Mašić Silvija, Vučić Majda, Seiwerth Sven
Clinic for Oncology and Nuclear Medicine, Sestre Milosrdnice Clinical Hospital Centre, Vinogradska cesta 29, Zagreb, Croatia.
Department of Pathology, Sestre Milosrdnice Clinical Hospital Centre, Vinogradska cesta 29, Zagreb, Croatia.
Respir Med Case Rep. 2017 Sep 14;22:254-256. doi: 10.1016/j.rmcr.2017.09.008. eCollection 2017.
Pulmonary myelolipoma is a very rare benign tumor composed of mature adipose tissue and hematopoietic elements such as erythroid, myeloid and megakaryocytic. It usually represents accidental finding during autopsy or chest imaging, since most cases are asymptomatic. Larger masses can lead to hemorrhage, chest pain and chest organ compression. We present a case of incidental finding of pulmonary myelolipoma during the autopsy of an 83- year old woman who died of abdominal aortic rupture. In the right lower lung lobe, solitary, well-circumscribed yellow-brown nodule which was 3 cm in its longest diameter was found. Pathohistological analysis revealed tumor composed of mature adipose tissue and hematopoietic cells (myeloid cells, megakaryocytes, erythroid cells) with fragments of mature bone tissue. Differential diagnosis of pulmonary myelolipoma includes lipoma, liposarcoma, hamartoma, phlebangioma, teratoma and extramedullary hematopoiesis. In majority of cases, tumor removal is not necessary, however, larger lesions should be surgically removed. No cases of malignant transformation or recurrence have so far been reported in the literature.
肺髓脂肪瘤是一种非常罕见的良性肿瘤，由成熟的脂肪组织和造血成分如红系、髓系和巨核细胞组成。它通常是在尸检或胸部影像学检查时偶然发现的，因为大多数病例无症状。较大的肿块可导致出血、胸痛和胸部器官受压。我们报告一例在一名死于腹主动脉破裂的83岁女性尸检时偶然发现肺髓脂肪瘤的病例。在右下肺叶发现一个孤立的、边界清楚的黄褐色结节，最长直径为3厘米。病理组织学分析显示肿瘤由成熟的脂肪组织和造血细胞（髓细胞、巨核细胞、红系细胞）以及成熟骨组织碎片组成。肺髓脂肪瘤的鉴别诊断包括脂肪瘤、脂肪肉瘤、错构瘤、静脉血管瘤、畸胎瘤和髓外造血。在大多数情况下，不需要切除肿瘤，然而，较大的病变应手术切除。迄今为止，文献中尚未报道有恶变或复发的病例。
