Angiomyolipoma other diagnostic studies: Difference between revisions

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{{CMG}} {{AE}}{{Faizan}},{{Rekha}}
{{CMG}} {{AE}}{{Faizan}},{{Rekha}}
==Overview==
==Overview==
[[CT]] guided biopsy is diagnostic of angiomyolipoma.However it is used to established the diagnosis,when imaging modalities fails to establish the diagnosis especially in cases of fat poor [[Angiomyolipoma]] <ref name="pmid25468637">{{cite journal| author=Schieda N, Kielar AZ, Al Dandan O, McInnes MD, Flood TA| title=Ten uncommon and unusual variants of renal angiomyolipoma (AML): radiologic-pathologic correlation. | journal=Clin Radiol | year= 2015 | volume= 70 | issue= 2 | pages= 206-20 | pmid=25468637 | doi=10.1016/j.crad.2014.10.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25468637  }}</ref>that is difficult to distinguish from the [[Renal cell carcinoma]].In case of presence of tumoural necrosis or calcification, that is highly suggestive of the malignancy, many clinicians prefers elective surgical removal instead of undergoing diagnosing biopsy.
[[CT]] guided [[biopsy]] is diagnostic of [[angiomyolipoma]]. However it is used to established the [[diagnosis]],when imaging modalities fails to establish the [[diagnosis]] especially in cases of fat poor [[Angiomyolipoma]] <ref name="pmid25468637">{{cite journal| author=Schieda N, Kielar AZ, Al Dandan O, McInnes MD, Flood TA| title=Ten uncommon and unusual variants of renal angiomyolipoma (AML): radiologic-pathologic correlation. | journal=Clin Radiol | year= 2015 | volume= 70 | issue= 2 | pages= 206-20 | pmid=25468637 | doi=10.1016/j.crad.2014.10.001 | pmc= | url=https://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=25468637  }}</ref>that is difficult to distinguish from the [[Renal cell carcinoma]]. In case of presence of [[Tumor|tumour]] [[necrosis]] or [[calcification]], that is highly suggestive of the [[malignancy]], many clinicians prefers elective surgical removal instead of undergoing diagnosing [[biopsy]].


==Biopsy Findings==
==Biopsy Findings==
Biopsy findings of angiomyolipoma include:
[[Biopsy]] findings of angiomyolipoma include:
===Microscopic Features===
===Microscopic Features===
Microscopic features of angiomyolipoma are:<ref name="pmid15584043">{{Cite journal  | last1 = Crapanzano | first1 = JP. | title = Fine-needle aspiration of renal angiomyolipoma: cytological findings and diagnostic pitfalls in a series of five cases. | journal = Diagn Cytopathol | volume = 32 | issue = 1 | pages = 53-7 | month = Jan | year = 2005 | doi = 10.1002/dc.20179 | PMID = 15584043 }}</ref>
[[Microscopic]] features of [[angiomyolipoma]] are:<ref name="pmid15584043">{{Cite journal  | last1 = Crapanzano | first1 = JP. | title = Fine-needle aspiration of renal angiomyolipoma: cytological findings and diagnostic pitfalls in a series of five cases. | journal = Diagn Cytopathol | volume = 32 | issue = 1 | pages = 53-7 | month = Jan | year = 2005 | doi = 10.1002/dc.20179 | PMID = 15584043 }}</ref>
*[[Smooth muscle]]
*[[Smooth muscle]]
*Adipose tissue
*[[Adipose]] tissue
*Abundant [[blood vessel]]s
*Abundant [[blood vessel]]s
<gallery>
<gallery>

Revision as of 16:16, 8 November 2019

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor(s)-in-Chief: Faizan Sheraz, M.D. [2],Rekha, M.D.

Overview

CT guided biopsy is diagnostic of angiomyolipoma. However it is used to established the diagnosis,when imaging modalities fails to establish the diagnosis especially in cases of fat poor Angiomyolipoma [1]that is difficult to distinguish from the Renal cell carcinoma. In case of presence of tumour necrosis or calcification, that is highly suggestive of the malignancy, many clinicians prefers elective surgical removal instead of undergoing diagnosing biopsy.

Biopsy Findings

Biopsy findings of angiomyolipoma include:

Microscopic Features

Microscopic features of angiomyolipoma are:[2]

  • Histopathologic image of renal angiomyolipoma. Nephrectomy specimen. H & E stain.[3]

    Histopathologic image of renal angiomyolipoma. Nephrectomy specimen. H & E stain.[3]

  • Histopathologic image of renal angiomyolipoma. Nephrectomy specimen. H & E stain.[3]

    Histopathologic image of renal angiomyolipoma. Nephrectomy specimen. H & E stain.[3]

  • Histopathologic image of renal angiomyolipoma. Nephrectomy specimen. H & E stain.[3]

    Histopathologic image of renal angiomyolipoma. Nephrectomy specimen. H & E stain.[3]

  • Histopathologic image of renal angiomyolipoma. Nephrectomy specimen. HMB-45 immunostain.[3]

    Histopathologic image of renal angiomyolipoma. Nephrectomy specimen. HMB-45 immunostain.[3]

Cytologic

Cytologic features of angiomyolipoma include:[2]

Immunohistochemistry

Immunohistochemistry markers of angiomyolipoma include:

  • Melanocytic markers positive[4]
    • HMB-45 positive in all cases (15/15)[5]
    • Melan A positive in ~87% of cases (13/15)
  • Epithelial markers negative[4]
    • EMA
    • AE1/AE3
  • SMA positive
  • CD117 positive/negative
  • Ki-67:[6]
    • Epithelioid variant of angiomyolipoma positive
    • Conventional angiomyolipoma negative

References

  1. ↑ Schieda N, Kielar AZ, Al Dandan O, McInnes MD, Flood TA (2015). "Ten uncommon and unusual variants of renal angiomyolipoma (AML): radiologic-pathologic correlation". Clin Radiol. 70 (2): 206–20. doi:10.1016/j.crad.2014.10.001. PMID 25468637.
  2. ↑ 2.0 2.1 Crapanzano, JP. (2005). "Fine-needle aspiration of renal angiomyolipoma: cytological findings and diagnostic pitfalls in a series of five cases". Diagn Cytopathol. 32 (1): 53–7. doi:10.1002/dc.20179. PMID 15584043. Unknown parameter |month= ignored (help)
  3. ↑ 3.0 3.1 3.2 3.3 http://librepathology.org/wiki/index.php/Angiomyolipoma
  4. ↑ 4.0 4.1 Template:Ref GUP
  5. ↑ Esheba, Gel S.; Esheba, Nel S. (2013). "Angiomyolipoma of the kidney: clinicopathological and immunohistochemical study". J Egypt Natl Canc Inst. 25 (3): 125–34. doi:10.1016/j.jnci.2013.05.002. PMID 23932749. Unknown parameter |month= ignored (help)
  6. ↑ Ooi, SM.; Vivian, JB.; Cohen, RJ. (2009). "The use of the Ki-67 marker in the pathological diagnosis of the epithelioid variant of renal angiomyolipoma". Int Urol Nephrol. 41 (3): 559–65. doi:10.1007/s11255-008-9473-1. PMID 18839327.

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