Adrenal myelolipoma

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Adrenal myelolipoma
Diagnosis in short

Myelolipoma. H&E stain.

LM adipose tissue, hematopoietic elements from all three lineages (erythroid, myeloid, megakaryocytic), +/-calcification
LM DDx angiomyolipoma of the kidney, lipoma, liposarcoma, teratoma
Site adrenal gland

Prevalence rare
Prognosis benign
Clin. DDx other adrenal tumours (e.g. adrenal cortical carcinoma), retroperitoneal tumours
Treatment excision if large

Adrenal myelolipoma is a benign tumour of the adrenal gland.

Myelolipoma redirects here.

General

  • Benign and rare.
  • Typically asymptomatic and hormonally inactive.[1]
    • Symptoms: back or abdominal pain.
  • Diagnosis - usu. by abdominal CT.

Treatment:

  • Watchful waiting if small (<=7 cm) and asymptomatic.[1]

Microscopic

Features:[2]

  • Adipose tissue.
  • Hematopoietic elements from all three lineages:
    1. Erythroid.
    2. Myeloid.
    3. Megakaryocytic.
  • +/-Calcification.[1]

DDx:[3]

Images

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A. Right Adrenal Gland, Adrenalectomy:
	- Adrenal myelolipoma.

Microscopic

The sections shows a lesion with bland adipocytes and hematopoietic elements (erythroid, myeloid, megakaryocytic) that is surrounded by a thin rim of adrenal cortex and a partial fibrous pseudocapsule. Significant cellular atypia is absent. The lesion appears to be clear of the inked margin.

See also

References

  1. 1.0 1.1 1.2 Daneshmand, S.; Quek, ML. (2006). "Adrenal myelolipoma: diagnosis and management.". Urol J 3 (2): 71-4. PMID 17590837.
  2. 2.0 2.1 Cha, JS.; Shin, YS.; Kim, MK.; Kim, HJ. (Aug 2011). "Myelolipomas of both adrenal glands.". Korean J Urol 52 (8): 582-5. doi:10.4111/kju.2011.52.8.582. PMC 3162227. PMID 21927708. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3162227/.
  3. Lam, KY.; Lo, CY. (Sep 2001). "Adrenal lipomatous tumours: a 30 year clinicopathological experience at a single institution.". J Clin Pathol 54 (9): 707-12. PMID 11533079.