Pancholi Varsha, Munjal Kavita, Jain Meenal, Munjal Saroj, Agrawal Rajeev, Nandedkar Shirish
Arihant Pathology Laboratory, Sri Aurbindo Institute of Medical Sciences, Indore, India.
Acta Cytol. 2006 Jul-Aug;50(4):466-8. doi: 10.1159/000325994.
Angiomyolipoma is a rare benign neoplasm, commonly involving the kidney. Preoperative diagnosis on fine needle aspiration cytology can confirm the diagnosis, reducing the chances of unnecessary surgery.
We studied cases of renal angiomyolipoma (AML) presenting within 1 year with palpable renal masses confirmed on ultrasound to be of renal origin. Fine needle aspiration cytology (FNAC) smears showed a few cohesive syncytial fragments with adipocytes, spindle cells and isolated single cells with foamy cytoplasm; a diagnosis of AML was made. The diagnosis was confirmed on histopathology, which showed mature adipose tissue, tortuous and thick-walled blood vessels lacking elastic tissue lamina and bundles of smooth muscles that seemed to emanate from the blood vessels.
A preoperative diagnosis of renal AML is of great importance for correct management. In fact, when the lesion is small and asymptomatic, a conservative approach may be considered. Partial nephrectomy is possible with masses < 5 cm. Preoperative FNAC along with computed tomographic findings and immunocytochemical analysis of FNAC smears with HNB-45 can confirm the diagnosis of AML, thus preventing unindicated nephrectomy.
血管平滑肌脂肪瘤是一种罕见的良性肿瘤，常见于肾脏。细针穿刺细胞学检查的术前诊断可确诊，减少不必要手术的几率。
我们研究了在1年内出现可触及肾脏肿块的肾血管平滑肌脂肪瘤（AML）病例，超声检查证实肿块起源于肾脏。细针穿刺细胞学检查（FNAC）涂片显示有一些含有脂肪细胞、梭形细胞和单个具有泡沫状细胞质的孤立细胞的黏合性多核巨细胞碎片；诊断为AML。组织病理学证实了诊断，显示有成熟的脂肪组织、缺乏弹性组织层的迂曲且厚壁的血管以及似乎从血管发出的平滑肌束。
肾AML的术前诊断对于正确治疗非常重要。实际上，当病变较小且无症状时，可考虑采取保守方法。肿块<5 cm时可行部分肾切除术。术前FNAC结合计算机断层扫描结果以及用HNB - 45对FNAC涂片进行免疫细胞化学分析可确诊AML，从而避免不必要的肾切除术。
