I-Adrenal cortical adenoma

nguJason Wasserman MD PhD FRCPC
February 12, 2024


I-adrenal cortical adenoma iyithumba elingenawo umdlavuza eliqala emangqamuzaneni ngokuvamile athola i-cortex (ungqimba lwangaphandle) lwendlala ye-adrenal. Ama-adenoma amaningi e-adrenocortical ayenzeka ngengozi ngoba awavezi noma yiziphi izimpawu futhi atholakala lapho izithombe zesisu noma i-pelvis zenziwa ngezinye izizathu.

Ingabe i-adrenal cortical adenoma iwuhlobo lomdlavuza?

Cha. I-adrenal cortical adenoma wuhlobo olungenalo umdlavuza lwe-adrenal gland tumor.

Uyini umehluko phakathi kwe-adenoma esebenzayo nengasebenzi?

I-adrenal cortical adenoma esebenzayo iyithumba elenza enye yamahomoni ajwayele ukwenziwa yi-adrenal cortex njenge-cortisol, i-aldosterone, ne-dehydroepiandrosterone (DHEA). Izimpawu ezibangelwa isimila esisebenzayo zincike ohlotsheni lwe-hormone ekhiqizwayo. I-adrenal cortical adenoma engasebenzi isimila esingakhiqizi noma yimaphi amahomoni. Ngenxa yalokho, izimila eziningi ezingasebenzi azibangeli noma yiziphi izimpawu nakuba izimila ezinkulu ezingasebenzi zingase zidale ubuhlungu uma ziphusha ezithweni eziseduze noma izicubu.

Yiziphi izimpawu ze-adrenocortical adenoma?

Izimpawu ze-adrenal cortical adenoma zincike ekutheni isimila siyawakha amahomoni nokuthi yimaphi amahomoni akhiqizwayo. Izimila ezikhiqiza i-Cortisol zingaholela emazingeni aphezulu kashukela egazini, ukuvuvukala kobuso nesisu, kanye nobuthakathaka bemisipha. Izimila ezikhiqiza i-Aldosterone zibangela umfutho wegazi ophakeme kanye namazinga aphansi e-potassium egazini. Izimila ezikhiqiza i-DHEA zingaphumela ekukhuleni kwe-virilization okuwukuthuthuka kwezici zomzimba zesilisa esikhulile (izwi elijulileyo, izinwele ezinde emzimbeni) kwabesilisa besifazane nabangaphambi kokuthomba. Amathumba angawenzi amahomoni ngokuvamile awabangeli noma yiziphi izimpawu futhi atholakala ngokuzenzakalelayo lapho ukuhlolwa kwesithombe kwenziwa ngezinye izizathu.

Izici ze-Microscopic

Uma ihlolwa ngaphansi kwe-microscope, iningi lama-adrenal cortical adenomas akhiwe ngamaseli afana namaseli avame ukutholakala engxenyeni ye-adrenal gland ebizwa ngokuthi i-cortex. Lawa maseli makhulu futhi icyoplasm (umzimba) weseli ugcwele i-lipid (amafutha) impahla ecebile. Ngalesi sizathu, amaseli abukeka emhlophe noma ecacile lapho ehlolwa ngesibonakhulu. Ezinye izimila zihlanganisa amangqamuzana amancane aqukethe i-lipid encane futhi abukeke i-eosinophilic (pink) lapho ehlolwa ngaphansi kwesibonakhulu. Amaseli wesimila ngokuvamile ahlelwa ngamaqembu amancane avame ukuchazwa njengezintambo, izidleke, noma iziqhingi. Izibalo ze-Mitotic (amangqamuzana esimila ahlukanayo ukuze akhe amaseli amasha esimila) awavamile ukubonakala futhi amaseli isimila ngokuvamile azungezwe ungqimba oluncane lwethishu okuthiwa a isimila capsule.

I-adrenocortical adenoma
I-adrenocortical adenoma

Isikolo se-Weiss

I-Weiss score iwuhlelo olwakhelwe ukusiza odokotela bezifo ukuthi banqume ukuthi isimila se-adrenal siyi-adrenal cortical adenoma engenawo umdlavuza noma uhlobo lomdlavuza olubizwa ngokuthi. i-adrenocortical carcinoma. Isikolo se-Weiss sihlanganisa izici ezingu-9 izazi zezifo ezizibhekayo lapho zihlola isimila ngaphansi kwesibonakhulu. Isici ngasinye se-microscopic sinikezwa iphuzu elingu-1. Isamba esiphelele esingaphansi koku-3 siphakamisa ukuthi isimila mancane amathuba okuthi sisabalele noma siziphathe njengomdlavuza futhi kufanele sibizwe nge-adrenal cortical adenoma. Ngokuphambene, amaphuzu aphelele angu-3 noma ngaphezulu aphakamisa ukuthi isimila sizoziphatha njengomdlavuza futhi kufanele sibizwe i-adrenocortical carcinoma.

Nazi izici ezingu-9 ezisetshenziselwa ukunquma isikolo se-Weiss:

  • Izinga lenuzi eliphezulu.
  • Izibalo ezingaphezu kwe-mitotic (ukuhlukanisa amaseli wesimila) 5 ku-10mm2 ngayinye.
  • Izibalo ze-Atypical ze-mitotic.
  • I-Necrosis (i-tumor cell death).
  • I-diffuse architecture (amaseli esimila akhula ngamaqembu amakhulu).
  • Amaseli acacile akha ngaphansi kwama-25% esimila.
  • Ukuhlasela kwe-tumor capsule.
  • Ukuhlasela kwemithambo.
  • Ukuhlasela kwe-lymphatic.
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