Angiomyolipoma pathophysiology: Difference between revisions
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Features<ref name=pmid15584043>{{Cite journal | last1 = Crapanzano | first1 = JP. | title = Fine-needle aspiration of renal angiomyolipoma: cytological findings and diagnostic pitfalls in a series of five cases. | journal = Diagn Cytopathol | volume = 32 | issue = 1 | pages = 53-7 | month = Jan | year = 2005 | doi = 10.1002/dc.20179 | PMID = 15584043 }}</ref> | Features<ref name=pmid15584043>{{Cite journal | last1 = Crapanzano | first1 = JP. | title = Fine-needle aspiration of renal angiomyolipoma: cytological findings and diagnostic pitfalls in a series of five cases. | journal = Diagn Cytopathol | volume = 32 | issue = 1 | pages = 53-7 | month = Jan | year = 2005 | doi = 10.1002/dc.20179 | PMID = 15584043 }}</ref> | ||
*Nuclei - round/ovoid. | *Nuclei - round/ovoid. | ||
*Chromatin - bland. | *Chromatin - bland.==IHC== | ||
*Melanocytic markers +ve.<ref name=Ref_GUP324>{{Ref GUP|324}}</ref> | |||
**HMB-45 +ve in all cases (15/15).<ref name=pmid23932749>{{Cite journal | last1 = Esheba | first1 = Gel S. | last2 = Esheba | first2 = Nel S. | title = Angiomyolipoma of the kidney: clinicopathological and immunohistochemical study. | journal = J Egypt Natl Canc Inst | volume = 25 | issue = 3 | pages = 125-34 | month = Sep | year = 2013 | doi = 10.1016/j.jnci.2013.05.002 | PMID = 23932749 }} | |||
</ref> | |||
**Melan A +ve in ~87% of cases (13/15). | |||
*Epithelial markers -ve<ref name=Ref_GUP324>{{Ref GUP|324}}</ref>, e.g. EMA and AE1/AE3. | |||
*SMA +ve. | |||
*CD117 +ve/-ve. | |||
*Ki-67:<ref name=pmid18839327>{{Cite journal | last1 = Ooi | first1 = SM. | last2 = Vivian | first2 = JB. | last3 = Cohen | first3 = RJ. | title = The use of the Ki-67 marker in the pathological diagnosis of the epithelioid variant of renal angiomyolipoma. | journal = Int Urol Nephrol | volume = 41 | issue = 3 | pages = 559-65 | month = | year = 2009 | doi = 10.1007/s11255-008-9473-1 | PMID = 18839327 }}</ref> | |||
**Epithelioid variant of AML +ve. | |||
**Conventional AML -ve. | |||
Revision as of 20:59, 21 September 2015
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1] Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [2], Faizan Sheraz, M.D. [3]
Overview
Pathophysiology
Gross
- Well circumscribed - uniform yellow.
Since all three components of an angiomyolipoma (vascular cells, immature smooth muscle cells and fat cells) contain a "second hit" mutation, they are believed to have derived from a common progenitor cell that suffered the common second hit mutation. Angiomyolipomas are members of the perivascular epithelioid cells tumour group (PEComas) and are composed of variable amounts of three components;blood vessels (-angio), plump spindle cells (-myo) and adipose tissue (-lipo). Almost all classic angiomyolipomas are benign but they do have the risk of rupture with bleeding or secondary damage/destruction of surrounding structures as they grow.
Variants
There is a special variant called an epithelioid angiomyolipoma, composed of more plump, epithelial looking cells, often with nuclear atypia, that have a described risk of malignant behaviour. This variant, unlike conventional AMLs, may mimic renal cell carcinoma.10 Metastases have also been described 9.
Microscopic Pathology
Microscopic
Features:
- Smooth muscle.
- Adipose tissue - not always present[1] - key feature.
- Abundant blood vessels.
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_HMB-45_immunostain.JPG)
Cytologic
Features[1]
- Nuclei - round/ovoid.
- Chromatin - bland.==IHC==
- Melanocytic markers +ve.[2]
- HMB-45 +ve in all cases (15/15).[3]
- Melan A +ve in ~87% of cases (13/15).
- Epithelial markers -ve[2], e.g. EMA and AE1/AE3.
- SMA +ve.
- CD117 +ve/-ve.
- Ki-67:[4]
- Epithelioid variant of AML +ve.
- Conventional AML -ve.
References
- ↑ 1.0 1.1 Crapanzano, JP. (2005). "Fine-needle aspiration of renal angiomyolipoma: cytological findings and diagnostic pitfalls in a series of five cases". Diagn Cytopathol. 32 (1): 53–7. doi:10.1002/dc.20179. PMID 15584043. Unknown parameter
|month=ignored (help) - ↑ 2.0 2.1 Template:Ref GUP
- ↑ Esheba, Gel S.; Esheba, Nel S. (2013). "Angiomyolipoma of the kidney: clinicopathological and immunohistochemical study". J Egypt Natl Canc Inst. 25 (3): 125–34. doi:10.1016/j.jnci.2013.05.002. PMID 23932749. Unknown parameter
|month=ignored (help) - ↑ Ooi, SM.; Vivian, JB.; Cohen, RJ. (2009). "The use of the Ki-67 marker in the pathological diagnosis of the epithelioid variant of renal angiomyolipoma". Int Urol Nephrol. 41 (3): 559–65. doi:10.1007/s11255-008-9473-1. PMID 18839327.