Fat-poor renal angiomyolipoma with prominent cystic degeneration:A case report and review of the literature  

作　　者：Shi-Qi Lu Wei Lv You-Jun Liu Huan Deng 

机构地区：[1]Medical College,Nanchang University,Nanchang 330006,Jiangxi Province,China [2]Department of Gastroenterology,West China Hospital,Sichuan University,Chengdu 610044,Sichuan Province,China [3]Department of Radiology,The Fourth Affiliated Hospital of Nanchang University,Nanchang 330003,Jiangxi Province,China [4]Department of Pathology,The Fourth Affiliated Hospital of Nanchang University,Nanchang 330003,Jiangxi Province,China

出　　处：《World Journal of Clinical Cases》2023年第2期417-425,共9页世界临床病例杂志

基　　金：Supported by the National Science Foundation of China,No.81860490 and 82160546;the Science Foundation of Jiangxi Province,No.20202BBG73027。

摘　　要：BACKGROUND Angiomyolipoma(AML),the most common benign tumor of the kidney,is usually composed of dysmorphic blood vessels,smooth muscle,and mature adipose tissue.To our knowledge,AML with cystic degeneration has rarely been documented.Cystic degeneration,hemorrhage,and a lack of fat bring great challenges to the diagnosis.CASE SUMMARY A 60-year-old man with hypertension presented with a 5-year history of cystic mass in his left kidney.He fell 2 mo ago.A preoperative computed tomography(CT)scan showed a mixed-density cystic lesion without macroscopic fat density,the size of which had increased compared with before,probably due to hemorrhage caused by a trauma.Radical nephrectomy was performed.Histopathological studies revealed that the lesion mainly consisted of tortuous,ectatic,and thick-walled blood vessels,mature adipose tissue,and smooth muscle-like spindle cells arranged around the abnormal blood vessels.The tumor cells exhibited positivity for human melanoma black-45,Melan-A,smooth muscle actin,calponin,S-100,and neuron-specific enolase,rather than estrogen receptor,progesterone receptor,CD68,and cytokeratin.The Ki-67 labeling index was less than 5%.The final diagnosis was a fat-poor renal AML(RAML)with prominent cystic degeneration.CONCLUSION When confronting a large renal cystic mass,RAML should be included in the differential diagnosis.

关 键 词：KIDNEY ANGIOMYOLIPOMA Cystic degeneration PATHOGENESIS Diagnosis Case report 

分 类 号：R73[医药卫生—肿瘤]