Abstract:Objective: To study the clinical and CT characteristics of the patients with adrenal tuberculosis. Methods: The clinical data of 18 patients who were diagnosised as having adrenal tuberculosis from January 2012 through June 2015 in Department of Urology in People's Hospital of Xinjiang Uygur Autonomous Region were analyzed. There were 9 males and 9 females with an average age of 53.2 years old (22-72 years old). There were 14 cases of bilateral involvement, and 4 cases of unilateral. Results: The most common clinical manifestations were symptoms of adrenal cortex hypofunction: hyperpigmentation of skin (8 cases); weakness (8 cases); weight loss (6 cases). Ten (55.6%) cases had the manifestation of adrenal cortex hypofunction. There were 6 cases of extra adrenal involvements: 4 cases of pulmonary tuberculosis; 2 cases or renal tuberculosis. The most common imaging characteristics of CT were adrenal gland enlargement (13 cases); calcification (17 cases); mass change (7 cases); nodular change (4 cases). Conclusions: When the diagnosis of adrenal tuberculosis was made, bilateral involvements were seen usually. The most common clinical manifestations were symptoms of adrenal cortex hypofunction. The most common imaging characteristics of CT were calcification, adrenal gland enlargement, mass or nodular change.
[1]Burrill J, Williams CJ, Bain G, et al. Tuberculosis: a radiologic review. Radiographics, 2007,27(5):1255-1273. [2]Lam KY, Lo CY. A critical examination of adrenal tuberculosis and a 28-year autopsy experience of active tuberculosis. Clin Endocrinol, 2001,54(5):633-639. [3]Guo YK, Yang ZG, Li Y, et al. Uncommon adrenal masses: CT and MRI features with histopathologic correlation. Eur J Radiol, 2007,62(3):359-370. [4]杨志刚,郭应坤,李媛,等.肾上腺结核的增强CT 表现特征与临床病程的相关性.中华放射学杂志,2006,40(10):1014-1017. [5]袁明远,包相华,韦玉新,等.肾上腺结核的CT 诊断与鉴别诊断.放射学实践,2011,26(9):938-940. [6]Ma ES, Yang ZG, Li Y, et al. Tuberculous Addison's disease: morphological and quantitative evaluation with multidetector-row CT. Eur J Radiol, 2007,62(3):352-358. [7]刘彪,李雪萍.肾上腺结核致Addison病的CT表现及其与临床病程的关系.临床放射学杂志,2012,31(9):1302-1305. [8]Oelkers W. Adrenal insufficiency. N Engl J Med, 1996,335(16):1206-1212. [9]Zhang XC, Yang ZG, Li Y, et al. Addison's disease due to adrenal tuberculosis: MRI features.Abdom Imaging, 2008,33(6):689-694. [10]全昌斌,袁小东,时文伟,等.多层螺旋CT 对肾上腺结核的诊断价值.临床放射学杂志,2015,34(8):1242-1245. [11]陈甜甜,汤葳,时国朝.16 例肾上腺结核的临床分析.内科理论与实践,2015,10(5):377-380. [12]Yang ZG, Guo YK, Li Y, et al. Differentiation between tuberculosis and primary tumors in the adrenal gland: evaluation with contrast-enhanced CT. Eur Radiol, 2006,16(9):2031-2036. [13]Sharma SK, Mohan A, Sharma A, et al. Miliary tuberculosis: new insights into an old disease. Lancet InfectDis, 2005,5(7):415-430.