Adrenolipoma pathophysiology: Difference between revisions
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On gross pathology, central congested red to brown lesion, with thin cortical rim is a characteristic finding of adrenolipoma. On microscopic histopathological analysis, variable amounts of [[adipocytes]] and [[hematopietic cells]] are characteristic findings of adrenolipoma. | On gross pathology, central congested red to brown lesion, with thin cortical rim is a characteristic finding of adrenolipoma. On microscopic histopathological analysis, variable amounts of [[adipocytes]] and [[hematopietic cells]] are characteristic findings of adrenolipoma. | ||
==Pathogenesis== | ==Pathogenesis== | ||
* | *Adrenlolipomas are usually less than 4 cm in size occasionally measuring more than 10 cm in size. | ||
*Extra-adrenal sites for myelolipomas include the retroperitoneum, thorax, and pelvis. | *Extra-adrenal sites for myelolipomas include the retroperitoneum, thorax, and pelvis. | ||
*Usually unilateral however they can also involve both adrenals. | *Usually unilateral however they can also involve both adrenals. | ||
*One hypothesis suggests that stimuli, such as necrosis, inflammation, infection, or stress could cause adrenocortical cell metaplasia | *One hypothesis suggests that stimuli, such as necrosis, inflammation, infection, or stress could cause adrenocortical cell metaplasia | ||
*If chronically present these stimulants lead to the development of neoplasms. | *If chronically present these stimulants lead to the development of neoplasms.This hypothesis is supported by the increased incidence of the lesion in the advanced years of life. | ||
This hypothesis is supported by the increased incidence of the lesion in the advanced years of life. | |||
*On gross pathologic examination, a cut section of a myelolipoma has a variegated appearance consisting of bright yellow areas of fat, dark red areas of hematopoietic myeloid tissue, and areas with intermixed red and yellow components. | *On gross pathologic examination, a cut section of a myelolipoma has a variegated appearance consisting of bright yellow areas of fat, dark red areas of hematopoietic myeloid tissue, and areas with intermixed red and yellow components. | ||
*On histopathologic examination, myelolipomas are predominantly composed of fatty areas with interspersed hematopoietic tissue components. | *On histopathologic examination, myelolipomas are predominantly composed of fatty areas with interspersed hematopoietic tissue components. | ||
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*In an isolated adrenal myelolipoma, a peripheral rim of normal adrenal cortical tissue can be commonly identified distinctly from the mass. | *In an isolated adrenal myelolipoma, a peripheral rim of normal adrenal cortical tissue can be commonly identified distinctly from the mass. | ||
*Rarely the myelolipomas can contain osteoid tissue in addition to the myeloid tissue. | *Rarely the myelolipomas can contain osteoid tissue in addition to the myeloid tissue. | ||
The hemorrhagic areas may be partly replaced by fibrotic tissue or may undergo calcification | *The hemorrhagic areas may be partly replaced by fibrotic tissue or may undergo calcification | ||
==Gross Pathology== | ==Gross Pathology== | ||
Latest revision as of 00:11, 4 October 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Ahmad Al Maradni, M.D. [2]
Overview
On gross pathology, central congested red to brown lesion, with thin cortical rim is a characteristic finding of adrenolipoma. On microscopic histopathological analysis, variable amounts of adipocytes and hematopietic cells are characteristic findings of adrenolipoma.
Pathogenesis
- Adrenlolipomas are usually less than 4 cm in size occasionally measuring more than 10 cm in size.
- Extra-adrenal sites for myelolipomas include the retroperitoneum, thorax, and pelvis.
- Usually unilateral however they can also involve both adrenals.
- One hypothesis suggests that stimuli, such as necrosis, inflammation, infection, or stress could cause adrenocortical cell metaplasia
- If chronically present these stimulants lead to the development of neoplasms.This hypothesis is supported by the increased incidence of the lesion in the advanced years of life.
- On gross pathologic examination, a cut section of a myelolipoma has a variegated appearance consisting of bright yellow areas of fat, dark red areas of hematopoietic myeloid tissue, and areas with intermixed red and yellow components.
- On histopathologic examination, myelolipomas are predominantly composed of fatty areas with interspersed hematopoietic tissue components.
- These fatty elements and hematopoietic areas may be clearly separated, or they are often intermixed.
- Tissue analysis often reveals a variable amalgamation of myeloid and erythroid cells, megakaryocytes, and occasionally lymphocytes.
- In an isolated adrenal myelolipoma, a peripheral rim of normal adrenal cortical tissue can be commonly identified distinctly from the mass.
- Rarely the myelolipomas can contain osteoid tissue in addition to the myeloid tissue.
- The hemorrhagic areas may be partly replaced by fibrotic tissue or may undergo calcification
Gross Pathology
Macroscopic examination demonstrates:[1]
Central congested red to brown lesion, with thin cortical rim. Large lesions may contain hemorrhage or infarction.
Microscopic Pathology
Histological examination demonstrates:[1]
- Variable amounts of mature adipocytes (with distended lipid vacuoles) similar to bone marrow
- Variable amounts of hematopoietic cells (including cells from myeloid, erythroid and megakaryocytic cells lines)