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张金榜医生:本例为男性,68岁;阵发性高血压25年;左上腹索状肿块逐渐增大,不慎碰击时有头晕、心慌、出汗、步态不稳、视物模糊、心率增快、心律失常等儿茶酚胺过多综合征;化验:尿VMA(3-甲氧基-4羟基苦杏仁酸)460um/L,显著升高;心电图:房性和室性早搏。超声波俭查左上腹可见14×12×7cm平段。X线:腹膜后空气造影显示二、三腰椎前缘左肾下方有一椭圆形致密阴影约6×5cm,报告为腹膜后肿瘤。据此诊断考虑为嗜铬细胞瘤(肾外型、良性)。本病起源于肾上腺髓质,交感神经节内和体内其它部位的嗜铬组织,分泌大量儿茶酚胺,临床上表现为高血压及代谢紊乱为主的综合症候群,大多为良性,约80～90％位于肾上腺髓质内。肾上腺外的多位于腹腔内,以腹膜后腹主动脉旁最多见,占10～
Dr. Zhang Jinbang: This case is a male, 68 years old; paroxysmal hypertension for 25 years; the left upper abdominal cord-like mass gradually increases, and when inadvertently hit, there is dizziness, palpitation, sweating, gait instability, blurred vision Symptoms such as increased catecholamines, heart rate, and arrhythmia; laboratory tests: urinary VMA (3-methoxy-4-hydroxymandelic acid) 460um/L, significantly elevated; ECG: atrial and ventricular premature beats. Ultrasound examination of the left upper quadrant can be seen 14 × 12 × 7cm section. X-ray: Retroperitoneal air radiography revealed a dense shadow of an ellipse about the bottom of the left and right kidneys of the second and third lumbar vertebrae, approximately 6 x 5 cm, and was reported as a retroperitoneal tumor. According to this diagnosis, pheochromocytoma (renal type, benign) was considered. The disease originated in the adrenal medulla, sympathetic ganglia and other parts of the body of the chromaffin tissue, secrete large amounts of catecholamines, clinical manifestations of hypertension and metabolic syndrome-based syndrome, mostly benign, about 80 to 90% Adrenal medulla. Most of the extra-adrenal glands are located in the abdominal cavity and are most commonly seen in the retroperitoneal abdominal aorta.