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Int J Clin Exp Pathol 2013;6(5):943-950

Case Report
Cystic lymphangioma-like adenomatoid tumor of the adrenal gland: report of a rare case
and review of the literature

Ming Zhao, Changshui Li, Jiangjiang Zheng, Minghui Yan, Ke Sun, Zhaoming Wang

Department of Pathology, Department of Radiology, Ningbo Yinzhou Second Hospital, Ningbo, Zhejiang Province, PR China; Department of
Pathology, the First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, PR China

Received February 6, 2013; Accepted March 19, 2013; Epub April 15, 2013; Published May 1, 2013

Abstract: Adenomatoid tumors (AT) are uncommon, benign tumors of mesothelial origination most frequently encountered in the genital tracts
of both sexes. Their occurrences in the extragenital sites are much rarer and could elicit a variety of differential diagnosis both clinically and
morphologically. With regard to the adrenal gland, to the best knowledge of us, only 31 cases of AT have been reported in the English literature.
Several histologic growth patterns have been documented in AT, among which cystic type is the least common one. We herein present a further
case of AT arising in the adrenal of a 62-year-old Chinese man with a medical history for systemic hypertensive disease. The tumor was
incidentally identified during routine medical examination. An abdomen computed tomography scan revealed a solitary mass in the right
adrenal. Grossly, the poorly-circumscribed mass measured 3.0 x 3.0 x 2.0 cm with a cut surface showing a gelatinous texture with numerous
tiny cystic structures. Microscopic examination showed an infiltrated lesion with honeycomb appearance mimicking a lymphangioma, which
composed predominantly of variably sized and shaped anastomosing small cystic spaces lined by flattened endothelial-like cells, without any
epithelioid or signet-ring like components present. Foci of extraadrenal tumor extension, lymphoid aggregates with occasional germinal centre
formation, intralesional fat tissue, stromal myoid proliferation and ossification were also observed. Immunohistochemical analyses confirmed
the mesothelial differentiation of this tumor and indicated a diagnosis of cystic lymphangiomatoid AT of the adrenal. (IJCEP1302009).

Keywords: Adrenal gland, adenomatoid tumor, lymphangioma, benign mesothelioma, immunohistochemistry, adrenal cyst

Address correspondence to: Dr. Ming Zhao, Department of Pathology, Ningbo Yinzhou Second Hospital, No. 1 North Qianhe Road, Yinzhou
District, 315100 Ningbo, Zhejiang Province, PR China. Tel: +86-574-83039018; Fax: +86-574-83038515; E-mail: zhaomingpathol@163.com