Angiomyolipoma of the liver: Its clinical and pathological diversity

Springer Science and Business Media LLC - Tập 3 - Trang 122-132 - 1996
Akitaka Nonomura1, Yuji Mizukami1, Masumi Kadoya2, Osamu Matsui2, Kohichi Shimizu3, Ryohei Izumi3
1Pathology Section, Kanazawa University Hospital, School of Medicine Kanazawa University, Kanazawa, Ishikawa, Japan
2Department of Radiology, Kanazawa University Hospital, School of Medicine, Kanazawa University, Kanazawa, Ishikawa, Japan
3Department of Surgery, Kanazawa University Hospital, School of Medicine, Kanazawa University, Kanazawa, Ishikawa, Japan

Tóm tắt

Eighty cases (82 tumors) of hepatic angiomyolipoma (AML) from the world literature were reviewed, including our 8 cases. The tumors occurred predominantly in females (female: male ratio, 56∶24). Only six patients (7.5%) had associated tuberous sclerosis. The majority of the tumors (95%) occurred in non-cirrhotic, almost normal liver. The tumors usually presented as a hyperechoic mass on ultrasound (US) examination, a hypodense mass on computed tomography (CT) scan, and hyperintense mass on both T1- and T2-weighted magnetic resonance (MR) imagings. However, the imaging features of the tumor were occasionally variable according to the content of fat tissue component, and the tumors could not be clearly differentiated from other hepatic tumors, particularly hepatocellular carcinoma (HCC), based on the imaging features alone. Tumor location was recorded in 81 tumors; 44 were located in the right lobe, 30 in the left, 5 in the caudate, and 2 in both lobes of the liver. The tumor diameter ranged from 0.3 to 36cm (mean, 8.0±7.0cm). Macroscopically, the tumors usually had no fibrous capsule. The cut surface was yellow to dark brown depending on the amount of fat tissue or blood vessels. The histologic features were quite variable and occasionally included atypical and/or pleomorphic cells, which could lead to the erroneous diagnosis of a variety of benign and malignant tumors, including lipoma, leiomyoma, HCC, hepatoblastoma, leiomyosarcoma, and malignant fibrous histiocytoma. Extramedullary hematopoiesis was found in 33% of the tumors. Reactivity of the tumor cells of the liver with HMB-45, a melanoma-specific antibody, can accurately establish the diagnosis of AML.

Tài liệu tham khảo

Nonomura A, Mizukami Y, Kadoya M (1994) Angiomyolipoma of the liver: A collective review J Gastroenterol 29:95–105 Murphy WM, Beckwith JB, Farrow GM (1993) Tumor of the kidney, bladdor, and related urinary structures. In: Rosai J, Sobin LH (eds) Atlas of tumor pathology, third series, fascicle 11, Washington, DC, Armed Forces Institute of Pathology, pp 161–175 Ishak KG (1976) Mesenchymal tumors of the liver. In: Okuda K, Peters RL (eds) Hepatocellular carcinoma. Wiley Medical, New York, pp 247–307 Hagiwara T, Nagata I, Yoshizaki I, Takahashi I, Eriguchi M, Miyamoto H, Fujii G (1980) A fare hepatic tumor, preoperatively suspected hepatocellular carcinoma (abstract, in Japanese). Jpn J Gastroenterol Surg 13:439 Pounder DJ (1982) Hepatic angiomyolipoma. Am J Surg Pathol 6:677–681 Ishida H, Inoue S, Awazu T (1983) A case of hepatic angiomyolipoma (in Japanese). Naika (Internal Medicine) 51:325 Kawarada Y, Mizumoto R (1983) Angiomyolipoma of the liver. Am J Gastroenterol 78:434–439 Goodman ZD, Ishak KG (1984) Angiomyolipoma of the liver. Am J Surg Pathol 8:745–750 Ueda Y, Mimura H, Tsumura M, Kashino H, Nagata H, Orita K (1984) A case of hepatic artery aneurysm with a big hepatic angiomyolipoma (in Japanese) Acta Hepatol Jap 25:925–930 Grippom P, Desaint B, Herve de Sigalon JP, Huguet C, Levy VG (1985) Angiomyolipome du foie. Une decouverte echographique fortuite. Gastroenterol Clin Biol 9:88–89 Keida Y, Miyagi M, Shaka T, Masaoka K, Yogi K, Miura T, Kunishima M (1986) A case of hepatic angiomyolipoma (abstract, in Japanese) Jpn J Gastroenterol 83:290 Nakajima K, Kimura T, Kojima H, Shinozaki K, Harada K, Toshi M (1987) A case of hepatic angiomyolipoma (abstract, in Japanese) Jpn J Gastroenterol 84:341 Hirano T, Korematsu M, Moronaga Y, Kobayashi K, Ebara T, Shimoji K, Hosoda Y (1987) A case of hepatic angiomyolipoma (abstract, in Japanese) J Jpn Soc Clin Cytol 26:333 Takayasu K, Shima Y, Muramatsu Y, Moriyama N, Yamada T, Makuuchi A, Hirohashi S (1987) Imaging characteristics of large lipoma and angiomyolipoma of the liver. Case reports. Cancer 59:916–921 Blumgart RL, Payne M, Rhodes AH. Case report: Angiomyolipoma of the liver (1987) Clin Radiol 38:329–330 Liessi G (1987) Lipomi ed angiomiolipomi del fegato. Radiol Med 74:471–473 Aoki Y, Hirai K, Shakado S, Iwai I, Ito H, Yamashita K, Kawazoe Y, Sakai T, Majima Y, Sato K, Kaga A, Tomoda N, Nakayama K, Sugihara S, Kosiro M, Fujiyoshi Y (1987) A case report of hepatic angiomyolipoma (in Japanese). Acta Hepatol Jap 28:966–970 Miyahara M, Kobayashi M, Tada I, Okada K, Sato K, Kim Y I, Hiraoka T, Yokoyama S (1988) Giant hewpatic angiomyolipoma simulating focal nodular hyperplasia. Jpn J Surg 18:346–350 Fobbe F, Hamm B, Schwarting R (1988) Angiomyolipoma of the liver: CT, MR, and ultrasound imaging. J Comput Assist Tomogr 12:658–659 Naito M, Yamamura F, Takahashi K, Iwasaki S, Mochinaga M (1988) Hepatic angiomyolipoma. A case report with review of the literature (in Japanese). Acta Pathol Jpn 38:799–804 Suga K, Ito S, Itose K, Nagasaki M, Sudo H, Yasunaga C, Sueishi K (1988) A case of hepatic angiomyolipoma (in Japanese). Gastroenterol Surg 11:101–104 Okada K, Yokoyama S, Nakayama I, Tada I, Kobayashi M (1989) An electron microscopic study of hepatic angiomyolipoma. Acta Pathol Jpn 39:743–749 Kristal H, Sperber F (1989) Hepatic angiomyolipoma in a tuberous sclerosis patient. Isr J Med Sci 25:412–414 Nguyen GK, Catzavelos C (1989) Solitary angiomyolipoma of the liver. Report of a case initially examined by fine needle aspiration biopsy. Acta Cytol 34:201–204 Ohmori T, Arita N, Uraga N, Tabei R, Yamamoto M, Kataoka M, Hamaoto K (1989) Giant hepatic angiomyolipoma. Histopathology 15:540–543 Schwartz P, Travers P, Hunt DR (1989) Angiomyolipoma of the liver. Aust NZ J Surg 59:969–971 Robinson J, Grant EG, Haller JO, Cohen HL (1989) Hepatic angiomyolipoma in tuberous sclerosis. Report of two cases. J Ultrasound Med 8:575–578 Yokoyama S, Nakayama I, Okada K, Tada I, Kobayashi M, Terao H (1990) Three cases of hepatic angiomyolipoma (in Japanese with English abstract). Pathol Clin Med 8:121–128 Miyazaki T, Yakehana T, Mou M, Minamide J, Shimizu T, Tomita Y, Arita E, Arita M. A case of hepatic angiomyolipoma (abstract, in Japanese). Acta Hepatol Jpn 31:999 Fujiwara S, Okamoto E, Toyasaka A, Yamanaka W, Mitsunobu M, Fujimoto J, Oriyama T, Kato T, Manabu Y, Furukawa K, Inoue A, Yoshimura J. Two cases of hepatic angiomyolipoma (abstract, in Japanese). Acta Hepatol Jap 31:999 Yamagiwa K, Higashiguchi T, Yokoi H, Imai T, Noguchi T, Kawarada Y, Mizumoto R, Yatani T. A Case of hepatic angiomyolipoma and two cases of hepatic malignant mixed tumor (abstract, in Japanese). Acta Hepatol Jap 31:1000 Linton PL, Ahn WS, Schwartz ME, Miller CM, Thung SN (1991) Angiomyolipoma of the liver: Immunohistochemical study of a case Liver 11:158–161 Tanabe Y, Yoshida K, Shinomiya S, Tominaga K, Hiroshige K, Koyanagi N, Takenaka K, Irisa T (1991) A case of hepatic angiomyolipoma simulating hepatocellular carcinoma on diagnostic imagings due to atypical histological findings. Jpn J Gastroenterol 88:1608–1611 Weeks DA, Malott RL, Arnesen M, Zuppan C, Aitken D, Mierau G (1991) Hepatic angiomyolipoma with striated granules and positivity with melanoma-specific antibody (HMB-45): A report of two cases. Ultrastructural Pathol 15:563–571 Tsui WMS, Yuen AKT, Ma KF, Tse CCH (1992) Hepatic angiomyolipoma with deceptive trabecular pattern and HMB-45 reactivity. Histopathol 21:569–573 Akatsu J, Tanaka H, Unoki H, Miura Y, Nagafuchi Y, Ohsato K, Furuta A, Otsuki M (1992) A case of hepatic antiomyolipoma mimicking a small liver cancer. Jpn J Gastroenterol 89:1305–1309 Mas CR, Gubernatis H, Pichlamyr R, Riemann JF (1992) Das solitäre Angiomyolipom der Leber. Leber Magen Darm 22:32–34 Nonomura A, Mizukami Y, Isobe M, Kurachi M, Matsubara F (1993) Smallest angiomyolipoma of the liver in the oldest patient. Liver 13:51–53 Masamune A, Okano T, Satake K, Yonemoto H, Toyota T (1993) A case of hepatic angiomyolipoma in follow up after established diagnosis by ultrasonography-guided aspiration biopsy (in Japanese). Jpn J Gastroenterol 90:180–184 Kajino S, Yoshioka N, Hasegawa C, Iizuka N, Suzuki T (1993) A case of hepatic angiomyolipoma (abstract, in Japanese) Acta Pathol Jpn 34 [Suppl 2]:104 Kudo M, Okuno T, Tomita S, Kajiwara T, Shirane H, Usuki N, Todo A (1993) Hepatic angiomyolipoma pre-operatively diagnosed by imaging. J Gastroenterol Hepatol 8:483–488 Yamada N, Shinzawa H, Makino N, Matsuhashi T, Itasaka S, Takahashi T, Fuyama S (1993) Small angiomyolipoma of the liver diagnosed by fine-needle aspiration biopsy under ultrasound guidance. J Gastroenterol Hepatol 8:495–498 Castiglione V, Fronti P, Cardinale L, Berti E, Todeschini G (1993) Angiomyolipoma epatico. Reperti ecografici, tomodensitometrici e angiografici, Radiol Med Torino 85:862–865 Henry L, Paliard P, Valette PJ, Labadie M, Berger F, Syschenko R, Barth X, Partensky C (1993) Angiomyolipomes du foie. Aspects diagnostiques et thérapeutiques de 4 observations et revue de la littérature. Gastroenterol Clin Biol 17:56–60 Murakami T, Nakamura H, Hori S, Nakamishi K, Mitani T, Kozuka T, Kimura Y, Monden M, Wakasa K, Sakurai M (1993) Angiomyolipoma of the liver. Ultrasound, CT, MR imaging and angiography Acta Radiol 34:392–394 Nonomura A, Mizukami Y, Muraoka K, Yajima M, Oda T (1994) Angiomyolipoma of the liver with pleomorphic histological features. Histopathol 24:279–281 Ma TKF, Tse MK, Tsui WMS, Yuen KT (1994) Fine needle aspiration diagnosis of angiomyolipoma of the liver using a cell block with immunohistochemical study. A case report. Acta Cytol 38:257–260 Lebreuil G, Le Treut YP, Garcia S, Chapel F, Marchetti B, De Micco C (1994) Angiomyolipome hépatique. A propos de deux cas et revue de la littérature. Ann Gastroenterol Hépatol (Paris) 30:19–24 Ishii K, Ichikawa T, Harada D, Nakano M (1994) A case of hepatic angiomyolipoma with HMB-45 reactivity, a melanoma specific antibody useful for pathologic diagnosis of anigiomyolipoma (in Japanese). Byoin Byori (J Jpn Assoc Pathol) 11:161 Low VHS, Breidahl WH, Robbins PD (1994) Hepatic angiomyolipoma. Abdom Imaging 19:540–542 Bergeron P, Oliva AL, Lalonde L, Allaire G, Déry R, Bui BT, Daloze P, AbouJaoude M. Liver angiomyolipoma: Classic and unusual presentations. Abd Imaging 19:543–545 Chang JC, Lee YW, Kim HJ (1994) Preoperative diagnosis of angiomyolipoma of the liver. Abdom Imaging 19:546–548 Hooper LD, Mergo PJ, Ros PR (1994) Multiple hepatorenal angiomyolipomas: Diagnosis with fat suppression, gadoliniumenhanced MRI, Abdom Imaging 19:549–551 Carmody E, Yeung E, McLoughlin M (1994) Angiomyolipomas of the liver in tuberous sclerosis. Abdom Imaging 19:537–539 Tashiro K, Kasahara M, Mizoguchi Y, Horibe Y, Inoue M, Kenmoto Y, Imazu M, Wakita H, Nonomura A (1995) A case of hepatic angiomyolipoma (abstract, in Japanese). Trans Soc Pathol Jap 84:334 Nonomura A, Mizukami Y, Kadoya M, Takayanagi N, Hirono T (1995) Multiple angiomyolipoma of the liver. J Clin Gastroenterol 20:248–251 Nonomura A, Mizukami Y, Shimizu K, Masuda S, Ishii K, Tashiro K, Mizoguchi Y (1995) Histologic classification of hepatic angiomyolipoma (Abstract, in Japanese). Acta Hepatol Jpn 36 (Suppl 3):164 Bret PM, Bretagnolle M, Gaillard D, Plauchu H, Labadie M, Lapray JF, Roullaud Y, Cooperberg P (1985) Small, asymptomatic angiomyolipoma of the kidney. Radiology 154:7–10 Nonomura A, Mizukami Y, Takayanagi N, Masuda S, Ishii K, Tashiro K, Mizoguchi Y (1996) Immunohistochemical study of hepatic angiomyolipoma. Pathol Internat 46:24–32 Chan JKC, Tsang WYW, Pau MY, Tang MC, Pang SW, Fletcher CDM (1993) Lymphoangiomyomatosis and angiomyolipoma: Closely related entities characterized by hamartomatous proliferation of HMB-45-positive smooth muscle cells. Histopathology 22:445–455 Bacchi CE, Gown AM (1992) Specificity of antibody HMB-45. Arch Pathol Lab Med 116:899–900 Yates AJ, Banerjee SS, Bishop PW, Graham KE (1993) HMB-45 in non-melanocytic tumours. Histopathology 23:477–478 Gaffery ML, Mills SE, Zarbo RJ, Weiss LM, Gown AM (1991) Clear cell tumor of the lung. Immunohistochemical and ultrastructural evidence of melanogenesis. Am J Surg Pathol 15:644–653 Ishak KG, Anthony PP, Sobin LH (1994) Nonepithelial tumours. In: Ishak KG, Anthony DP, Sobin LH (eds) Histological typing of tumours of the liver. World Health Organization international histological classification of tumours, 2nd edn. Springer, Berlin Heidelberg Tokyo New York, pp. 22–27 Wassermann F (1965) The development of adipose tissue. In: Renold AE, Cahill GF (eds) Handbook of physiology, sect. 5, adipose tissue. Willams and Wilkins, Baltimore, pp 87–100 Rhodin JAG (1968) Ultrastructure of mammalian venous capillaries, venules, and small collecting veins. J Ultrastruct Res 25:452–500 Kapur RP, Bigler SJ, McGrath E, Skelly M, Gown AM (1991) Anti-melanoma antibody identifies an oncofetal premelanosome-associated glycoprotein. Mod Pathol 4:105A Smoller BR, Hsu A, Krueger J (1991) HMB-45 moncolonal antibody recognizes an inducible and reversible melanocyte cytoplasmic protein. J Cutan Pathol 18:315–322 Wick MR (1991) HMB-45; a clue to the biology of malignant melanoma? J Cutan Pathol 18:307–308 Taatjes DJ, Durand BA, von Turkovich M, Trainer TD (1993) HMB-45 antibody demonstrated melanosome specificity by immunoelectron microscopy. Arch Pathol Lab Med 117:264–268 Wang J, Dhillon AP, Sankey EA, Wightman AK, Lewin L, Scheuer PJ (1991) Neuroendocrine differentiation in primary neoplasms of the liver. J Pathol 163:61–67 Nonomura A, Kono N, Mizukami Y, Nakanuma Y, Matsubara F (1992) Duct-acinar-islet tumor of the pancreas. Ultrastruct pathol 16:317–329 Kiyomatsu K (1989) Pathomorphological study on hepatocellular carcinoma (HCC): A study of fatty change in HCC (in Japanese, with English abstract). Acta Hepatol Jpn 30:974–979 Kadoya M, Matsui S, Takashim T, Nonomura A (1992) Hepatocellular carcinoma: Correlation of MR image and histopathologic findings. Radiology 183:819–825 Yoshikawa J, Matsui O, Takashima T, Ida M, Takanaka T, Kawamura I, Kakuda K, Miyata S (1988) Fatty metamorphosis in hepatocellular carcinoma: Radiologic features in ten cases. AJR 151:717–720 Kragel PJ, Toker C (1985) Infiltrating recurrent renal angiomyolipoma with fatal outcome. J Urol 133:90–91 Lowe BA, Brewer J, Houghton DC, Jacobson E, Pitre T (1992) Malignant transformation of angiomyolipoma. J Urol 147:1356–1358 Ferry JA, Malt RA, Young RH (1991) Renal angiomyolipoma with sarcomatous transformation and pulmonary metastases. Am J Surg Pathol 15:1083–1088