Journal of Pathology and Translational Medicine

Imprint Cytology of Hepatic Angiomyolipoma: A Case Report.: Ae Ri Kim, Hong Jin Kim, Joon Hyuk Choi; Korean J Cytopathol. 2008;19(2):188-193.; DOI: https://doi.org/10.3338/kjc.2008.19.2.188

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Angiomyolipoma of the liver is a rare benign tumor that's composed of variable mixtures of adipose tissue, smooth muscle and thick-walled blood vessels. We report here on the imprint cytologic features of a hepatic angiomyolipoma in a 47-year-old man. The smears showed spindle and epithelioid tumor cells in clusters, trabeculae and single cells. The spindle cells had elongated, cigar-shaped nuclei with finely granular chromatin and fibrillary cytoplasm. The epithelioid cells had round nuclei with a moderate amount of cytoplasm. Any adipose tissue was not found. Immunohistochemically, both the spindle and epithelioid cells revealed cytoplasmic positivity for smooth muscle actin and HMB-45.

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Hepatic Angiomyolipoma with Variable Histologic Features: 8 Cases Resembling Hepatocellular Carcinoma or Inflammatory Pseudotumor
Ilseon Hwang, Eunsil Yu, Kyung-Ja Cho
The Korean Journal of Gastroenterology.2012; 60(4): 242. CrossRef
Hepatic epithelioid angiomyolipoma with trabecular growth pattern: A mimic of hepatocellular carcinoma on fine needle aspiration cytology
Linjun Xie, Jose Jessurun, J. Carlos Manivel, Stefan E. Pambuccian
Diagnostic Cytopathology.2012; 40(7): 639. CrossRef

Epithelioid Angiomyolipoma of the Kidney: A case report.: You Kyung Kim, Jong Sil Lee, Ky Hyun Chung, Sun Hoo Park, Gyung Hyuck Ko; Korean J Pathol. 2000;34(11):953-956.

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Abstract PDF: Angiomyolipoma is considered by many authors to be a hamartoma, occurring in a sporadic form or in association with tuberous sclerosis. This lesion consists of thick walled blood vessels, smooth muscle, and mature adipose tissue in varying amounts. We have experienced a case of the angiomyolipoma composed of monotypic epithelioid cells. The patient was a 69-year-old female. Clinically, there was no evidence of tuberous sclerosis. Microscopically, the tumor was composed of polygonal cells with abundant eosinophilic granular or clear cytoplasm, pleomorphic nuclei, prominent nucleoli, and multinucleated giant cells. The tumor cells showed positive reaction for HMB45, CD68, smooth muscle actin, and S-100, and negative reaction for epithelial membrane antigen, cytokeratin, vimentin, desmin, CD34, estrogen receptor, and progesterone receptor. Ultrastructual analysis showed the presence of glycogen, mitochondria, and other microorganelles in neoplastic cells. Melanosome or premelanosome was not identified.

Renal Angiomyolipoma with Vascular Leiomyomatous Features: A Case Report.: Na Rae Kim, Yeon Lim Suh; Korean J Pathol. 2002;36(5):353-356.

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Abstract PDF: Angiomyolipoma is the most common mesenchymal tumor of the kidney. It occurs sporadically and is associated with tuberous sclerosis. It can appear in any organs, but most commonly in the kidney, and it appears slightly more in females. Angiomyolipoma is pathologically composed of three heterogeneous components of blood vessels, smooth muscle cells and fat cells of varying proportion, which occasionally make several unusual histologic variants. We describe a variant of renal angiomyolipoma simulating vascular leiomyoma on routine hematoxylin-eosin stain; prominent thick-walled blood vessels interspersed with proliferation of smooth muscle cells and total absence of fat cells. Perivascular spindle-shaped smooth muscle cells were reactive for smooth muscle actin, desmin and HMB-45 immunostains. This case illustrates vascular leiomyoma-like angiomyolipoma, which was finally diagnosed on the basis of HMB-45 immunostain, and also raises a question about the real existence of renal vascular leiomyoma.

Fine Needle Aspiration Cytology of the Renal Angiomyolipoma.: Yong Hee Lee, Dong Won Min, Hyeon Joo Jeong, Kwang Gil Lee; Korean J Cytopathol. 1994;5(1):65-70.

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Abstract PDF: We describe a case of fine needle aspiration cytologyof renal angiomyolipoma which was not associated with the clinical complex of tuberous sclerosis and was incidentally found. It was a solitary lesion and the clinical impression before needle aspiration was renal cell carcinoma. The aspirated specimen showed mature fat cells, clusters of renal tubular epithelial cells and sheets of pleomorphic smooth muscle cells with fibrillary cytoplasm. The nuclei of smooth muscle cells varied in size and shape. Since the treatment of renal angiomyolipoma differs from that of renal cell carcinoma, the preoperative cytological diagnosis is of great value.

Multiple Angiomyolipoma of the Liver: Report of a Case with Diagnosis by Fine Needle Aspiration Cytology.: Hyu Lee Yim, Kwang Wha Park, Kyi Beom Lee; Korean J Cytopathol. 1998;9(1):79-84.

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Abstract PDF: Angiomyolipoma(AML) of the liver is a rare benign tumor; about 60 cases, almost solitary, have been reported. We present here a extremely rare case of multiple AML in the liver diagnosed by fine needle aspiration cytology (FNAC). Two large masses were found in a 51 year-old woman complaining of abdominal discomfort by computed tomography and several smaller masses are scattered in the liver. FNAC was performed, showing bundles of spindle shaped smooth muscle cells intermingled with mature fat cells. FNAC may be a valuable method for definitive diagnosis of hepatic AML. The diagnosis was further confirmed by histologic examination with immunohistochemical studies.

Giant Retroperitoneal Lipomatous Angiomyolipoma Simulating Liposarcoma: A Brief Case Report.: Dakeun Lee, Joungho Han, Sung Joo Kim, Dongil Choi; Korean J Pathol. 2007;41(6):406-408.

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Abstract PDF: Extrarenal retroperitoneal angiomyolipomas (AML) are extremely rare, therefore they may present a diagnostic challenge. In this paper, the authors describe a case of a huge retroperitoneal AML in a 49-year-old woman who presented with sudden abdominal pain. Computed tomography revealed the presence of a large, round, fatty mass in the retroperitoneal space, which was easily removed by surgery. The mass was well encapsulated and dark yellow on the cut surface. Microscopically, the tumor was exclusively composed of adipose tissue with frequent multivacuolated, lipoblast-like cells masquerading as well differentiated liposarcoma. In addition, there were many clear, epithelioid cells present, especially around the small blood vessels, which were reactive for HMB-45 and smooth muscle actin.

Angiomyolipoma of the Nasal Cavity.: Jai Hyang Go; Korean J Pathol. 2005;39(4):284-286.

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Abstract PDF: Nasal angiomyolipomas are exceedingly rare and usually present as small tumors in middle-aged or old men. Their histology is similar to that of the renal counterpart, but they differ in the absence of epithelioid cells, the lack of HMB-45 immunoexpression and no association with tuberous sclerosis. A case of angiomyolipoma occurring in the right nasal cavity was presented in a 44-year-old male patient. The mass was removed by an endoscopic approach. A well-circumscribed, 1.3 cm-sized, ovoid mass was composed of yellowish gray, solid, soft tissue. Histologically, it consisted of bundles of smooth muscles, mature fat cells and thick-walled blood vessels. Nests of seromucous glands were admixed within the mass. Neither epithelioid nor pleomorphic cells were found, and HMB-45-positive cells were not detected. No recurrence has been detected for 2 months after the operation.

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