Myelolipoma
刘正智 赵明 夏成青
更新时间:2020-02-06 10:27:00
概述:
发病部位:肾上腺、腹膜后和盆腔,少数病例还可发生于肠系膜、脾脏、睾丸和纵隔。
诊断要点:
1. 多见于40岁以上的成年人;肿块<5cm;
2. 好发于肾上腺、腹膜后和盆腔,少数病例还可发生于肠系膜、脾脏、睾丸和纵隔;
3. 大体检查类似脂肪瘤,以造血成分为主时,可呈灰色或灰红色;
4. 镜下由成熟脂肪组织和骨髓造血组织混合组成,各成分间比例变化较大,造血成分以红系和巨核细胞为主;
5.成熟脂肪组织无非典型或脂母细胞;
6.成熟骨髓造血细胞;
7.代表所有3种细胞系(髓系、红系、巨核细胞);
8.可能存在淋巴样病灶;
9.罕见化生骨、粘液样改变;
10.无肝脾肿大或造血功能紊乱。
免疫组织化学染色:
分子标记:
鉴别诊断:
2、髓系肉瘤:缺乏脂肪细胞;原始的骨髓成分;常与急性白血病同时发生。
预后:
治疗:
参考文献:
1. Ramirez M et al: Adrenal myelolipoma: To operate or not? A case report and review of the literature. Int J Surg Case Rep. 5(8):494-496, 2014
2. Suárez-Peñaranda JM et al: Unusual Forms of Adrenal and Extra-Adrenal Myelolipomas. Int J Surg Pathol. 22(5):473-477, 2014
3. Baker KS et al: Presacral myelolipoma: a case report and review of imaging findings. J Radiol Case Rep. 6(6):1-9, 2012
4. Goltz JP et al: [Ruptured giant myelolipoma of the adrenal gland with acute retroperitoneal hemorrhage.] Rofo. 181(5):485-7, 2009
5. Sagan D et al: Primary myelolipoma of the chest wall. Ann Thorac Surg. 88(4):e39-41, 2009
6. Vaziri M et al: Primary mediastinal myelolipoma. Ann Thorac Surg. 85(5):1805-6, 2008
7. Bishop E et al: Adrenal myelolipomas show nonrandom X-chromosome inactivation in hematopoietic elements and fat: support for a clonal origin of myelolipomas. Am J Surg Pathol. 30(7):838-43, 2006
8. Kiriakopoulos A et al: Surgical management of adrenal myelolipoma: a series of 10 patients and review of the literature. Minerva Chir. 61(3):241-246, 2006