CAJ | 학술논문

目的：探讨肾上腺皮质嗜酸细胞腺瘤(ACO)的 CT 表现,以提高对该病的认识和诊断水平。方法回顾分析9例经手术、病理证实的 ACO 的 CT 特征,并与病理结果进行对照。结果9例中5例位于左侧,4例位于右侧,病变边界清楚,呈圆形或椭圆形。其中实性病变3例,肿瘤直径<3 cm,密度均匀,增强后病灶中度持续强化；囊实性病变6例,肿瘤直径>3 cm,CT 表现为囊性与实性成分相互掺杂,呈多囊样改变,增强后实性部分明显强化,囊性部分未见强化；其中4例病灶实性成分呈片状、絮状强化,1例呈岛屿状强化；3例病灶中央见网格样分隔,1例见星芒状改变。镜下肿瘤由胞质内充满嗜酸颗粒的嗜酸细胞组成,部分病灶内见坏死及纤维组织分隔,细胞无病理性核分裂象。结论ACO 的 CT 表现具有一定特征性,但特异性不高,最后诊断常需依靠病理证实。
목적：탐토신상선피질기산세포선류(ACO)적 CT 표현,이제고대해병적인식화진단수평。방법회고분석9례경수술、병리증실적 ACO 적 CT 특정,병여병리결과진행대조。결과9례중5례위우좌측,4례위우우측,병변변계청초,정원형혹타원형。기중실성병변3례,종류직경<3 cm,밀도균균,증강후병조중도지속강화；낭실성병변6례,종류직경>3 cm,CT 표현위낭성여실성성분상호참잡,정다낭양개변,증강후실성부분명현강화,낭성부분미견강화；기중4례병조실성성분정편상、서상강화,1례정도서상강화；3례병조중앙견망격양분격,1례견성망상개변。경하종류유포질내충만기산과립적기산세포조성,부분병조내견배사급섬유조직분격,세포무병이성핵분렬상。결론ACO 적 CT 표현구유일정특정성,단특이성불고,최후진단상수의고병리증실。
Objective To explore the computed tomography (CT)manifestations of adrenocortical oncocytoma (ACO)for better understanding the disease and improving its diagnosis accuracy.Methods The CT manifestations of 9 cases with adrenocortical onco-cytomas confirmed by surgery were retrospectively reviewed and compared with pathological results.Results Five of cases were lo-cated in left side while 4 cases were in right side.Well defined and round or oval border could be found in all the cases.Of all the ca-ses,3 cases were solid lesions with equal density,< 3 cm in diameter,and mild consistent intensification after enhancement.Cystic lesion was detectd in 6 cases with > 3 cm in diameter.The mixed cystic and solid components with polycystic changes could be found on CT image,and remarkable intensification on solid lesion while no intensification on cystic lesion after the enhancement. Moreover,patchy or cotton-like shape could be found on solid lesion in 4 cases and 1 case with island like intensification;reticular pattern could be found in the central of lesion in 3 cases and 1 case with stellate shape.Pathological observation showed that the on-cotytomas were comprised of cells with abundant eosinophilic cytoplasm and necrotic and fibrous capsule without pathological mitosis could be found in some of lesion.Conclusion The characteristic CT features of adrenocortical oncotytoma has a worse specificity,its diagnosis was dependent on pathologic examination.