レックリングハウゼン病に合併した副腎髄質過形成

ADRENAL MEDULLARY HYPERPLASIA ASSOCIATED WITH VON RECKLINGHAUSEN DISEASE:REPORT OF A CASE

　57歳，男性．既往歴にレックリングハウゼン病．主訴は頭重感と右上下肢の脱力感．脳梗塞で内科入院し，発作性高血圧と尿中カテコールアミン高値を指摘される．CTで左副腎が軽度腫大し，静脈血サンプリングで左副腎静脈エピネフリン，ノルエピネフリン異常高値で左副腎全摘術を行った．摘出重量3.5g，皮質・髄質比1.86：1，病理形態学的に副腎髄質過形成と診断した．副腎髄質過形成は両側発生があり，注意深い観察を行う予定である．

A 57-year-old man with von Recklinghausen's disease was admitted to our hospital with the chief complaint of headache and weakness of the right arm and leg. The diagnosis of cerebral infarction was established and he was found to have hypertension and an elevated urinary catecholamines level. CT scan showed a slight swelling of the left adrenal gland. Plasma norepinephrine and epinephrine from the left adrenal vein were very high. Left adrenalectomy was performed. The weight of the adrenal gland was 3.5 g, and the ratio of cortical to medullary area was 1.86: 1.