A 41-year-old female smoker was diagnosed with right thigh. An abdominal ultrasound was performed due to an elevation of the associated catecholamines in blood (noradrenaline and dopamine).
A hypoanechoic nodular lesion of about 3 cm of maximum dimension was observed at the adrenal level, compatible with a solid cystic lesion with multilayered degeneration.
The lesion was confirmed by CT and scintigraphy.
The patient underwent surgery with clinical judgments of pheochromocytoma versus adrenal gland adenoma.
An irregular fragment of adipose tissue of 9 cm was received, whose serial sections showed a tapered appearance of 1.2 cm along with a multilocular cystic formation in the papillary walls and whitish formations.
The histological study showed cystic formation without content stricture caused by planar central spindle cells, occasionally protruding intraepithelially (te), with immunohistochemical positivity for CD31 and CD34 and negative for goblet cells.
Cystic formations of similar characteristics to those described although of smaller size were observed both in location adjacent to the main and randomly distributed in the sinus of the adrenal parenchyma.
With these findings the diagnosis of cystic lymphangioma was made.
