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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 correspondence 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 correspondence 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
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