Myelolipoma and Related Changes
The term myelolipoma was first coined by Oberling (1929) to denote a rare benign lesion of the adrenal gland which consists of admixtures of adipose, bone marrow and lymphocyte-like elements, whose first description is usually credited to Gierke in 1905. Nearly 200 examples of this rare entity have now been described in the world literature, and the review and analysis by Plaut (1958) is by far the most comprehensive. There does not appear to be either sex or side predilection and there is no correlation with anaemia in the adult, unlike extra-adrenal myelolipomas. Although normal fatty marrow will aromatise androgens to oestrogens (Frisch et al. 1980), these lesions are not associated with detectable aberrations of steroidogenesis or haematopoeisis in the vast majority of cases and hence present as ‘non-functioning’ tumours. Most are asymptomatic and are detected as incidental autopsy findings. However, some of the larger lesions may cause pain, haematuria or present as abdominal masses. With recent advances in radiological technology and sonography (Gee et al. 1975; Behan et al. 1977) an increasing number have been detected during life and removed successfully at operation (Newman and Silen 1968; Whittaker 1968; Olsson et al. 1973; Desai et al. 1979) the first successful example being recorded by Dyckman and Freedman (1957). According to Desai et al. (1979), an adrenal myelolipoma should be suspected when a biochemically non-functioning radiolucent, solid adrenal mass without neovascularity on angiography is detected.
KeywordsAdrenal Gland Zona Fasciculata Zona Reticularis Myeloid Metaplasia Detectable Aberration
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