Fine needle aspiration diagnosis of extraadrenal myelolipoma presenting as a pleural mass. A case report

BACKGROUND

Myelolipoma is a benign tumor composed of mature adipose tissue and hematopoietic cells. Although they are commonly found in adrenal glands, extraadrenal myelolipomas (EMLs) are rare but well documented. They have been found in various sites, including mediastinum, liver, stomach, lungs, pelvis, spleen, retroperitoneum, presacral region and mesentery. EMLs must be distinguished from extramedullary hematopoieses, which are also composed of hematopoietic elements but may lack adipose tissue and are associated with anemia and marked bone marrow hyperplasia.

CASE

We describe a case of a pleura-based, extraadrenal myelolipoma in a 53-year-old female with unremarkable bone marrow findings that were initially encountered on fluoroscopy-guided fine needle aspiration (FNA). One year later the mass was removed via open thoracotomy. It showed typical EML features histologically.

CONCLUSION

EML manifests on aspiration cytology as a cellular specimen with numerous trilineage hematopoietic cells and a variable proportion of mature adipose cells. To our knowledge, FNA cytology of EML has not been found in this location before. Aspiration biopsy offers a simple and reliable method for the diagnosis of EML in the presence of appropriate clinical settings.

Abdominal pregnancy: magnetic resonance identification with ultrasonographic follow-up of placental involution

Abdominal pregnancy is a rare event and preoperative diagnosis may be difficult. Recently, sonographic examination and magnetic resonance imaging have proved helpful in the preoperative diagnosis in a patient who presented with advanced abdominal pregnancy after tubal sterilization. As well, ultrasound was of benefit in the follow-up of placental involution after delivery.