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adrenal epithelioid angiomyolipoma

Wednesday 14 July 2010

Epithelioid angiomyolipoma (AML) is an uncommon renal mesenchymal tumor with malignant potential and is frequently associated with tuberous sclerosis.

Extrarenal AMLs are rare.

Synopsis

- adrenal mass
- epithelioid smooth muscle cells

  • slightly pleomorphic nuclei
  • sometimes with prominent nucleoli
  • eosinophilic cytoplasm resembling oncocytic tumors.

Immunochemistry

Epithelioid cells were positive for melanoma (HMB45 and positive MelanA) and smooth muscle markers (alpha-smooth muscle-specific actin), but not for epithelial markers (cytokeratin, EMA).

Differential diagnosis

- renal cell carcinoma
- adrenal gland carcinoma
- metastatic carcinoma

References

- Monotypic epithelioid angiomyolipoma of the adrenal gland: an unusual site for a rare extrarenal tumor. D’Antonio A, Caleo A, Caleo O, De Dominicis G, Boscaino A. Ann Diagn Pathol. 2009 Oct;13(5):347-50. PMID: 19751913