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Adult renal hamartomas

B J Wagner1, J J Wong-You-Cheong, C J Davis

  • 1Department of Radiologic Pathology, Armed Forces Institute of Pathology, Washington, DC 20306, USA.

Radiographics : a Review Publication of the Radiological Society of North America, Inc
|January 1, 1997
PubMed
Summary

Renal angiomyolipomas are rare benign tumors diagnosed via imaging. Their appearance varies, but fat content is key for diagnosis, distinguishing them from renal cell carcinoma.

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Area of Science:

  • Radiology
  • Oncology
  • Pathology

Background:

  • Renal angiomyolipomas are uncommon hamartomas.
  • They are of limited clinical importance but diagnostically significant in radiology.
  • Their varied composition can lead to diverse radiologic presentations.

Purpose of the Study:

  • To describe the radiologic features of renal angiomyolipomas.
  • To highlight the diagnostic challenges posed by atypical presentations and the absence of fat.
  • To differentiate angiomyolipomas from other renal lesions, particularly renal cell carcinoma.

Main Methods:

  • Review of sonographic and computed tomography (CT) findings in renal angiomyolipomas.
  • Analysis of imaging characteristics related to tumor composition (fat content) and presence of hemorrhage.
  • Comparison with imaging features of renal leiomyoma and renal cell carcinoma.

Main Results:

  • Sonography shows echogenic masses with acoustic shadowing.
  • CT typically reveals well-marginated, small, cortical masses with fat attenuation and interspersed soft tissue.
  • Hemorrhage can cause larger, poorly marginated lesions.
  • Angiomyolipomas lacking fat are indistinguishable from renal cell carcinoma on imaging.
  • Renal leiomyomas appear homogeneous without detectable fat, mimicking malignant lesions.

Conclusions:

  • Radiologic diagnosis of renal angiomyolipomas is achievable in most cases, primarily based on fat content.
  • Atypical features like hemorrhage or absence of fat can complicate diagnosis.
  • Distinguishing fat-poor angiomyolipomas and renal leiomyomas from renal cell carcinoma remains a challenge.

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