Thiravit Shanigarn, Teerasamit Wanwarang, Thiravit Phakphoom
1 Department of Radiology, Faculty of Medicine Siriraj Hospital, Mahidol University , Bangkok , Thailand.
Br J Radiol. 2018 Apr;91(1084):20170533. doi: 10.1259/bjr.20170533. Epub 2018 Feb 6.
Renal angiomyolipoma (AML) is an uncommon renal tumour, generally composed of mature adipose tissue, dysmorphic blood vessels and smooth muscle. Identification of intratumoral fat on unenhanced CT images is the most reliable finding for establishing the diagnosis of renal AML. However, AMLs sometimes exhibit atypical findings, including cystic as well as solid forms; some of these variants overlap with the appearance of other renal tumours. A rare type of AML, the epithelioid type, possesses malignant potential. The aim of this pictorial review is to gather the different imaging features of AMLs including the classic and fat-poor types, AMLs with epithelial cysts, epithelioid AML, AML associated with tuberous sclerosis, haemorrhagic AML and large AMLs mimicking retroperitoneal liposarcomas. The diagnostic clues that help to distinguish AMLs from other renal tumours are also described in the review.
肾血管平滑肌脂肪瘤(AML)是一种少见的肾肿瘤,通常由成熟脂肪组织、形态异常的血管和平滑肌组成。在未增强CT图像上识别瘤内脂肪是确立肾AML诊断的最可靠发现。然而,AML有时表现出非典型表现,包括囊性和实性形式;其中一些变异型与其他肾肿瘤的表现重叠。一种罕见类型的AML,上皮样型,具有恶性潜能。本影像综述的目的是收集AML的不同影像特征,包括经典型和少脂型、伴有上皮囊肿的AML、上皮样AML、与结节性硬化症相关的AML、出血性AML以及酷似腹膜后脂肪肉瘤的巨大AML。本综述还描述了有助于将AML与其他肾肿瘤区分开来的诊断线索。