Prahlow J A, Loggie B W, Cappellari J O, Scharling E S, Teot L A, Iskandar S S
Department of Pathology, Bowman Gray School of Medicine of Wake Forest University, Winston-Salem, NC 27157-1072, USA.
South Med J. 1995 Jun;88(6):639-43. doi: 10.1097/00007611-199506000-00008.
Myelolipomas are benign tumors composed of an admixture of mature adipose tissue and normal hematopoietic cells. The vast majority occur within the adrenal glands, but several extra-adrenal myelolipomas (EAMLs) have been reported. The typical EAML is a solitary, well-defined mass within the abdomen, most commonly in the retroperitoneal presacral area. EAMLs may produce symptoms related to their mass effect, but they are occasionally incidental findings. Most commonly, the patient is older than 40 years and has no hematologic abnormalities. It is important to distinguish EAMLs from other soft tissue tumors, in particular liposarcomas, myxoid malignant fibrous histiocytomas, and extramedullary hematopoietic tumors. We discuss two cases of EAML. The first was in the retroperitoneum of a 76-year-old woman. It is the largest EAML ever reported, measuring 26 cm x 15 cm x 11 cm. The second, a presacral mass in a 68-year-old man, was diagnosed preoperatively by percutaneous computed tomography-guided fine needle aspiration biopsy. Preoperative diagnosis facilitated surgical management in this case. We discuss the clinical, radiologic, and pathologic characteristics and the differential diagnosis of this rare entity.
髓脂肪瘤是由成熟脂肪组织和正常造血细胞混合组成的良性肿瘤。绝大多数发生于肾上腺，但也有几例肾上腺外髓脂肪瘤（EAML）的报道。典型的EAML是腹部内一个孤立的、边界清晰的肿块，最常见于骶前腹膜后区域。EAML可能因其占位效应而产生症状，但偶尔也为偶然发现。最常见的情况是，患者年龄超过40岁，且无血液学异常。将EAML与其他软组织肿瘤区分开来很重要，尤其是脂肪肉瘤、黏液样恶性纤维组织细胞瘤和髓外造血肿瘤。我们讨论两例EAML。第一例位于一名76岁女性的腹膜后。它是有史以来报道的最大的EAML，尺寸为26 cm×15 cm×11 cm。第二例是一名68岁男性的骶前肿块，术前通过经皮计算机断层扫描引导下细针穿刺活检确诊。术前诊断有助于该病例的手术处理。我们讨论了这种罕见实体的临床、放射学和病理学特征以及鉴别诊断。
