[Hepatic angiomyolipoma simulating hepatocytic tumor. 3 cases].
Hepatic angiomyolipoma is a rare, benign, mesenchymal tumor. We report 3 cases of atypical angiomyolipomas simulating benign hepatic tumors in 3 women free of tuberous sclerosis (Bourneville's disease). Hepatic angiomyolipomas were solitary in 2 cases and multiple in one. At imaging, the 6 lesions were large (7 cm in mean diameter), mainly hypoechoic and heterogeneous. At CT, lesions did not contain fat and were hypervascular. At MR imaging, lesions were hypointense in 4 cases and isointense in one case on T1-weighted sequences, hyperintense and isointense on T2-weighted sequences in four and in one case respectively. Percutaneous biopsy, performed in 2 cases, did not provide a correct diagnosis. Histopathologic examination of the resected specimen showed angiomyolipomas with very low or lacking fat in all 3 patients. All lesions were positive with the HMB-45 antibody. In conclusion, hepatic angiomyolipoma with a low fat component may mimic other hepatic tumors. Diagnosis may be improved by using HMB-45 reactivity on the biopsy specimen.
Arblade
S
S
Service de Radiologie, Hôpital Beaujon, Clichy.
Vilgrain
V
V
Terris
B
B
Zins
M
M
Vullierme
M P
MP
Fléjou
J F
JF
Belghiti
J
J
Menu
Y
Y
D018248:Adenoma, Liver Cell / Q000175:diagnosis*; D000328:Adult; D000368:Aged; D018207:Angiomyolipoma / Q000175:diagnosis*; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D008113:Liver Neoplasms / Q000175:diagnosis*