1/73. angiomyolipoma of the parotid gland: a case report.angiomyolipoma is a hamartomatous process that most frequently occurs as a single lesion or multiple foci in the kidneys of patients affected by tuberous sclerosis. angiomyolipoma can also arise in extrarenal sites, among which the liver is the most frequently recorded. Only rare cases of angiomyolipoma located in the head and neck region (ear and oral and nasal cavity) have been described. The purpose of the present article is to report a case of angiomyolipoma of the parotid gland. A 68-year-old woman appeared for treatment with a slow-growing nodule located in her right parotid gland. Ultrasound examination revealed a heterogeneous nodule with well-defined margins. The nodule was surgically removed by total parotidectomy and showed the characteristic appearance of angiomyolipoma, with an admixture of fat smooth muscle cells, and tortuous, thick-walled blood vessels. Careful physical examination of the patient failed to reveal features of tuberous sclerosis. angiomyolipoma should be considered in the differential diagnosis of mesenchymal lesions involving the salivary gland.- - - - - - - - - - ranking = 1keywords = blood vessel, vessel (Clic here for more details about this article) |
2/73. angiomyolipoma of the liver--a case report and review of 48 cases reported in japan.Hepatic angiomyolipoma was considered to be a rare benign tumor, but the number of cases has been increasing recently as imaging techniques improve. We describe a case of hepatic angiomyolipoma for which a definitive diagnosis could not be made on imagings and in which resection was performed. The patient had anti-HCV antibody and slight dysfunction of the liver. The tumor showed a heterogeneous high echo on ultrasonography and a low attenuation value of 32.6 Housfield Units, which was much higher than fat density, on plain computed tomography. Discrimination from hepatocellular carcinoma with fatty change was difficult preoperatively. Microscopically, the tumor consisted of spindle-shaped and epithelioid smooth muscles, adipose tissues and proliferating blood vessels and these histological findings confirmed the diagnosis of hepatic angiomyolipoma. The appearance of hepatic angiomyolipoma on imaging diagnosis varies widely due to the fact that the relative proportion of vessels, muscles and fats varies widely from tumor to tumor. The tumor in our case had relatively few fat components. We review 48 cases reported in japan and discuss imaging diagnosis and surgical indications for tumors.- - - - - - - - - - ranking = 1.0160166111775keywords = blood vessel, vessel (Clic here for more details about this article) |
3/73. Mucocutaneous angiomyolipoma. A report of 2 cases arising in the nasal cavity.OBJECTIVE: angiomyolipoma (AML) is a distinctive tumor that usually occurs in the kidney and rarely in the liver. angiomyolipoma of other sites is extremely rare, and, to our knowledge, only 2 cases have been described in the nasal cavity. We present 2 additional cases of AML of the nasal cavity and discuss the difference between them and renal AML. case reports AND PATHOLOGIC FINDINGS: Two tumors in a 66-year-old man and an 88-year-old woman without tuberous sclerosis are described. They showed 20-mm, well-circumscribed, polypoid shapes. Histologically, they were composed of mature smooth muscle cells, fat cells, and various-sized blood vessels. In addition, aggregated small lymphocytes were noted. Neither epithelioid smooth muscle cells nor HMB45 immunoreactivity was seen in either case. CONCLUSIONS: The clinicopathologic features of AML of the nasal cavity are distinct from renal and hepatic AML and are common to those of AML arising in the skin and oral and pharyngeal mucosa. The term mucocutaneous angiomyolipoma is thought to be appropriate to express these characteristic tumors.- - - - - - - - - - ranking = 1keywords = blood vessel, vessel (Clic here for more details about this article) |
4/73. Lymphangiectasia within angiomyolipoma in a tuberous sclerosis patient.This is a presentation of a case of tuberous sclerosis with multifocal hamartomas in the retroperitoneum, both kidneys, and the liver. Lymphangiectasia and numerous ectatic lymphatic channels penetrating through the retroperitoneal angiomyolipoma were demonstrated by lymphography and computed tomography. The findings in our study may document the presence of degenerative change in the lymphatic system--not just in elastic vessels--an association which has not yet been reported in the radiological literature.- - - - - - - - - - ranking = 0.01601661117747keywords = vessel (Clic here for more details about this article) |
5/73. Paratesticular liposarcoma with smooth muscle differentiation mimicking angiomyolipoma.AIMS: To discuss the differential diagnosis of a case of well-differentiated liposarcoma which had areas resembling angiomyolipoma-a feature which, to our knowledge, has not been reported previously. methods AND RESULTS: A tumour in the paratesticular region had apparently been present for 40 years, but had grown recently. A fat component containing lipoblasts was admixed with areas resembling angiomyolipoma, i.e. desmin positive, but HMB45-negative smooth muscle proliferation with atypia and thick-walled blood vessels devoid of elastin. CONCLUSION: The diagnosis of liposarcoma, rather than angiomyolipoma with adipose atypia, in this case is based on the fact that smooth muscle differentiation is documented in liposarcoma, lack of HMB45 staining and recent clonality studies which suggest that the fat in angiomyolipoma is not neoplastic.- - - - - - - - - - ranking = 1keywords = blood vessel, vessel (Clic here for more details about this article) |
6/73. Malignant angiomyolipoma of the liver: a hitherto unreported variant.AIMS: After their original recognition in the kidney, angiomyolipomas (AMLs) have been reported in the liver for more than 20 years. In the kidney, five cases of malignant AML have been reported. We report the first case of malignant hepatic AML. methods AND RESULTS: A 70-year-old female patient presented with abdominal discomfort. Clinical examination revealed a palpable liver. CT scan showed a polymorphous hypervascular lesion in the right liver lobe. A biopsy was taken and resulted initially in a differential diagnosis between a hepatocellular carcinoma, a metastatic tumour (possibly of renal origin) and angiomyolipoma (AML). After immunohistochemistry, a hepatic AML was suggested, given the immunoreactivity for HMB45/NKIC-3. The mass was resected 5 years later because of relapsing abscess formation. Gross examination of the resection specimen showed a focally encapsulated brown mass with focal necrosis. Microscopic examination showed a tumour growing in sheets, separated by sinusoidal-like vessels. Most of the tumour cells had a large, polygonal, clear cytoplasm, often with eosinophilic condensation around the nucleus. There was prominent vascular invasion. immunohistochemistry (reactivity for HMB-45, NKIC-3, S100 and alpha smooth muscle actin, negativity for cytokeratin and vimentin) and electron microscopy confirmed the diagnosis of monomorphic epithelioid AML with prominent vascular invasion. Seven months after tumour resection, the patient died of recurrent disease. CONCLUSIONS: This case highlights the importance of immunohistochemistry and electron microscopy in diagnosing this type of tumour. Possibly, in the past, malignant AML of the liver has been misdiagnosed as HCC.- - - - - - - - - - ranking = 0.01601661117747keywords = vessel (Clic here for more details about this article) |
7/73. Monotypic epithelioid angiomyolipoma of the liver.AIMS: Monotypic epithelioid angiomyolipoma is a recently recognized renal tumour, which is composed purely of epithelioid cells coexpressing markers of both smooth muscle differentiation and melanogenesis (HMB45). We report here the first case of monotypic epithelioid angiomyolipoma arising in the liver. CASE DETAILS: A 30-year-old woman without tuberous sclerosis complex (TSC) was incidentally found to have a hepatic mass by ultrasonography. Grossly, the resected tumour showed a nodule-in-nodule appearance, with large areas of haemorrhagic necrosis. Microscopically, the tumour was composed of pleomorphic epithelioid cells with clear, eosinophilic cytoplasm. Neither adipocytes nor abnormal vessels were recognized in the tumour. Immunohistochemically, the tumour cells were strongly positive for HMB45 and S100 protein, focally positive for desmin, vimentin and smooth muscle actin, and negative for epithelial markers (cytokeratins, EMA). Ultrastructural analysis showed numerous dense granules with some striated ones resembling melanosomes, myofilaments and pinocytic vesicles in the cytoplasm. Molecular analysis showed no allelic loss of the TSC2 region or 12 other chromosomal regions. The patient is free of disease over 1 year after the operation. CONCLUSION: We consider that this hepatic tumour is closely related to angiomyolipoma, and a counterpart of renal monotypic epithelioid angiomyolipoma.- - - - - - - - - - ranking = 0.01601661117747keywords = vessel (Clic here for more details about this article) |
8/73. angiomyolipoma mimicking true lipoma of the liver: report of two cases.Hepatic angiomyolipoma (AML) is very rare and only about 80 cases have been reported. The tumor is fundamentally heterogeneously composed of the three tissue components of blood vessels, smooth muscle cells (SMC), and fat cells. Two cases of hepatic AML are reported here, both of which are histologically composed predominantly of a fat cell element and resembled true lipoma (lipomatous AML). However, careful examination of both tumors revealed the presence of a small amount of epithelioid SMC, especially around blood vessels. Immunohistochemical study using monoclonal antibody for melanoma (HMB-45) clearly revealed a small amount of HMB-45-positive SMC around the blood vessels and scattered in the diffuse fat cell growth in both tumors. Since no liver tissue components or primary liver tumors are reactive with HMB-45 except AML cells, the presence of HMB-45-positive cells within the tumor clearly established the diagnosis of hepatic AML. Any fatty tumor or focal fatty lesion of the liver that superficially resemble true lipomas should be tested for the presence of HMB-45-positive SMC in the tumor to differentiate it from AML.- - - - - - - - - - ranking = 3keywords = blood vessel, vessel (Clic here for more details about this article) |
9/73. US power Doppler of hepatic angiomyolipoma with low fat content.Hepatic angiomyolipoma (AML) is a rare tumor containing a variable amount of fat. angiomyolipoma prevalently constituted by vessels can be difficult to differentiate from other hypervascular hepatic tumors containing a small amount of fat. We describe US power Doppler findings in a case of hepatic AML with minimal fat content.- - - - - - - - - - ranking = 0.01601661117747keywords = vessel (Clic here for more details about this article) |
10/73. Retroperitoneal epithelioid angiomyolipoma leading to fatal outcome.Epithelioid angiomyolipoma (AML) is a newly established variant of AML, characterized by monomorphous epithelioid cells that show HMB-45 immunopositivity, and it often displays aggressive behavior. To date, they have mostly appeared in the kidneys; however, the present autopsy case of a 43-year-old female without the stigmata of tuberous sclerosis complex had a huge retroperitoneal mass, accompanied by involvement of the regional lymph nodes. Histopathologically, the tumor was composed of round, polygonal or short spindle-shaped monomorphous cells with abundant eosinophilic cytoplasm and large nuclei with frequent multinucleation. Mitotic figures were scattered. Mature fat cells and thick-walled abnormal blood vessels were totally absent. Immunohistochemically, the tumor cells were reactive with HMB-45 and alpha-smooth muscle actin antibodies. In spite of curative surgery and repeated radio- and chemotherapy, the tumor continued to grow and brought about the patient's death 4 years after the initial symptoms. At autopsy, the peritoneal cavity was filled with the tumor mass exceeding 5.5 kg. Histopathological features were essentially the same as those of biopsy samples, but the cellular pleomorphism and emperipolesis were more easily identified. This report calls attention to this unusual manifestation of AML in the retroperitoneum and the importance of distinguishing it from sarcomas and/or paragangliomas.- - - - - - - - - - ranking = 1keywords = blood vessel, vessel (Clic here for more details about this article) |
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