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 retroperitoneal liposarcoma, adrenal myelolipoma, and renal cell carcinoma.

Differential Diagnosis

Angiomyolipoma must be differentiated from the following:

Differential diagnosis	Characteristic features of the differential diagnosis
Retroperitoneal liposarcoma	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
Renal cell carcinoma	May contain fat: lipid necrosis or osseous metaplasia
Oncocytoma	May contain fat
Wilm's tumor	May contain fat
Retroperitoneal sarcoma	Liposarcoma Leiomyosarcoma
Renal cell carcinoma	Sarcomatoid differentiation
Renal leiomyoma	Very rare Desmin +ve HMB-45 -ve
Perirenal fat entrapment	Renal junctional parenchymal defect
Adrenal myelolipoma	Fat in renal parenchyma