1. Clinical and Histologic Features
Myelolipoma of the Adrenal Gland:
Clinical and Histologic Features
MEDICAL SCHOOL
Dimitriadis I.1, Tsiviltidou P.1, Konstantinidou P.1, Zagelidou E.2, Papaioannou N.3, Anestakis D.1
1 Department of Forensic Histopathology, Laboratory of Forensic Medicine and Toxicology, Medical School, Aristotle University, Thessaloniki, Makedonia, Greece
2 Ministry of Justice, Transparency and Human Rights, Hellenic Republic, Thessaloniki Forensic Service, Thessaloniki, Makedonia, Greece
3 Department of Pathology, School of Veterinary Medicine, Aristotle University, Thessaloniki, Makedonia, Greece
Objective:
Adrenal myelolipomas are rare, non-functional, benign tumor-like lesions of the adrenal gland. They are usually found to occur alone in one adrenal gland but not both and there may be a right sided predilection.
Method:
We received an adrenal gland measuring 6.5x6x1.4cm and weighing 32.8gr with its fat and a brown to red tissue fragment measuring 7.5x2.5x2.7cm and weighing 40.4gr (Fig.1). Histopathological examination was performed.
Fig.1: Macroscopic appearance of Adrenal Myelolipoma: On cut section, a solid tumor showing expanded yellowish areas together with hemorrhagic areas.
Results:
Microscopic examination from the adrenal’s tissue fragment showed partial autolysis details, focal fibrosis, presence of inflammatory infiltrations, macrophages, hemosiderin granules and congested vessels with slightly thickened wall (Fig. 2). Microscopic examinations in both tissue fragments revealed, in an expanded almost universal extent, the presence of mature adipocytes together with extramedullary hematopoietic details. There were also observed haemorrhagic infiltrations, phagocytes, hemosiderin granules and the local presence of amorphous eosinophilic material. All above indicated myelolipoma.
Conclusion:
Adrenal myelolipomas can vary widely in size. They are characterized as rare tumors with estimated autopsy prevalence of 0.08 to 0.4%. They are usually indentified in adults, either incidentally or if complicated by haemorrhage. There is no gender predilection. The tumor affects men and women equally and is most commonly found between the fifth and seventh decades of life with a mean age of 62 years.
Fig.2: Microscopic examination of an Adrenal Myelolipoma: Section revealed characteristic admixture of mature adipose tissue with normal hematopoietic tissue. (Η&Ε stain, 10x).
References:
Meaglia JP, Schmidt JD (1992), Natural history of an adrenal myelolipoma, J Urol. 147:4 1089–90
Hakim A, Rozeik C (2014), Adrenal and Extra-adrenal Myelolipomas-A Comparative Case Report, J Radiol Case Reports 8: 1-12
Mondal SK, Sengupta S, Biswas PK, Sinha MG (2011), Adrenal Myelolipoma with abdominal pain: A rare presentation, Indian J Endocrinol Metab 15: 57–59