J Korean Soc Radiol.  2010 Aug;63(2):173-176.

CT and MRI Findings of Angiomyolipoma with Epithelial Cysts of the Kidney: A Case Report

• Yeo DM
• Chung DJ
• Kim TJ
• Lee IK
• Hahn ST
• Lee JM

Abstract

Angiomyolipoma with epithelial cysts (AMLEC) or cystic angiomyolipoma has been recently described as a distinct cystic variant of angiomyolipoma. Although angiomyolipoma (AML) is usually composed of adipose, vascular, and muscular tissue lacking an epithelial element, AMLEC contains an epithelial component in the form of gross or microscopic cysts. To date, the radiologic appearance of AMLEC has been demonstrated in only one case report, as a solid mass containing a tiny cystic focus. This report shows another imaging feature of AMLEC, which presents as a multiloculated cystic mass without a visible solid portion on CT and MRI.

MeSH Terms

Angiomyolipoma
Kidney Diseases, Cystic
Kidney Neoplasms

Figure

• 

  Fig. 1 Cystic angiomyolipoma in the right kidney presenting with a multilocular cystic mass in a 67-year-old man. A, B. Enhanced axial (A) and coronal (B) CT scans show an exophytic multilocular cystic mass with an enhancing thin wall and septa (arrows). There is no enhancing mural nodule in the mass, which suggests the presence of a Bosniak III lesion. C, D. Coronal T2-weighted MR image (C) shows a homogenous high signal intensity fluid in the whole locules of the mass. A fat-suppressed enhanced T1-W image (D) reveals an enhancement of the thin wall and septa, without a solid component. E. The gross specimen of an excised renal mass. The mass shows a well-demarcated multi-cystic cut surface with no evidence of capsular or cortical invasion. F, G. The microscopic examinations of the mass show multiple cysts (arrows) and stroma (asterisks) (F, H & E ×40). The stroma are comprised of smooth muscle bundles admixed with small or medium sized vessels and adipose tissue (G, H & E ×100).

Reference

1. Armah HB, Yin M, Rao UN, Parwani AV. Angiomyolipoma with epithelial cysts (AMLEC): a rare but distinct variant of angiomyolipoma. Diagn Pathol. 2007; 2:11–15.

2. Davis CJ, Barton JH, Sesterhenn IA. Cystic angiomyolipoma of the kidney: a clinicopathologic description of 11 cases. Mod Pathol. 2006; 19:669–674.

3. Rosenkrantz AB, Hecht EM, Taneja SS, Melamed J. Angiomyolipoma with epithelial cysts: mimic of renal cell carcinoma. Clin Imaging. 2010; 34:65–68.

4. Aydin H, Magi-Galluzzi C, Lane BR, Sercia L, Lopez JI, Rini BI, et al. Renal angiomyolipoma: clinicopathologic study of 194 cases with emphasis on the epithelioid histology and tuberous sclerosis association. Am J Surg Pathol. 2009; 33:289–297.

5. Fine SW, Reuter VE, Epstein JI, Argani P. Angiomyolipoma with epithelial cysts (AMLEC): a distinct cystic variant of angiomyolipoma. Am J Surg Pathol. 2006; 30:593–599.

6. Leung CS, Srigley JR, Stone CH, Amin BM. Epithelial tubules, cysts and neoplasms in renal angiomyolipoma (AML) : a study of 32 cases. Mod Pathol. 1998; 11:87A abstract 501.

7. Mikami S, Oya M, Mukai M. Angiomyolipoma with epithelial cysts of the kidney in a man. Pathol Int. 2008; 58:664–667.

8. Freire M, Remer EM. Clinical and radiologic features of cystic renal masses. AJR Am J Roentgenol. 2009; 192:1367–1372.