Two in One: Epithelioid angiomyolipoma within a classic kidney angiomyolipoma - a case report
| Autor: | Holger Moch, Walter Gysel, Jan Tuma, Gerd Stuckmann, Andreas L. Serra |
|---|---|
| Přispěvatelé: | University of Zurich, Serra, Andreas L |
| Rok vydání: | 2017 |
| Předmět: |
Pathology
medicine.medical_specialty Angiomyolipoma Epithelioid angiomyolipoma Lipomatosis Contrast enhanced ultrasound Biopsy 610 Medicine & health Case Report lcsh:RC870-923 030218 nuclear medicine & medical imaging 03 medical and health sciences 0302 clinical medicine 10049 Institute of Pathology and Molecular Pathology Internal medicine medicine Humans Computed tomography 2727 Nephrology medicine.diagnostic_test business.industry Kidney Angiomyolipoma Epithelioid Cells Lipoma Middle Aged medicine.disease lcsh:Diseases of the genitourinary system. Urology Kidney Neoplasms Nephrology 030220 oncology & carcinogenesis Female Differential diagnosis business Epithelioid cell Contrast-enhanced ultrasound |
| Zdroj: | BMC Nephrology BMC Nephrology, Vol 19, Iss 1, Pp 1-5 (2018) |
| ISSN: | 1471-2369 |
| Popis: | Background Epithelioid angiomyolipoma is defined as potentially malignant mesenchymal neoplasm, characterized by proliferating epithelioid cells, whereas classic angiomyolipoma, composed of fat, smooth muscle cells and dysmorphic vessels, is defined as a potentially benign. The usual or classic angiomyolipoma is often found incidentally on imaging studies, relatively easily identified due to the presence of fat, in contrast to the epithelioid angiomyolipoma that can pose diagnostic challenges. Case presentation We report a 51-year-old female patient in which an ultrasonography examination showed a solid mass close to the right renal pelvis with hypoechoic and hyperechoic areas. A differential diagnosis of atypical sinus lipomatosis, lipoma and a transitional cell carcinoma was postulated whereas in a subsequent computed tomography a classic angiomyolipoma was postulated. A re-examination by contrast enhanced ultrasound revealed a striking perfusion difference of the hypoechoic and hyperechoic areas. The hypoechoic area showed homogenous and prolonged enhancement whereas the hypoechoic area displayed a marked slower contrast material flooding and a relatively rapid wash out. The histological analysis from the biopsy of the hyperechoic area showed a classic angiomyolipoma, whereas the sample of the hypoechoic central portion revealed an epithelioid angiomyolipoma. A nephrectomy was performed because of the malignant potential of the epithelioid variant of the angiomyolipoma. Conclusions A solid kidney mass with two sharply defined parts, one-part compatible with a classical angiomyolipoma and the other being suspected of carcinoma, is rare, but also illustrative and instructive. The combination of different imaging modalities in the work up of a solid renal mass facilitated to discriminate benign from malignant areas. |
| Databáze: | OpenAIRE |
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