Adrenal myelolipoma: a comprehensive review

INTRODUCTION: Adrenal myelolipoma is an invariably benign neoplasm of the adrenal gland that is the second most common primary adrenal incidentaloma following adrenocortical adenomas. It is composed of elements of adipose tissue and extramedullary hematopoiesis. Hypotheses on stem cells and hormonal factors have been formulated regarding its pathogenesis that is still obscure. Despite its benign behavior, adrenal myelolipoma is clinically relevant as it might cause significant difficulties in the differential diagnosis of adrenal tumors. METHODS: We have reviewed 420 cases reported between 1957 and 2017 on adrenal myelolipoma retrieved from PubMed and Scopus databases and also 20 of our case series to provide a comprehensive analysis of their pathology, epidemiological and clinical features. RESULTS AND CONCLUSIONS: The average age for its diagnosis was 51 years, and no gender difference was observed. The average size of tumors was 10.2 cm. Congenital adrenal hyperplasia was associated to 10% of all cases analyzed, while other adrenal hypersecretory disorders (cortisol, aldosterone) were found in 7.5% of cases. Computed tomography and magnetic resonance imaging can be reliably used for its differential diagnosis. If the diagnosis of an adrenal myelolipoma is unambiguous, and no associated symptoms or hormonal activity are established, surgical intervention is usually not necessary

Endogenous Lipoid Pneumonia with Special Reference to Carcinoma of the Lung

Demonstrable fat in the lung due to the inhal-ation of mineral or vegetable oils or to fat embolism is well known. The occurrence of lipoid consolidation in which the fat was of endogenous origin and shown to consist largely of cholesterol and its esters was reported in a previous communication (De Navasquez, Trounce, and Wayte, 1951) and it was concluded that such fatty change was primarily the result of degen-eration due to chronic injury. The present study was made to investigate the incidence and mechanism of such pathological changes and to test this conclusion. MATERIALS AND METHODS The lungs from 42 necropsies on a wide variet