Department of Orthopedics, Shanxi Provincial People's Hospital, Taiyuan, Shanxi, China.
Department of Biostatistics, Shanxi Provincial People's Hospital, Taiyuan, Shanxi, China.
J Int Med Res. 2020 Jul;48(7):300060520936972. doi: 10.1177/0300060520936972.
Mediastinal myelolipoma is extremely rare. It is a benign nonfunctioning tumor composed of hematopoietic tissue and mature fatty tissue. Although computed tomography and magnetic resonance imaging are effective in diagnosing mediastinal myelolipoma, a definitive diagnosis is difficult to establish for rare extra-adrenal myelolipomas by imaging alone. Such tumors are often misdiagnosed as malignant retropleural liposarcoma, denoting a poor prognosis. We herein describe a 72-year-old man with multiple bilateral paravertebral mediastinal myelolipomas and discuss the imaging findings and differential diagnoses. We used a computed tomography-guided core biopsy to attain a preoperative diagnosis. Using this technique, we avoided an unnecessary surgical procedure for the patient's asymptomatic and relatively small lesions.
Instead of biopsy by lesion excision, we advocate conducting a precisely targeted, minimally invasive computed tomography-guided core biopsy to obtain a definitive preoperative diagnosis and thus avoid unnecessary surgery for mediastinal myelolipoma, a benign nonfunctioning tumor.
纵隔髓性脂肪瘤极为罕见。它是一种由造血组织和成熟脂肪组织组成的良性无功能肿瘤。虽然计算机断层扫描和磁共振成像在诊断纵隔髓性脂肪瘤方面非常有效，但仅凭影像学很难对罕见的肾上腺外髓性脂肪瘤做出明确诊断。此类肿瘤常被误诊为预后不良的恶性后肋胸膜脂肪肉瘤。我们在此描述一名 72 岁男性患者，其患有多个双侧椎旁纵隔髓性脂肪瘤，并讨论其影像学表现和鉴别诊断。我们使用 CT 引导下的核心活检来获得术前诊断。通过这种技术，我们避免了对患者无症状且相对较小的病变进行不必要的手术。
我们主张对纵隔髓性脂肪瘤进行精确靶向、微创的 CT 引导下核心活检，以获得明确的术前诊断，从而避免对这种良性无功能肿瘤进行不必要的手术。
