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]

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
• Wilms tumour: may contain fat
• perirenal fat entrapment / renal junctional parenchymal defect