Fine needle aspiration of hepatic angiomyolipoma with extramedullary hematopoiesis: A case report

Abstract

Angiomyolipoma (AML), a perivascular epithelioid cell tumour, is a benign tumour, typically involving the kidney. In this location, the cytological and histological characteristics of this lesion allow for a straightforward diagnosis in most cases. When AML occurs in extrarenal sites such as the liver, AML can mimic a malignant tumour clinically and radiologically. 1 A definitive diagnosis of hepatic angiomyolipoma (HAML) usually relies on histopathological evaluation of biopsy or resection material. A diagnosis of HAML is less often made, or at least suspected, on cytology specimens obtained using techniques such as fine needle aspiration (FNA). 1 In this setting, the interpretation can be challenging. We report a case of HAML with extramedullary hematopoiesis (EMH) presenting as a large hepatic mass, diagnosed by cytology through endoscopic ultrasound guided fine-needle aspiration. | C A S E REP ORTAn 81-year-old man with a history of chronic kidney disease stage III and diabetes was found to have an incidental 6 cm well-circumscribed mass in the left lobe of the liver mass on computed tomography (CT).The mass showed central low density suggestive of a scar, and focal nodular hyperplasia was suggested as an initial diagnosis. FNA of the lesion showed a mixture of spindled and epithelioid cells in a background of mixed histiocytes, plasma cells, and eosinophils (Figure 1).The epithelioid cells displayed abundant cytoplasm, round nuclei with prominent a nucleolus, and rare binucleated forms. In addition, the cellblock demonstrated mature adipose tissue and rare megakaryocytes suggestive of extramedullary hematopoiesis (Figure 2). Immunohistochemical staining of the cellblock showed positivity for HMB-45 and Mart-1 (weak), as well as absence of CD45,

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Giant hepatic angiomyolipoma presenting with severe anemia: A surgical case report and review of literature

“…Abdominal ultrasound is initial and simple examination for diagnosing hepatic masses, which is well circumscribed and homogenous because contains many fatty components with rapid enhancement in the arterial phase of ultrasound contrast and distinguish from hemangiomas with a posterior echogenic image [12] . Endoscopic ultrasound guided fine-needle aspiration (EUS-FNA) was rarely used in selective case for diagnosing, due to component of blood vessels could led to internal tumoral hemorrhage or rupture [13] . In computed tomography ( CT ), the tumor was hypodense due to adipose component, hypervascular in richly vascularized HAML with wash-out in the portal and late portal phase, or persistent portal and late-phase enhancement in HAML with few or no vessels [14] .…”

Angiomyolipoma of Uterine Cervix: Report of a Rare Case

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