Fine needle aspiration of hepatic angiomyolipoma with extramedullary hematopoiesis: A case report

Cytopathology. 2022 Jul;33(4):534-539. doi: 10.1111/cyt.13100. Epub 2022 Feb 9.

Abstract

Angiomyolipoma, a perivascular epithelioid cell tumour, is easily identifiable as a benign tumour in the kidneys. However, when occurring in extrarenal sites it can mimic malignancy (Cancer Cytopathol. 2017;125:257). Pathologists must be aware of the classical morphological features of this lesion, its pitfalls in extrarenal sites, and the need for immunohistochemistry in order to establish the correct diagnosis (World J Gastroenterol. 2000;6:608). We report a case of angiomyolipoma with extramedullary hematopoiesis presenting as a large hepatic mass, diagnosed by cytology through endoscopic ultrasound guided fine needle aspiration. Our case exemplifies the classic cytological findings that are important in the differentiation between hepatic angiomyolipoma (HAML) and differentials in this organ such as hepatocellular carcinoma (HCC) and focal nodular hyperplasia. A brief literature review and comparison of significant features between HAML and HCC are presented.

Keywords: extramedullary hematopoiesis; fine needle aspiration; hepatic angiomyolipoma.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Angiomyolipoma* / diagnosis
  • Angiomyolipoma* / pathology
  • Carcinoma, Hepatocellular* / diagnosis
  • Carcinoma, Hepatocellular* / pathology
  • Endoscopic Ultrasound-Guided Fine Needle Aspiration
  • Gastrointestinal Neoplasms*
  • Hematopoiesis, Extramedullary*
  • Humans
  • Kidney Neoplasms* / pathology
  • Liver Neoplasms* / diagnosis
  • Liver Neoplasms* / pathology