Imaging and Histopathologic Basis of Adrenal Myelolipoma / 实用放射学杂志

ABSTRACT

Objective To investigate the histologic basis of imaging manifestations on adrenal myelolipoma and evaluate the value of various imaging modalities in diagnosing the tumor.Methods The imaging manifestations and pathological features of 21 cases of adrenal myelolipoma proved by postsurgical pathology were retrospectively analysed.Results Histologically,the myelolipoma presented hematopoietic elements amidst fatty tissue and showed indefinite border.The myeloid tissue was well vascularized and were adherent closely to normal adrenal gland.Both CT and MRI detected a single mass with irregular plaque or streak of bone marrow tissues between fatty components.The capsule of the tumor was not apparent,but rarely it presented an irregular local “capsule”which was composed of adrenal tissue with compression surrounding the tumor.Enhanced-scan found foggy enhancement in fatty tissue and enhancement of bone marrow tissue which made myeloid plaque enlarged and the edge misted.Ultrasonography demonstrated highly echogenic fat-containing ball of adrenal,while intravenous urography only showed translocation and renal axis alteration of homolateral kidney.Conclusion CT scan appears to be the most accurate qualitative modality to demonstrate adrenal myelolipoma while coronal and sagittal section scanning on MRI can make its localization more exact.Ultrasonography is also an important way in detecting the mass whereas intravenous urography and abdominal plain film should not be used to be the qualitative criterion.