Angiomyolipoma: Difference between revisions

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==External links==
==External links==
* {{Chorus|00488}}
* {{Chorus|00488}}
 
* [http://www.thelamfoundation.org/ The LAM Foundation (US)]





Revision as of 17:39, 7 March 2009

Angiomyolipoma
ICD-10 D30.0
ICD-9 223.0
ICD-O: M8860/0
DiseasesDB 29496
MeSH D018207

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Please Take Over This Page and Apply to be Editor-In-Chief for this topic: There can be one or more than one Editor-In-Chief. You may also apply to be an Associate Editor-In-Chief of one of the subtopics below. Please mail us [2] to indicate your interest in serving either as an Editor-In-Chief of the entire topic or as an Associate Editor-In-Chief for a subtopic. Please be sure to attach your CV and or biographical sketch.

Overview

Angiomyolipoma is a benign renal neoplasm previously considered to be a hamartoma or choristoma, but now known to be neoplastic.[1] It is composed of variable amounts of fat, vascular, and smooth muscle elements. The fat density of the tumour on CT has been regarded to be pathognomonic, although there are now case reports of renal cell carcinoma types also possessing macroscopic fat.

The lesion is well demarcated and contains mature elements. It occurs in more than 50% of individuals with tuberous sclerosis, often bilaterally. Angiomyolipomata also occur in 40% of women who have a rare, cystic lung disease called lymphangioleiomyomatosis, or LAM.[2]

Incidence

The incidence is about 0.3-3%. It occurs in more than 50% of individuals with tuberous sclerosis, often bilaterally. It is twice as common in females as in males.

Types

  • Isolated Angiomyolipoma (80%)
    • Angiomyolipoma is about 4 times more common in women than in men.
    • Interestingly, 80% of the cases involve the right kidney.
  • Angiomyolipoma associated with tuberous sclerosis (20%).
    • Angiomyolipoma occurs in 80% patients with tuberous sclerosis.
    • Angiomyolipoma also occurs young women with lymphangiomyomatosis without other stigmata of tuberous sclerosis. Angiomyolipoma and lymphangiomyomatosis are sometimes considered the forme fruste of tuberous sclerosis.

Diagnosis

Demonstration of fat in renal tumor is virtually diagnostic of angiomyolipoma. Most small lesions are asymptomatic and incidental findings on images. The fat density of the tumour on CT is pathognomonic.

Diagnostic Findings

Images courtesy of RadsWiki

MRI: Angiomyolipoma


MRI: Angiomyolipoma


US: Angiomyolipoma


CT: Angiomyolipoma


CT: Large right angiomyolipoma


CT: Large right angiomyolipoma


Additional images

1. Histopathologic image of renal angiomyolipoma. Nephrectomy specimen. H & E stain.


2. Histopathologic image of renal angiomyolipoma. Nephrectomy specimen. The same case as demonstrated in "Image 1". H & E stain.


3. Histopathologic image of renal angiomyolipoma. Nephrectomy specimen. The same case as demonstrated in "Image 1". H & E stain.


4. Histopathologic image of renal angiomyolipoma. Nephrectomy specimen. The same case as demonstrated in "Image 1". HMB-45 immunostain.


Complications

Complications include hematuria, flank pain, and shock as a result of spontaneous hemorrhage.

References

  1. Eble JN. Angiomyolipoma of the kidney. Semin Diagn Pathol 1988;15:21-40
  2. McCormack FX (2006). "Lymphangioleiomyomatosis". MedGenMed. 8 (1): 15. PMC 1682009. PMID 16915145.

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