Montone Kathleen T, Rosen Mark, Siegelman Evan S, Fogt Franz, Livolsi Virginia A
Departments of Pathology and Laboratory Medicine, Hospital of the University of Pennsylvania, Philadelphia, Pennsylvania.
Endocr Pract. 2009 Mar;15(2):128-33. doi: 10.4158/EP.15.2.128.
To present pathologic and radiographic features of 3 patients with adrenocortical neoplasms-2 with uncertain malignant potential and 1 adenoma with areas of myelolipomatous and lipomatous metaplasia.
We describe 3 patients who had adrenocortical neoplasms with foci of myelolipomatous and lipomatous metaplasia. For each patient, the clinical and pathologic data are reviewed.
All 3 patients were women, with a mean age at presentation of 58 years. The lesion size averaged 6.8 cm (range, 3.9 to 11.0), and the mean gland weight was 128.8 g (range, 32.5 to 249). Two patients showed imaging findings compatible with adrenal myelolipoma. Pathologically, 2 of the lesions were classified as adrenocortical neoplasms of uncertain malignant potential, and 1 lesion was classified as an adrenocortical adenoma. All 3 lesions contained myelolipomatous foci throughout the neoplasm, and 2 of the tumors contained several pure lipomatous foci.
Adrenocortical neoplasms, including those associated with an uncertain malignant potential, may be associated with areas of myelolipomatous and lipomatous metaplasia. Imaging studies may result in a false diagnosis of a benign adrenal myelolipoma and potential undertreatment in such patients.
介绍3例肾上腺皮质肿瘤患者的病理和影像学特征，其中2例具有不确定的恶性潜能，1例为肾上腺皮质腺瘤，伴有骨髓脂肪瘤样和脂肪瘤样化生区域。
我们描述了3例患有肾上腺皮质肿瘤且伴有骨髓脂肪瘤样和脂肪瘤样化生灶的患者。对每位患者的临床和病理数据进行了回顾。
所有3例患者均为女性，就诊时的平均年龄为58岁。病变大小平均为6.8 cm（范围3.9至11.0），腺体平均重量为128.8 g（范围32.5至249）。2例患者的影像学表现与肾上腺骨髓脂肪瘤相符。病理上，2个病变被分类为具有不确定恶性潜能的肾上腺皮质肿瘤，1个病变被分类为肾上腺皮质腺瘤。所有3个病变在整个肿瘤中均含有骨髓脂肪瘤样灶，其中2个肿瘤含有几个纯脂肪瘤样灶。
肾上腺皮质肿瘤，包括那些具有不确定恶性潜能的肿瘤，可能与骨髓脂肪瘤样和脂肪瘤样化生区域相关。影像学检查可能会导致对良性肾上腺骨髓脂肪瘤的误诊，并可能使此类患者治疗不足。
