Low-fat angiomyolipoma of the liver studied with contrast-enhanced ultrasound and multidetector computed tomography.
We report the case of a 30-year-old woman with persistent pain at the right hypochondrium, relapsing fever, and normal serum tests. Ultrasound showed a hyperechoic inhomogeneous mass; following sulfur hexafluoride injection, uniform enhancement at 14-16 s and rapid wash-out at 26 s was found. Multidetector computed tomography showed an inhomogeneously hypodense mass, with no detectable negative density values, characterized by inhomogeneous enhancement at the arterial phase and wash-out at the portal phase. Histopathology demonstrated a hepithelioid angiomyolipoma with a poor fatty component. This diagnosis should always be considered in the presence of a very rapid wash-out after intravenous contrast injection. However, a hepatocellular carcinoma cannot be excluded and the final diagnosis of low-fat angiomyolipoma must be pathologically proved based on immunohistochemistry.
Flor
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N
Department of Diagnostic and Interventional Radiology, University of Milan, San Paolo Hospital, Milan, Italy. flornic@hotmail.com
Sardanelli
F
F
Serantoni
S
S
Brovelli
F
F
Cornalba
G P
GP
D000328:Adult; D018207:Angiomyolipoma / Q000000981:diagnostic imaging* / Q000473:pathology; D003287:Contrast Media; D005260:Female; D006801:Humans; D007089:Image Enhancement / Q000379:methods; D007091:Image Processing, Computer-Assisted / Q000379:methods*; D007150:Immunohistochemistry; D008113:Liver Neoplasms / Q000000981:diagnostic imaging* / Q000473:pathology; D010743:Phospholipids; D013459:Sulfur Hexafluoride; D014057:Tomography, X-Ray Computed / Q000379:methods*; D014463:Ultrasonography
D003287:Contrast Media; D010743:Phospholipids; C420843:contrast agent BR1; D013459:Sulfur Hexafluoride