Adrenal gland & paraganglia

Other tumors

Myelolipoma

Author: Lan L. Gellert, M.D., Ph.D.

Topic Completed: 1 January 2017

Minor changes: 4 February 2021

Copyright: 2002-2021, PathologyOutlines.com, Inc.

PubMed Search: adrenal myelolipoma

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Table of Contents

Cite this page: Gellert LL. Myelolipoma. PathologyOutlines.com website. https://www.pathologyoutlines.com/topic/adrenalmyelolipoma.html. Accessed December 8th, 2021.

Definition / general

Benign and usually unilateral tumor composed of hematopoietic precursor cells and mature fat
Usually an incidental autopsy finding or CT / MRI finding
Not associated with hematologic disorders; nonfunctioning

Essential features

Benign and usually unilateral tumor composed of hematopoietic precursor cells and mature fat
Usually an incidental finding
Not associated with hematologic disorders; nonfunctioning

Epidemiology

No gender predilection
Typically in the fifth to seventh decade of life

Etiology

May due to metaplastic change in the reticuloendothelial cells in response to stimuli including necrosis, infection or stress (Int J Urol 2005;12:239)

Radiology images

Images hosted on other servers:

Abdominal US scan

CT abdomen findings

MRI scan findings

Giant bilateral myelolipomas of abdomen

Axial section of
computed tomogram
showing mass in right
supra renal gland

Case reports

11 year old girl with adrenal myelolipoma (J Indian Assoc Pediatr Surg 2014;19:236)
20 year old woman with coexisting adrenal myelolipoma and adrenal ganglioneuroma (Arch Pathol Lab Med 2002;126:736)
40 year old man with giant myelolipoma presented with massive hemorrhage and abscess (Nephrourol Mon 2015;7:e22671)
48 year old woman with beta thalassemia trait had right adrenal myelolipoma (Int J Surg Case Rep 2016;24:83)
51 year old man with bilateral giant adrenal myelolipomas (Endocrinol Diabetes Metab Case Rep 2015;2015:150079)
58 year old woman with nonfunctional unilateral adrenal mass (J Clin Diagn Res 2015;9:ED03)
66 year old woman with 8 cm adrenal tumor (Arch Pathol Lab Med 2004;128:703)
66 year old woman with giant, asymptomatic and perirenal extra adrenal tumor (Arch Pathol Lab Med 1994;118:188)
Ectopic adrenal myelolipoma arising in or next to spleen of a patient with sickle cell disease (Arch Pathol Lab Med 1995;119:561)

Treatment

Follow up or excision if symptomatic

Gross description

Nonencapsulated, bright yellow adipose-like tissue with hemorrhagic foci (contains marrow tissue)
May be up to 5 kg

Gross images

Contributed by
Lan L. Gellert, M.D., Ph.D.

Myelolipoma

Case of the Week #170

Various images

Images hosted on other servers:

Bright yellow, and focally red, fatty tumor with extensive hemorrhage

Gross specimen of left adrenal myelolipoma

Gross appearance of adrenal myelolipoma

Grey / brown / yellowish areas with areas of hemorrhage

Intraoperative picture showing large suprarenal mass

Well circumscribed
tumor with multiple
areas of hemorrhage

Microscopic (histologic) description

Islands of hematopoietic cells and mature fat
Usually show normal trilineage hematopoiesis, but often with markedly increased megakaryocytes
Larger tumors may have hemorrhage, necrosis, calcification and cysts
Rarely may have areas of fibromyxoid degeneration resembling low grade fibromyxoid sarcoma

Microscopic (histologic) images

Contributed by Lan L. Gellert, M.D., Ph.D.

Various images

Case of the Week #170

Various images

Differential diagnosis