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Published on: March 30, 2015
Spectrum of Renal Angiomyolipoma with Radiologic-Pathologic Correlation
Meghan G Lubner1, Jamie Marko1, Myles T Taffel1
1From the Department of Radiology, University of Wisconsin School of Medicine and Public Health, Madison, Wis (M.G.L.); American College of Radiology Institute for Radiologic Pathology, 1100 Wayne Ave Suite 1020, Silver Spring, MD, 20910 (M.G.L., J.M., M.T.T., J.M.H.); Department of Radiology, NYU Langone Health, New York, NY (M.T.T.); Department of Radiology, Northwestern University Feinberg School of Medicine, Chicago, Ill (J.M.H.); and Department of Pathology, University of Michigan Medical School, Ann Arbor, Mich (A.M.U.).
Angiomyolipoma (AML) is a benign tumor composed of fat, muscle, and vessels. While typically benign, AMLs can cause hemorrhage and may require intervention based on size and type.
Area of Science:
- Radiology
- Pathology
- Oncology
Background:
- Angiomyolipoma (AML) is a mesenchymal tumor characterized by a mix of vascular, smooth muscle, and adipose tissues.
- AMLs are associated with tuberous sclerosis complex (TSC) and lymphangioleiomyomatosis (LAM).
- Imaging findings of AMLs correlate with their pathological composition, distinguishing classic (fat-containing) from fat-poor variants.
Purpose of the Study:
- To review the imaging characteristics and clinical behavior of angiomyolipomas.
- To discuss the histopathologic features and potential complications of AMLs.
- To outline current treatment strategies for AMLs based on their presentation and risk factors.
Main Methods:
- Review of imaging findings (CT, MRI) in relation to histopathology.
- Analysis of clinical data regarding tumor behavior, complications, and treatment outcomes.
- Correlation of imaging features with tumor components (fat, smooth muscle).
Main Results:
- Fat-poor AMLs exhibit specific imaging features like increased CT attenuation and low T2 signal due to smooth muscle predominance.
- Hemorrhage is a significant complication, particularly in large AMLs or those with aneurysms ≥5 mm.
- Epithelioid AML (EAML) variants may show aggressive behavior, including recurrence and metastasis.
Conclusions:
- AML imaging appearance is highly predictive of its composition and behavior.
- Management of AMLs ranges from observation to intervention, tailored to lesion characteristics and patient factors.
- Understanding AML variants and potential complications is crucial for effective clinical management.
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