- 期刊
- OpenAccess
Adrenal Myelolipoma in a Hemodialysis Patient – Case Report and Review of Literature
腎上腺骨髓脂肪瘤於尿毒症透析病患：病例報告及文獻回顧
摘要
腎上腺骨髓脂肪瘤是一種不常見的腫瘤病變，由不同比例的成熟脂肪細胞與類似類骨髓的造血細胞混合而成。骨髓脂肪瘤最敘發現於腎上腺，但也有出現在腎上腺以外的地方被報告過。骨髓脂肪瘤是一種良性的病變，通常是較小的，而且單側存在。它通常沒有症狀，而是在意外或解剖的情況下被發現。骨髓脂肪瘤本身沒有內分泌的功能，偶而會合併發生一些內分泌異常。本文提出一位63歲女性因尿毒症已經透析兩年的病例報告，她的右腎上腺骨髓脂肪瘤是在為了尋找發燒合併右上腹痛及肝功能異常的原因時被發意外發現。腹部超音波發現一個8.7公分乘5.0公分的右腎上腺病變，而進一步的腹部電腦斷層掃描發現為一個擁有脂肪結構的不均質的右腎上腺腫塊。在病人發燒情況改善之後，她接受外科手術治療切除，而病理報告也證實為骨髓脂肪瘤。其術後狀況良好，定期追蹤也未發現有復發現象。這是文獻上第一例尿毒症患者合併骨髓脂肪瘤，我們在本文中討論其臨床特徵、放射影像表現及其病理特徵，並針對相關文獻作一個回顧與整理。
並列摘要
Myelolipoma is an uncommon adrenal tumor composed of a variable mixture of mature adipose tissue and hematopoietic elements that resemble the content of bone marrow. Adrenal glands are the commonest involved site, but other extra-adrenal sites are also reported. Myelolipoma is a benign lesion, usually small and unilateral, asymptomatic, and discovered by accident or at autopsy. Most myelolipomas do not cause an endocrine disorder, but cases associated with endocrine disorders have been reported. We report a 63-year-old female who had received regular hemodialysis for two years and the dialysis courses were smooth. She received abdominal ultrasonography to evaluate the source of fever and right-upper-quadrate abdominal pain and abnormal liver function. Accidentally, it revealed an 8.7×5.0 cm lesion over right suprarenal area. Abdominal computed tomography showed a fat-density, homogeneous right adrenal mass. No other intra-abdominal lesions, except bilatereal contracted kineys, culd be noted. She was finally operated and histological examination showed that it was mainly composed of mature adipocytes. Hematopoietic cells, resembling the picture in bone marrow, were noted between the fat cells. To our knowledge, this is the first case report in uremic patient. Follow-up examinations showed no recurrence and patient stayed well on hemodialysis.
延伸閱讀
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