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雌激素和皮质醇共分泌上腺腺瘤和结核性淋巴腺炎
Gabriela Garza-García1, José Diego Sánchez-Villa1, Flavio Enrique Díaz-Trueba2
1Department of Endocrinology, Instituto Nacional de Ciencias Médicas y Nutrición Salvador Zubirán, 14080 Mexico City, Mexico.
JCEM case reports
|September 26, 2024
概括
这一案例突出显示了一种罕见的上腺腺瘤与结核病同时发生的情况,这给诊断带来了挑战. 由于荷尔蒙过度产生的恶性瘤最初的怀疑被组织学证实为虚假.
科学领域:
- 内分泌学 在内分泌学.
- 在瘤学瘤学.
- 传染性疾病 传染性疾病
背景情况:
- 从临床上讲,区分良性与恶性上腺皮质瘤是具有挑战性的.
- 同时产生雄激素和皮质醇可以表明恶性瘤.
- 上腺副瘤需要仔细评估,以排除功能性瘤.
研究的目的:
- 为了呈现一种独特的上腺腺瘤病例与骨髓脂质形转化和并发性结核病.
- 讨论激素过度产生的诊断挑战和成像发现.
- 突出综合性遗传病理学检查的重要性.
主要方法:
- 一个36岁妇女的病例报告显示,她有过多荷尔蒙的症状.
- 使用对比增强计算机断层扫描 (CT) 和18F-FDG PET/CT进行成像.
- 进行了激素检测 (,皮质醇) 和德克萨米他抑制试验.
- 进行了手术上腺切除和淋巴切除术,随后进行了他的病理学分析和PCR检测Mycobacterium tuberculosis.
主要成果:
- 图像检测显示了右上腺质量和肝胃腺病.
- 增加的总丸激素和非抑制的皮质醇证实了激素的过度生产.
- 18F-FDG PET/CT显示上腺质量和腺病的吸收增加.
- 组织病理学证实了上腺腺瘤与骨髓脂质形转化和阳性PCR用于腺瘤病变中的Mycobacterium结核病菌.
结论:
- 在上腺体中同时产生雄激素和皮质醇可能会误导,模仿恶性瘤.
- 这一案例强调了在上腺病理学中考虑结核病等传染病因的重要性.
- 全面的诊断工作,包括先进的成像和明确的组织学,对于准确的诊断和管理至关重要.
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