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A Rare Case of a Multifocal Extra-Adrenal Myelolipoma with Markedly Hypocellular Bone Marrow

Address correspondence to John Lazarchick, M.D., Department of Pathology and Laboratory Medicine, Medical University of South Carolina, P.O. Box 250908, Charleston, SC 29425, USA; tel 843 792 2933; fax 843 792 4811; e-mail lazarj{at}musc.edu.

Extra-adrenal myelolipomas are rare, generally solitary, non-functioning tumors consisting of adipose tissue and hematopoetic elements. These lesions are not known to be associated with underlying hematologic disorders or documented bone marrow abnormalities. We describe the extremely rare occurrence of multifocal, extra-adrenal myelolipomas in a 35-yr-old male. A markedly hypocellular bone marrow is noted, despite normal peripheral blood counts. To our knowledge, this is the first case report of a markedly abnormal marrow examination in a patient with extra-adrenal myelolipoma, and implicates the extra-osseous masses as the driving force behind his normal hematopoesis.

Keywords: myelolipoma, bone marrow hypoplasia, extramedulary hematopoiesis