後縦隔に発生した骨髄脂肪腫の1例

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  • Myelolipoma of the posterior mediastinum

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We report a case of myelolipoma originating in the posterior mediastinum. A 62-year-old man with a history of essential hypertension and alcoholic liver dysfunction was referred to our hospital for further evaluation of an abnormal shadow identified on a routine chest radiograph. Chest CT revealed a well-encapsulated, 3×2-cm mass adjacent to the right side of the T10 thoracic vertebra. There was no evidence of bony destruction of the vertebra, pleural effusion, or invasion of surrounding tissues. The density of the mass on CT scan was inhomogeneous and consisted of a combination of fatty- and soft- tissue components. These findings were suggestive of a neurogenic tumor or other soft tissue tumors. Video-assisted thoracoscopic surgery was applied to resect the tumor. Macroscopically, the tumor had a thin capsule and was solid, soft, oval, and reddish-brown. Histopathologically, the tumor consisted of lobulated mature fat tissues interspersed with normal hematopoietic tissues including normoblasts, myeloblasts, and megakaryocytes. Since physical examination and laboratory data showed no evidence of hematologic disease, a myelolipoma arising from the posterior mediastinum was diagnosed.

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