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2014 ; 93
(28
): e194
Nephropedia Template TP
gab.com Text
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English Wikipedia
Hepatic angiomyolipoma mimicking hepatocellular carcinoma: magnetic resonance
imaging and clinical pathological characteristics in 9 cases
#MMPMID25526436
Wang CP
; Li HY
; Wang H
; Guo XD
; Liu CC
; Liu SH
; Gao XD
; Qu JH
; Liu Z
; Chang XJ
; Lu YY
; Zeng Z
; Lou M
; Yang YP
Medicine (Baltimore)
2014[Dec]; 93
(28
): e194
PMID25526436
show ga
Hepatic angiomyolipoma (HAML) is a rare mesenchymal tumor of the liver with
marked histological diversity. The present study was to review the magnetic
resonance imaging (MRI) and clinical pathological features of HAML resembling
hepatocellular carcinoma (HCC). Nine patients who underwent surgical resection
and had pathological diagnosis of HAML were retrospectively analyzed. All of 9
patients (5 males and 4 females) had a solitary hepatic mass with a median size
of 4?cm (from 1.4?cm to 15.3?cm). Seven cases were identified as incidental liver
tumors during health screening and 2 patients were diagnosed for hepatic mass
when visited hospitals with unspecific abdominal discomfort. Before resection, 6
cases were diagnosed as HCC on MRI. MRI on chemical shift imagings showed a large
amount of lipids in 5 cases. The enhancement pattern of MRI was classified into 2
types: in 2 cases, lesions with small or no vessels that demonstrated prolonged
enhancement (1 mixed subtype and 1 myomatous subtype) and in 7 cases, lesions
with abundant central vessels that show rapid washout (3 mixed subtypes and 4
myomatous subtypes) in the portal venous/delayed phase. All patients underwent
resection of hepatic tumor and no recurrence was observed during follow-up
(range: 2-24 months) of median 10 months. By immunohistochemistry, the tumor
cells demonstrated positive immunostaining for human melanoma black-45, smooth
muscle actin, and CD34. In conclusion, all of 9 patients with HAML presented with
none or nonspecific clinical manifestations. The diagnosis of HAML relies on
disease and immunohistochemistry, but not MRI due to its resemblance to HCC.