Elderly women, blood pressure rise in January, please diagnose!

Endocrinology"Basic information"patients, female, 60-year-oldblood pressure increased in January
"other examination"blood pressure: 125/92mmHg, ultrasound: right adrenal realness accountabilityImagecaptiontheof theof thecomments: uneven density of the right adrenal region, border clearing, strengthening obvious, considering chrome cell tumorsResultsPathological diagnosis: chromite cell tumor(case summary) (i) chrome cell tumor is an adrenal myelin tumor, characterized by abnormal hypertension Adrenal myelin is like a huge sympathetic nerve ending, usually releasing normal amounts of catecholamine into the bloodstream, acting on the corresponding receptors of the body organs Once converted to a tumor, the tumor continues to release a large amount of catecholamine, causing the sympathetic nerve to often be in a state of overexcitement, which can lead to a series of corresponding signs If the tumor is mainly to release epinephrine, the signs are elevated blood pressure, pulse pressure, tastotic hyperactivity, arrhythmia and blood sugar rise; (2) Long-term large amount of catecholamine release caused by persistent hypertension, can lead to damage to systemic tissue organs, to the heart muscle is most important, early occurrence of myocardial fibrosis, the late cardiomyocytes have been replaced by tissue cells and loose connective tissue, lesions mainly affect the left ventricular (iii) Hypertension caused by chromic cell tumors can be divided into three categories: 1 Outbreak of hypertension, accounting for 30% to 50% Seizures are accompanied by severe headache, palpitations, shortness of breath, precardial pain, nausea, vomiting, accompanied by elevated body temperature, elevated blood sugar, increased blood and urine The end of the seizure is often sweaty and extremely debilitating 2 Persistent hypertension, no seizures, symptoms such as headache, sweating, tremors and weakness 3 On the basis of persistent hypertension, blood pressure fluctuates greatly CT performance: 1 Most of the tumor body in 3 to 5 cm, individual up to 10cm or more, the form is round, oval or pear-shaped lumps; 2 Most of the tumor density is uneven, a few can occur calcification; 3 Tumor blood supply rich, enhanced part of the substantive reinforcement obviously, strengthened part and non-reinforced necrotic cystic part often form multi-room change; differential diagnosis: 1 Adrenal cortical adenocarcinoma: mostly on the left, the age of onset 27-72 years old, the incidence of women is about 2 times that of men Patients have no specific performance, most in the physical examination or due to non-specific symptoms found, such as the performance of high blood pressure, abdominal pain, back pain, vomiting, feminization and other symptoms, tumors are generally larger CT performance: 1) tumor body is often larger, diameter is greater than 5cm, 2) density is uneven, bleeding necrosis and calcification is common; 3) enhanced scanning lesions unevenly strengthened, necrosis area display more clearly; 4) if the tumor breaks through the envelope, then the edge is blurred 2 Adrenal metastatic tumor: adrenal metastatic tumor sitinin in the tumor blood line metastasis of the good hair site, mostly from lung cancer, breast cancer, stomach cancer, liver cancer and pancreatic cancer Therefore, in patients with the above-mentioned primary malignant tumor, and found adrenal lumps, should first consider adrenal metastatic tumor CT performance: 1) adrenal metastatic tumor for one or both sides, lesions are generally small, diameter of 1 to 3 cm, circular or oval; 2) lesions are clear outline, density is uniform; source: the image
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