Arora Komal, Sidhu Jagmohan
The University of Texas MD Anderson Cancer Center, Houston, TX 77030, USA.
UHS Wilson Medical Center, 33-57 Harrison Street, Johnson City, NY 13790, USA.
Case Rep Hematol. 2016;2016:7364951. doi: 10.1155/2016/7364951. Epub 2016 Mar 29.
Myelolipoma is a benign tumor consisting of mature fat interspersed with hematopoietic elements resembling bone marrow. The vast majority occurs within the adrenal glands, but several cases of extra-adrenal myelolipomas (EAMLs) have been reported. We report a case of a 64-year-old male who presented with complaint of lower abdominal discomfort. CT scan of abdomen and pelvis showed a 6 cm × 5 cm, well-circumscribed, predominantly fatty mass in the presacral region. Histological examination of the pelvic mass revealed a myelolipoma heavily infiltrated by small lymphoid cell aggregates with immunophenotypic features of small lymphocytic lymphoma/chronic lymphocytic leukemia (SLL/CLL). Review of the literature revealed that there is only one published report of SLL/CLL involving a myelolipoma, which was also an extra-adrenal myelolipoma, and, therefore, our case is the second case of a SLL/CLL involving a myelolipoma that is an extra-adrenal myelolipoma. Extra-adrenal myelolipomas seem to the preferred myelolipomas for involvement by SLL/CLL.
髓脂肪瘤是一种由成熟脂肪组织夹杂类似骨髓的造血成分构成的良性肿瘤。绝大多数髓脂肪瘤发生于肾上腺，但也有几例肾上腺外髓脂肪瘤（EAML）的报道。我们报告一例64岁男性，主诉下腹部不适。腹部和盆腔CT扫描显示在骶前区域有一个6厘米×5厘米、边界清晰、以脂肪为主的肿块。盆腔肿块的组织学检查显示为髓脂肪瘤，有小淋巴细胞聚集灶大量浸润，具有小淋巴细胞淋巴瘤/慢性淋巴细胞白血病（SLL/CLL）的免疫表型特征。文献回顾显示，仅有一篇关于SLL/CLL累及髓脂肪瘤的报道，该病例也是肾上腺外髓脂肪瘤，因此，我们的病例是第二例SLL/CLL累及肾上腺外髓脂肪瘤的病例。肾上腺外髓脂肪瘤似乎是SLL/CLL累及的髓脂肪瘤的首选类型。
