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肾上腺皮质和髓质由于起源不同,其病变往往独立发生,皮髓质混合性病变较为罕见。本文报告4例肾上腺皮髓质混合病变患者的临床资料。4例病人CT检查肾上腺均发现异常,术前误诊原发性醛固酮增多症3例,嗜铬细胞瘤1例。4例均行单侧肾上腺全切除,3例痊愈,1例术后15年复发,考虑对侧有病变。术后病理报告均为肾上腺皮髓质混合病变。在临床上若发现肾上腺疾病有原醛症的表现,同时又有儿茶酚胺症的特点时,要考虑肾上腺皮髓质混合病变的可能。围手术期应按儿茶酚胺症准备,确诊靠病理检查。
Adrenal cortex and medulla due to different origins, the lesions often occur independently, corticomedullary mixed lesions are rare. This article reports 4 cases of adrenal corticobasal mixed lesions in patients with clinical data. 4 cases of patients with abnormalities were found in the adrenal CT examination, preoperative misdiagnosis of 3 cases of primary aldosteronism, pheochromocytoma in 1 case. 4 cases were performed unilateral adrenalectomy, 3 cases recovered, 1 case 15 years after the recurrence, consider contralateral lesions. Postoperative pathological reports were adrenal medullary mixed lesions. Adrenal disease if found in the clinical manifestations of the original aldehyde disease, while the characteristics of catecholamines, to consider the possibility of adrenal cortex mixed lesions. Perioperative catecholamines should be prepared, confirmed by pathological examination.