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KMID : 0371319930440060903
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Journal of the Korean Surgical Society
1993 Volume.44 No. 6 p.903 ~ p.910
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Bilateral Primary Pigmented Nodular Adrenocortical Disease
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Abstract
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35-year-old male patients was admitted to the Kyung Hee University Hospital for evaluation of hypertension. On his past history, he felt facial flushing and sweating especially walked up the stairs.
This cases of Cushing's syndrome due to bilateral pigmented nodular adrenal diseases who have undergone bilateral adrenalectomy under posterior approach is presented, In endocrinologic tests, increased plasma cortisol level, plasma ACTH level
which
was
undetectable or low, and lack of suppression with low-dose and high-dose dexamethasone test were detected. The contained lipofuscin and either had a clear cytoplasm or an eosinophilic cytoplasm with a prominent nucleus. Lymphocytes and fatty
metaplasia
within the nodules are two of the prominent histological features. Ther is extreme internodular atrophy which atrophy which suggests that primary adrenocortical nodular disease is a non-adrenocorticotropic hormone dependent condition. Since the
disorder
appears to involve primarily the cortex of both adrenals, the treatment of choice is bilateral adrenalectomy followed by steroid replacement. The characterisic clinicopathological manifestations that separate this diagnosis from other of adrenal
disease
are also discussed. This is the first reported ase in Korea that was documented with pertinent clinicopathological findings.
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KEYWORD
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