Adrenal myelolipoma

ADRENAL MYELOLIPOMA

• Benign tumor consisting of hematopoietic element and mature adipose tissue

• Age – above 30 years (most common at 50years)

• Sex – equal predilection for both sexes

• It is solitary and unilateral

• Clinical presentation – Abdominal or flank pain, hematuria, palpable mass and hypertension

• Myelolipoma is associated with other endocrine abnormalities like

  • Cushing’s syndrome

  • Addisons disease

  • Virilism

  • Pseudohermaphroditism

• Theories regarding histogenesis of Adrenal myelolipoma are 

  1. Bone marrow embolizing into adrenal through hematogenous route

  2. Intra adrenal embryonic rests of bone marrow

  3. Metaplasia of adrenal cortical cells

  4. Metaplasia of uncommitted or pluripotential adrenal stromal cells 

• Morphology

  • Gross

    • Well circumscribed tumor

    • Colour varies from reddish brown to deep red depending on the quantity of fat and hematopoietic elements

  • Microscopy

    • Normal or compressed cortical cells surrounding the lesion

    • There is variable mixture of hematopoietic elements and mature fat

    • Hemorrhage, infarction , calcification and ossification can be present.

Reference: Ernest E.Lack. Tumors of the adrenal glands and extraadrenal paraganglia. AFIP Atlas of tumor pathology Series 4.