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
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
- Renal cell carcinoma with sarcomatoid differentiation
- Renal leiomyoma[1]
- very rare
- desmin +ve
- HMB-45 -ve
References
- ↑ Patil, PA.; McKenney, JK.; Trpkov, K.; Hes, O.; Montironi, R.; Scarpelli, M.; Nesi, G.; Aron, M.; Sangoi, AR. (2014). "Renal Leiomyoma: A Contemporary Multi-institution Study of an Infrequent and Frequently Misclassified Neoplasm". Am J Surg Pathol. doi:10.1097/PAS.0000000000000354. PMID 25517956. Unknown parameter
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