Angiomyolipoma differential diagnosis

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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]

Overview

Angiomyolipoma must be differentiated from [[differential dx1], [differential dx2], and [differential dx3].

Differential Diagnosis

When an AML has typical appearances there is essentially no differential. If atypical, especially when fat-poor other lesions to consider include:

• Retroperitoneal liposarcoma invading the kidney:
  • Presence of a large vessel extending into the renal cortex suggestive of AML; liposarcoma is hypovascular
  • Renal parenchymal defect at the site of tumour contact favours exophytic angiomyolipoma- claw sign
  • Calcifications suggest liposarcoma
• Adrenal myelolipoma
• Renal cell carcinoma (RCC)
  • May contain fat: lipid necrosis or osseous metaplasia
• Oncocytoma: may contain fat
• Wilm's tumor: may contain fat
• Perirenal fat entrapment / renal junctional parenchymal defect
• Retroperitoneal sarcoma
  • Liposarcoma
  • Leiomyosarcoma
• Renal cell carcinoma with sarcomatoid differentiation
• Renal leiomyoma
  • very rare
  • desmin +ve
  • HMB-45 -ve