Angiomyolipoma pathophysiology: Difference between revisions
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===Pathology=== | ===Pathology=== | ||
===Gross=== | ===Gross=== | ||
On gross pathology, well circumscribed and uniform yellow mass are characteristic findings of [[angiomyolipoma]]. | On gross pathology, well circumscribed and uniform yellow mass are characteristic findings of [[angiomyolipoma]].[[File:Angiomyolipoma-7.JPG | ||
|thumb|none|200px|Angiomyolipoma Gross Pathology]]<ref>Image courtesy of Dr Andrew Ryan. [http://www.radiopaedia.org Radiopaedia] (original file [http://radiopaedia.org/cases/angiomyolipoma-7]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC</ref> | |||
===Variants=== | ===Variants=== | ||
Revision as of 14:23, 25 September 2015
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Risk calculators and risk factors for Angiomyolipoma pathophysiology |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [2] Associate Editor-In-Chief: Cafer Zorkun, M.D., Ph.D. [3], Faizan Sheraz, M.D. [4]
Overview
On gross pathology, well circumscribed and uniform yellow mass are characteristic findings of angiomyolipoma.
Pathophysiology
Three components of an angiomyolipoma include:
- Vascular cells
- Immature smooth muscle cells
- Fat cells
They are 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)
- adipose tissue (-lipoma)
Pathology
Gross
On gross pathology, well circumscribed and uniform yellow mass are characteristic findings of angiomyolipoma.[[File:Angiomyolipoma-7.JPG |thumb|none|200px|Angiomyolipoma Gross Pathology]][1]
Variants
- Epithelioid angiomyolipoma
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.
Microscopic Pathology
Features:
- Smooth muscle.
- Adipose tissue - not always present[2] - key feature.
- Abundant blood vessels.
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_HMB-45_immunostain.JPG)
Cytologic
Features[2]
- Nuclei - round/ovoid.
- Chromatin - bland.
Immunohistochemistry
- Melanocytic markers +ve.[3]
- HMB-45 +ve in all cases (15/15).[4]
- Melan A +ve in ~87% of cases (13/15).
- Epithelial markers -ve[3], e.g. EMA and AE1/AE3.
- SMA +ve.
- CD117 +ve/-ve.
- Ki-67:[5]
- Epithelioid variant of AML +ve.
- Conventional AML -ve.
References
- ↑ Image courtesy of Dr Andrew Ryan. Radiopaedia (original file [1]).[http://radiopaedia.org/licence Creative Commons BY-SA-NC
- ↑ 2.0 2.1 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) - ↑ 3.0 3.1 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.