Korean J Urol.  2007 Jun;48(6):655-658. 10.4111/kju.2007.48.6.655.

Renal Angiomyolipoma Partially Containing Epithelioid Component

• Kim HM
• Park JM
• Yang SW
• In YH
• Kim MG
• Yang WJ
• Sung LH
• Chung JY
• Kim HJ
• Kim SH

• KMID: 1885550
• DOI: http://doi.org/10.4111/kju.2007.48.6.655

Abstract

Epithelioid renal angiomyolipoma is a recently recognized pathologic variant of angiomyolipoma, which represents a more malignant course than a classical renal angiomyolipoma. We report a case of histologically proven renal angiomyolipoma. The patient presented with the symptoms and signs of spontaneous rupture of the kidney. On surgical exploration, the ruptured kidney with upper pole kidney mass was resected. The enlarged regional lymph nodes were also removed, which showed the same pathology.

Keyword

Epithelioid cells; Angiomyolipoma; Kidney

MeSH Terms

Angiomyolipoma*
Epithelioid Cells
Humans
Kidney
Lymph Nodes
Pathology
Rupture, Spontaneous

Figure

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  Fig. 1 The computed tomography (CT) pre-enhanced (A) and enhanced (B) images. A tumor contains fat and an enhancing solid portion. The high-attenuating material suggests hematoma, which is visible in the perirenal space.

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  Fig. 2 An ill-defined fibrofatty mass (6.5×5.5×3cm) is located at the upper pole of the left kidney. The surrounding perirenal fat tissue contains a large number of blood clots.

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  Fig. 3 The tumor is composed of a heterogenous populations of a mature fat tissue, spindle cells and thick walled vessels (H&E, ×100).

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  Fig. 4 (A) The medium power view shows epithelioid tumor cells arising from the vessel (H&E, ×100). (B) HMB-45 immunostaining is focally positive in some epithelioid tumor cells (HMB-45, ×400).

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  Fig. 5 The para-aortic lymph nodes showed an aggregation of spindle-to-ovoid tumor cells in the juxtacapsular area. However, the pericapsular sinus or intranodal structures are intact and not involved with tumor emboli. This supports that this is multifocality rather than true metastasis (H&E, ×100).

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