Correlation of MRI and CT findings with histopathology in hepatic angiomyolipoma

Högemann, Dagmar; Flemming, Peer; Kreipe, Hans; Galanski, Michael

doi:10.1007/s003300000750

Cited by 60 publications

(44 citation statements)

References 30 publications

(37 reference statements)

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“…The enhancement of the lesions was seen earlier than the enhancement of adjacent liver parenchyma, consistent with evidence reported in the literature [7,11,[19][20][21]. The hypervascularity in hepatic AML is associated with the proliferating thick-walled blood vessels in the lesion.…”

Section: Discussionsupporting

confidence: 88%

Imaging features of hepatic angiomyolipomas on real-time contrast-enhanced ultrasound

Wang

Xu²,

Xie³

et al. 2010

BJR

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ABSTRACT. The aim of this study was to evaluate the imaging features of hepatic angiomyolipoma (AML) on contrast-enhanced ultrasound (CEUS). The imaging features of 12 pathologically proven hepatic AML lesions in 10 patients who had undergone baseline ultrasound (BUS) and CEUS examinations were evaluated retrospectively. The enhancement extent, pattern and dynamic change, along with the enhancement process, on CEUS were analysed. The diagnostic results of BUS and CEUS before pathological examination were also recorded. The results showed that 75% (9/12) of the AML lesions exhibited mixed echogenicity on BUS and most showed remarkable hyperechogenicity in combination with a hypoechoic or anechoic portion. Arterial flow signals were detected in 75% (9/12) of the lesions on colour Doppler imaging. On CEUS, 66.7% (n58) of the 12 lesions exhibited hyperenhancement in the arterial phase, slight hyperenhancement (n52) or isoenhancement (n56) in the portal phase, and slight hyperenhancement (n51) or isoenhancement (n57) in the late phase. Three (25%) lesions exhibited hyperenhancement in the arterial phase and hypoenhancement in both portal and late phases. One (8.3%) lesion exhibited hypoenhancement throughout the CEUS process. Before pathological examination with BUS, only 3 (25%) lesions were correctly diagnosed as hepatic AML. Conversely, on CEUS, correct diagnoses were made for 66.8% (8/12) of hepatic AMLs. Therefore, arterial hyperenhancement and subsequent sustained enhancement on CEUS were found in the majority of hepatic AMLs. The combination of BUS and CEUS leads to the correct diagnosis in the majority of hepatic AMLs, and is higher than the success rate achieved by BUS alone.

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Section: Discussionsupporting

confidence: 88%

Imaging features of hepatic angiomyolipomas on real-time contrast-enhanced ultrasound

Wang

Xu²,

Xie³

et al. 2010

BJR

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“…Studies report several radiological definitions of PEComa's. Some studies present an association between presence of arteriovenous hypervascularity on CT cross-sections and PEComa (8,9). Most of the CT and MRI exams indicate that majority of the lesions are heterogeneous in arterial and venous phases while they are mildly hypodense in the late phase.…”

Section: Discussionmentioning

confidence: 99%

Perivascular Epithelioid Cell Tumor of the Kidney: A Rare Case Report

Karakoç¹,

Çelik²,

Bozkurt³

et al. 2017

jus

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IntroductionPerivascular epithelioid cell tumors (PEComas) of the kidney are a group of tumor family covering classical angiomyolipoma (AML), microscopic AML (microhamartoma), intraglomerular lesions, cystic AML, epithelioid AML, oncocytoma-like AML and lymphangiomyomatosis of the renal sinus. The World Health Organization (WHO) defines PEComa as a "mesenchymal tumor that contains perivascular epithelioid cells presenting histological and immunohistochemical differences". While classical AML is benign, epithelioid AMLs are defined as potentially malign mesenchymal lesions for their capacity to develop local recurrence and metastasis (1,2,3). Surgical treatment may be required in AML for symptoms such as hemorrhage and pain, or for the risk of malignancy in tumors that cannot be differentiated from AML in the case of PEComa and certain variants of AML (3,4,5).This case report aimed to present a patient who undergone retroperitoneoscopic partial nephrectomy due to a renal mass and diagnosed with PEComa after pathological examination. Case PresentationWe planned magnetic resonance imaging (MRI) in a 25-year-old male patient, who was admitted to our clinic due to left-sided flank pain, with no pathological finding during the examination and laboratory tests, however, with a suspicious mass lesion located at the inferior pole of the left kidney detected during ultrasonographic examination. It was decided to perform surgical excision after detection of a 4 cm tumoral lesion in the inferior pole of the left kidney on MRI (Figure 1). We performed left retroperitoneoscopic partial nephrectomy in our clinic. The total operative time was 90 minutes with the warm ischemia time Böbreğin perivasküler epiteloid hücre tümörleri nadir görülen histolojik ve immünohistokimyasal olarak farklı perivasküler epiteloid hücrelerden oluşan mezenkimal tümörlerdir. Çoğunluğu benign tümörlerdir; fakat malign olanları agresif seyredebilir ve metastaza yol açabilir. Standart tedavi yöntemi ise cerrahi eksizyondur. Olgumuzda 25 yaşında sol böbrek alt polünde 4 cm kitle saptanan ve cerrahi olarak eksize ettiğimiz hastayı sunmayı amaçladık. Anahtar Kelimeler: Böbrek tümörü, perivasküler epiteloid hücre tümörü, parsiyel nefrektomi Perivascular epithelioid cell tumors are rare mesenchymal tumors composed of histologically and immunohistochemically distinctive perivascular epithelioid cells. They are mostly benign, however, malignant tumors with aggressive behavior and distant metastasis can also occur. The standard treatment is surgical excision. Here, we report a case of a 25-year-old male with a 4 cm-mass located in the inferior pole of the left kidney, treated by surgical excision.

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“…bleme. Das KM-Enhancement ist variabel [16]. Der Nachweis von Fett in einer Leberläsion schränkt die Differenzialdiagnose im Wesentlichen auf ein Lipom/Liposarkom, ein Adenom oder Teratom/Xanthom ein.…”

Section: Leberzelladenomunclassified

Diagnosis and differential diagnosis of benign liver tumors and tumor-like lesions

Galanski

Jördens

Weidemann

2008

Chirurg

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Benign liver tumors and tumor-like lesions cover a broad spectrum of differential diagnoses, varying from dysontogenetic cysts to pseudolesions. Focal nodular hyperplasia, adenoma and regenerating nodules play a major role in clinical practice. Based on imaging findings, these lesions can be classified as cystic or solid, solitary or multiple, and hyper- or hypovascular. Haemangioma, FNH, steroid-associated adenoma, cystadenoma and echinococcus cysts can be reliably diagnosed using imaging techniques. The same is true for pseudolesions, which are found in particular on dynamic computed tomography. Other entities such as adenoma in cirrhotic livers, angiomyolipoma, regenerating nodules or Echinococcus alveolaris cannot be safely diagnosed by imaging and require biopsy. Morphological and functional characteristics of the most common lesions in the different imaging modalities will be discussed. Where possible, a diagnostic strategy will be presented.

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Correlation of MRI and CT findings with histopathology in hepatic angiomyolipoma

Cited by 60 publications

References 30 publications

Imaging features of hepatic angiomyolipomas on real-time contrast-enhanced ultrasound

Imaging features of hepatic angiomyolipomas on real-time contrast-enhanced ultrasound

Perivascular Epithelioid Cell Tumor of the Kidney: A Rare Case Report

Diagnosis and differential diagnosis of benign liver tumors and tumor-like lesions

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