{'fraction_non_alphanumeric': 0.027403414195867025, 'fraction_numerical': 0.009433962264150943, 'mean_word_length': 5.203342618384401, 'pattern_counts': {'":': 0, '<': 0, '<?xml version=': 0, '>': 0, 'https://': 0, 'lorem ipsum': 0, 'www.': 0, 'xml': 0}, 'pii_count': 0, 'substrings_counts': 0, 'word_list_counts': {'cursed_substrings.json': 1, 'profanity_word_list.json': 0, 'sexual_word_list.json': 0, 'zh_pornsignals.json': 0}}
FNA diagnosis of adrenal myelolipoma: A rare entity

Dear Dr. Bedrossian: Myelolipoma is a benign tumor consisting of mature fat interspersed with hematopoietic elements resembling bone marrow. Adrenal myelolipomas are rare benign nonfunctioning tumors that are mostly detected incidentally by imaging. These usually do not present with any symptom unless they are large enough to become clinically apparent. A 36-year-old male presented to Jaber Al-Ahmed, Armed Forces Hospital, Kuwait with an abdominal lump in the right lumbar region for the past three months. The mass was 12.5 3 6 cm in size, mobile, spherical, and firm in consistency. The patient was of average built, and his vitals and routine investigations were within normal limits. Fine-needle aspiration cytology (FNAC) under ultrasonographic guidance was done, which showed scattered cells of myeloid series along with interspersed fat cells (Fig. 1). A tentative diagnosis of adrenal myelolipoma was rendered. Right adrenalectomy was performed, and the tissue was sent for histopathological examination. On gross examination, the mass was oval in shape, yellowish brown, and measured around 12.5 cm. The cut section was bright yellow in color with foci of red–brown discoloration (Fig. 2). Microscopically, the tumor consisted mainly of mature adipose tissue with scattered islands of hematopoietic cells (Fig. 3). Thus, a diagnosis of adrenal myelolipoma was confirmed. Adrenal myelolipoma is an unusual benign lesion characterized by the presence of adult fat containing active bone marrow elements within the adrenal gland. The lesion occurs most frequently in middle life with no sex predilection. Circumscribed bone marrow like structures were first recognized by Gierke in the year 1905, but it was only in 1929 that Oberling gave the name ‘‘myelolipoma’’ for the lesion. Most of the cases are found incidentally, either at autopsy or through radiological imaging done for other reasons, primarily because these present asymptomatically. It is only when the lesion attains a large size and is predominantly fatty that it becomes clinically apparent. Myelolipoma manifests in four distinct clinicopathologic patterns: isolated adrenal myelolipoma, adrenal