Mai K T, Yazdi H M, Perkins D G, Thijssen A
Division of Anatomical Pathology, Department of Laboratory Medicine, Ottawa Hospital, Civic Campus, 1053 Carling Avenue, Ottawa, Ontario, Canada K1Y 4E9.
Acta Cytol. 2001 Mar-Apr;45(2):233-6. doi: 10.1159/000327280.
Epithelioid angiomyolipoma (AMYL) is a variant of angiomyolipoma characterized by sheets of epithelioid cells that may mimic renal cell carcinoma. This is the first report describing the fine needle aspiration biopsy features of this lesion.
A 47-year-old man with a history of epithelioid angiomyolipoma of the kidney treated with nephrectomy nine months previously presented with a recurrent retroperitoneal mass and multiple nodular liver lesions. Fine needle aspiration biopsy of one of the liver lesions showed fragments and sheets of noncohesive epithelioid cells with thin cytoplasm, markedly atypical nuclei, and scattered bizarre and multinucleated forms. The epithelioid cells focally expressed HMB-45 and were nonimmunoreactive, with epithelial markers.
Epithelioid AMYL may pose differential diagnostic problems with high grade carcinoma, especially renal cell, hepatocellular and metastatic carcinoma. An awareness of this entity and its characteristic cytologic features and immunoreactivity with HMB-45 is helpful in its identification.
上皮样血管平滑肌脂肪瘤（AMYL）是血管平滑肌脂肪瘤的一种变体，其特征为成片的上皮样细胞，可能类似肾细胞癌。这是首篇描述该病变细针穿刺活检特征的报告。
一名47岁男性，9个月前因肾上皮样血管平滑肌脂肪瘤接受肾切除术，现出现复发性腹膜后肿块及多发肝脏结节性病变。对其中一个肝脏病变进行细针穿刺活检，结果显示有散在的、不成团的上皮样细胞碎片及细胞片，细胞质薄，细胞核明显异型，可见散在奇异型及多核细胞。上皮样细胞局灶性表达HMB-45，对上皮标记物无免疫反应。
上皮样AMYL可能与高级别癌，尤其是肾细胞癌、肝细胞癌及转移癌存在鉴别诊断问题。认识该实体及其特征性细胞学表现以及与HMB-45的免疫反应性，有助于对其进行识别。
