Hematopoietic elements associated with adrenal glands. A study of the spectrum of change in nine cases.

Abstract

We report nine cases of hematopoietic elements or myelolipomatous foci that were found in association with normal and neoplastic adrenal glands. A spectrum of change occurred that ranged from small clusters of purely erythroid or myeloid cells to microscopic myelolipomas that contained a mixture of hematopoietic elements. Recognition of the myeloid elements was facilitated with the use of the chloroacetate esterase (Leder) stain and a CD15 (myelomonocytic antigen) immunohistochemical stain. The majority (six of nine) of these cases were found in association with cortical adenomas in middle-aged women, but myelolipomatous foci were also found in association with an adrenocortical carcinoma, a pheochromocytoma, and a renal angiomyolipoma. The histogenesis of the foci remained speculative. However, the association with hormonally active neoplasms suggested that the hormonal microenvironment may have played a role in the development of the myelolipomatous foci.