞构成无显著性差异,大腺瘤囊变发生率高于小腺瘤,大、小腺瘤出血发生率无显著性差异。结论肾上腺大腺瘤囊变发生率高于小腺瘤,大、小腺瘤的细胞构成及出血发生率无显著性差异。
Objective To analyze the CT features of adrenal gland adenoma and to compare the pathological features of large and small adenomas and to raise awareness of adrenal gland adenomas. Methods CT findings of 14 cases of adrenal adenomas confirmed by surgery and pathology and pathological signs of 30 cases of small adenomas were analyzed. In accordance with the composition of tumor cells, cystic tumor, the incidence of bleeding in 3 aspects of large and small adenoma pathological features. Results CT signs were as follows: unilateral single hair in 14 cases, unclear boundary in 3 cases, clear border in 11 cases, regular shape in 14 cases, size between 5 cm × 5.5 cm and 18 cm × 20 cm, , 3 cases of calcification within the tumor, 6 cases of cystic degeneration within the tumor; most of the enhanced scan was moderately uneven enhancement. Pathological features: small adenoma cells constitute the main transparent cells, macrophages are dense dense cell-based and transparent cells, dense cells and the proportion of both; 3 cases of small adenomas and 6 cases of adenoma within the cyst 5 cases of small adenoma and 4 cases of large adenoma tumor hemorrhage; statistical analysis, large and small adenomas of the cell structure was no significant difference in the incidence of cystadenoma large adenoma, small and large adenoids The incidence of hemorrhage no significant difference. Conclusions The incidence of cystic degeneration of adrenal gland adenomas is higher than that of small adenomas. The cell constitution and the incidence of hemorrhage in large and small adenomas are not significantly different.