angiomyolipoma; AML HMB-45

Size: px

Start display at page:

Download "angiomyolipoma; AML HMB-45"

Octavia Watkins
5 years ago
Views:

1 FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF Vol. 3, pp , 2003 FFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFFF HMB-45 angiomyolipoma; AML AML HMB-45 angiomyolipoma;aml 3 3 HMB-45 AML HMB-45 AML 30 mm 53 cm 5 kg 2 3

diameter is identified in the lateral segment. a b Fig.

a) A non-enhanced CT demonstrating a slightly

b) The mass is well enhanced on arterial phase.

2 Fig.. Abdominal ultrasonography. Solitary hyperechoic mass measuring about 30mm in diameter is identified in the lateral segment. a b Fig.2. Abdominal computed tomography (CT) image. a) A non-enhanced CT demonstrating a slightly low-density in the liver. b) The mass is well enhanced on arterial phase. A cyst is demonstrated near the tumor. c) The mass is a low-density area on portal phase. c T2 Fig. 3 Fig mm Fig. CT Fig. 2 MRI T S2 2

a b Fig. 3. Abdominal magnetic resonance images.

hepatic lobe on T2 weighted image. Fig.4.

Round-shaped hypervascular mass is detected in the left

A cut section of the partial resected liver.

A portion of the hepatic angiomyolipoma (HE, x 200).

3 a b Fig. 3. Abdominal magnetic resonance images. a) The mass with low-intensity on T weighted image. A cyst is demonstrated near the tumor. b) High signal intensity mass and a cyst are noted in left hepatic lobe on T2 weighted image. Fig.4. Abdominal angiography. Round-shaped hypervascular mass is detected in the left hepatic lobe(arrow). Fig. 5. A cut section of the partial resected liver. A well-circumscribed whitish mass is demonstrated. Fig.6. A portion of the hepatic angiomyolipoma (HE, x 200). The tumor is composed of epithelioid smooth muscle cells(dotted line), blood vessels (black arrow), and lipocytes(white arrow). Fig. 7. Immunohistochemical study for HMB-45 (x 200). Some of the smooth muscle cells are positive for HMB-45. 3

4 factor-viii Melanoma melan-a (MART-) 2.5 x 2.2 x antigen (HMB-45).6 cm Fig. 5 AML S S M A AML C D 3 CD 34 CT Fig. 6 HMB-45 MRI T Fig. 7 T2 hypervascular 8 ) AML A M L 976 I s h a k ) AML AML 50 HMB-45 AML AML % 7.5 % 2) 5 ) 0 ) 3 3 ) 3 AML AML AML HMB-45 AML Nonomura 4 ) epithelial membrane antigen E M A cytokeratin v i m e n t i n d e s m i n - S M A S - 00 n e u r o n - specific enolase NSE S-00 NSE S-00 m e l a n o m a - s p e c i f i c 5-7) AML v i r u s m a r k e r tumor marker AML 7) 9) 4

5 ) Ishak KG. Mesenchymal tumors of the liver. In:Okuda K, Peters RL (eds.), Hepatocellular carcinoma, Wiley Medical, New York, 976: ) Nonomura A, Mizukami Y, Kadoya M, Matsui O, Shimizu K and Izumi R. Angiomyolipoma of the liver : Its clinical and pathological diversity. J Hep Bil Pancr Surg 996; 3: ) Tsui WM, Yuen AK, Ma KF, Tse H. Hepatic angiomyolipomas with a deceptive trabecular pattern and HMB-45 reactivity. Histopathol 992; 2: ) Nonomura A, Mizukami Y, Takayanagi N, Masuda S, Ishii K, Tashiro K and Mizoguchi Y. Immunohistochemical study of hepatic angiomyolipoma. Pathol Int 996; 46: ),,,, 0) Guidi G, Catalano O and RotondoA. Spontaneous,. rupture of a hepatic angiomyolipoma:ct findings and. 2002; 43: ) Weeks DA, Malott RL, Arnesen M, Zuppan C, Aitken D and Mierau G. Hepatic angiomyolipoma with striated granules and positivity with melanomaspecific antibody (HMB-45): a report of two cases. Ultrastruct Pathol 99; 5: ),,,,,,, ; 43: ),,.. 997; 94: ) Dalle I, Sciot R, de Vos R, Aerts R, van Damme B, desmet V and Roskams T. Malignant angiomyolipoma of the liver:a hitherto unreported variant. Histpathol 2000; 36: literature review. Europ. Radiol. 997; 7:

6 Abstract A Case of Angiomyolipoma of the Liver with Minimum Adipose Cell Component Hiroko Takahashi, Shirou Maeyama, Masayuki Takagi, Mamoru Tadokoro Toshiyuki Uchikoshi, Yasuto Takahashi 2, Hitonobu Moriya 3, Susumu Yamaguchi 3 A case of angiomyolipoma (AML) of the liver is reported. The patient was a 6 years old man in whom a hyperechoic lesion measuring about 30mm in diameter was detected on urtrasonography (US). He underwent an operation because the tumor could not be distinguished from hepatocellular carcinoma. Pathological analysis of the surgical material revealed a tumor composed of three components; blood vessels, smooth muscles, and minimum adipose cells. Immunohistological study showed HMB-45 positive staining in some of the smooth muscle cells. The tumor was pathologically diagnosed as AML from these features. Generally, AML is difficult to distinguish from other hepatic tumors by imaging apparatus alone before operation, since the tumor has various extents of these three component cells, particularly, in the case with minimum adipose components. We reported a case of AML containing minimum adipose cells. The HMB-45 immunohistological staining was useful for the diagnosis of this rare disease. Department of Pathology, St. Marianna University School of Medicine 2 Division of Gastroenterology and Hepatology, Department of Internal Medicine, St. Marianna University School of Medicine 3 Division of Gastroenterological Surgery, Department of Surgery, St. Marianna University School of Medicine 6

Diagnosis and treatment of hepatic angiomyolipoma

Original Article Diagnosis and treatment of hepatic angiomyolipoma Shunda Du 1*, Ying Li 1*, Yilei Mao 1, Xinting Sang 1, Xin Lu 1, Wenze Wang 2, Qing Zhang 3, Huadan Xue 4, Xiaobo Yang 1, Shaohua Li 1,