Angiomyolipoma other diagnostic studies

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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 of angiomyolipoma include:

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]

Cytologic features of angiomyolipoma include:^[2]

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

↑ 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.
↑ ^2.0 ^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)
↑ ^3.0 ^3.1 ^3.2 ^3.3 http://librepathology.org/wiki/index.php/Angiomyolipoma
↑ ^4.0 ^4.1 Template:Ref GUP
↑ 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)
↑ 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.