腎上腺骨髓性脂肪瘤的超音波和電腦斷層特性

Sonographic and CT Features of Adrenal Myelolipoma

我們報告一個巨大的腎上腺骨髓性脂肪瘤的病例。病人曾因中風導致右肢癱瘓而住院；在例行的腹部超音波檢查中，發現有一高回音的後腹腔腫瘤。電腦斷層檢查確定是：含有脂肪成份的巨大腫瘤；其特性是此一低密度的腫塊內混含著軟組織，後著代表骨髓成份。因為腫瘤非常大，而且可能內含出血，所以建議病人接受開刀，以切除腫瘤。從切除的標本可以發現，有很豐富的成熟脂肪組織，並有造血組織；病理上稱為腎上腺骨髓性脂肪瘤。從本篇報告，可以窺知腎上腺骨髓性脂肪瘤超音波和電腦斷層的典型特性；由於腫瘤內有出血和鈣化現象，超音波診斷上或有困難，此時電腦斷層有助於解決。

We presented a case of huge adrenal myelolipoma in a patient admitted for a cerebrovascular accident with right hemiparesis. A huge fat-containing tumor depicted as hyperechoic retroperitoneal tumor mass was found by screening abdominal sonography and confirmed by computed tomography (CT). The CT features of the hypoattenuating mass was consistent with fat tissues mixed with some soft tissue density representing myeloid tissue. Due to the large size of the tumor and the presence of hemorrhage, elective surgical resection of the tumor was performed. The pathological diagnosis is adrenal myelolipoma since the tumor contained mature adipose tissue in combination with hematopoietic components. This report presents some typical sonographic and CT features of adrenal myelolipoma. The presence of hemorrhage and calcification within the tumor however, also contributed to the variable sonographic pattern and caused some difficulty in diagnosis.