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Ektopien der Nebenniere

Ectopia of the adrenal

  • Schwerpunkt: Ektopes Gewebe
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Zusammenfassung

Ektopien adrenokortikalen Gewebes sind sehr häufig in kleinstknotiger Form periadrenal nachweisbar, entsprechen akzessorischem Gewebe und stellen eine Normvariante dar. Weiter entfernte Ektopien sind im Bereich der inneren männlichen wie weiblichen Genitale nachweisbar. Bei Zuständen starker chronischer Überstimulationen werden sie hyperplastisch und können echte Tumoren vortäuschen („adrenal rest tumors“). Echte autonome Tumoren aus ektopem Gewebe mit oder ohne Überfunktionen sind selten. Ektopien adrenomedullären Gewebes kommen fast nur in unmittelbarer Nachbarschaft des normalen Markes vor. Ektopien in der Nebenniere entsprechen fast ausschließlich Schilddrüsenparenchym. Eine ektope Hormonbildung entsteht fast nur aus Phäochromozytomen und betrifft größtenteils Adrenokortikotropin (ACTH), sodass sich ein Cushing-Syndrom entwickelt.

Abstract

Ectopia of nodular adrenocortical tissue is very frequently found in the periadrenal region. It corresponds to accessory adrenal tissue and is a normal variant. Ectopia in more distant regions are found in inner male or female genitalia. Strong long-lasting hyperstimultions induce hyperplasia and simulate true tumors (“adrenal rest tumors”). Real autonomic tumors from ectopic adrenal tissue with or without hyperfunction are rare. Ectopia of adrenomedullary tissue are nearly exclusively found in the surroundings of normal medulla. Ectopia in the adrenals corresponds almost exclusively with thyroid tissue. Ectopic secretion of hormones, mostly ACTH, can be found in pheochromocytomas and induces hyperfunction (Cushing’s syndrome).

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Der Autor dankt allen Pathologen, die seinen Konsiliardienst nutzen. Daraus ergaben sich anregende Gespräche, neue Ideen und interessante Kasuistiken.

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  1. Institut für Pathologie, Universitätsklinikum Hamburg-Eppendorf, Martinistraße 52, 20246, Hamburg, Deutschland

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Saeger, W. Ektopien der Nebenniere. Pathologe 39, 409–414 (2018). https://doi.org/10.1007/s00292-018-0459-1

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