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| IJCEP Copyright © 2007-All rights reserved. |
| International Journal of Clinical and Experimental Pathology |
Int J Clin Exp Pathol 2(1),95-98;2009
Case Report
Small Lymphocytic Lymphoma/Chronic Lymphocytic Leukemia in a Pelvic
Myelolipoma
Shereen Gheith, Richard Boulay and Dennis Cornfield
Department of Pathology and Laboratory Medicine, Health Network laboratories/Lehigh Valley Hospital, Allentown, PA
Received January 21, 2008; accepted and available online January 31, 2008
Abstract: Myelolipoma is a rare benign tumor composed of mature adipose tissue and normal hematopoietic elements. Extra-adrenal
myelolipomas are extremely rare, with approximately 50% of cases occurring in the presacral region. We report a case of an 85 year old
woman who presented with small bowel obstruction relating to a pelvic mass detected on computed tomography (CT) scan. At
laparotomy, a 12-cm. pre-sacral mass was resected. Histologic examination showed a myelolipoma with dense lymphoid aggregates.
On immunostains, the lymphoid aggregates showed positivity for CD20, CD5, and CD23, consistent with small lymphocytic
lymphoma/chronic lymphocytic leukemia (SLL/CLL). Molecular evaluation confirmed the presence of a clonal B-cell lymphocytic
proliferation that did not harbor BCL-2 or BCL-1 gene rearrangements. This case represents the first report of a myelolipoma involved by
a non-Hodgkin lymphoma. The unique combination of these findings raises questions about the relationship between the two observed
entities. The likeliest scenario is that an unusual benign tumor (myelolipoma) was colonized by a relatively common systemic
hematopoietic neoplasm SLL/CLL, producing a collision tumor. (IJCEP801002).
Key Words: Extra adrenal myelolipoma, lymphoma, small lymphocytic lymphoma, chronic lymphocytic leukemia, non-Hodgkin lymphoma
Full text: PDF
Address all correspondences to: ShereenGheith, MD PhD, Pathology and Laboratory Medicine, Health Network laboratories/Lehigh
Valley Hospital, 1200 Cedar Crest, Allentown, PA 18103. Tel: 610-402-5901; Fax: 610-402-1691; Email: gheiths@comcast.net
Case Report
Small Lymphocytic Lymphoma/Chronic Lymphocytic Leukemia in a Pelvic
Myelolipoma
Shereen Gheith, Richard Boulay and Dennis Cornfield
Department of Pathology and Laboratory Medicine, Health Network laboratories/Lehigh Valley Hospital, Allentown, PA
Received January 21, 2008; accepted and available online January 31, 2008
Abstract: Myelolipoma is a rare benign tumor composed of mature adipose tissue and normal hematopoietic elements. Extra-adrenal
myelolipomas are extremely rare, with approximately 50% of cases occurring in the presacral region. We report a case of an 85 year old
woman who presented with small bowel obstruction relating to a pelvic mass detected on computed tomography (CT) scan. At
laparotomy, a 12-cm. pre-sacral mass was resected. Histologic examination showed a myelolipoma with dense lymphoid aggregates.
On immunostains, the lymphoid aggregates showed positivity for CD20, CD5, and CD23, consistent with small lymphocytic
lymphoma/chronic lymphocytic leukemia (SLL/CLL). Molecular evaluation confirmed the presence of a clonal B-cell lymphocytic
proliferation that did not harbor BCL-2 or BCL-1 gene rearrangements. This case represents the first report of a myelolipoma involved by
a non-Hodgkin lymphoma. The unique combination of these findings raises questions about the relationship between the two observed
entities. The likeliest scenario is that an unusual benign tumor (myelolipoma) was colonized by a relatively common systemic
hematopoietic neoplasm SLL/CLL, producing a collision tumor. (IJCEP801002).
Key Words: Extra adrenal myelolipoma, lymphoma, small lymphocytic lymphoma, chronic lymphocytic leukemia, non-Hodgkin lymphoma
Full text: PDF
Address all correspondences to: ShereenGheith, MD PhD, Pathology and Laboratory Medicine, Health Network laboratories/Lehigh
Valley Hospital, 1200 Cedar Crest, Allentown, PA 18103. Tel: 610-402-5901; Fax: 610-402-1691; Email: gheiths@comcast.net