Bonzanini M, Pea M, Martignoni G, Zamboni G, Capelli P, Bernardello F, Bonetti F
Servizio di Anatomia Patologica, Ospedale S. Chiara di Trento, Italy.
Pathology. 1994 Apr;26(2):170-5. doi: 10.1080/00313029400169421.
A preoperative diagnosis of renal angiomyolipoma (AML) is of great importance for a correct management of these patients with this tumor. In fact when the lesion is small and asymptomatic a conservative approach may be considered. We have evaluated the radiographic and fine needle aspiration cytology (FNAB) findings in 8 cases of AML. In 3 cases both radiology and cytology were suggestive of carcinoma and thus the patients underwent surgery. In one case both techniques suggested AML but surgery was performed because the lesion was large and symptomatic. In 4 cases where both radiology and cytology suggested AML no surgery was performed. Follow-up data are consistent with the benign nature of the lesions. The immunocytochemical analysis of the FNAB with a panel of antibodies including keratin, vimentin, actin and HMB-45 was indicative of AML in 7 of 8 cases, including 2 of the 3 cases misdiagnosed as carcinomas. The presence of HMB-45-positive perivascular epithelioid cells in the FNABs was the most significant finding. It is concluded that immunocytochemical analysis of FNAB with this monoclonal antibody panel can increase the accuracy of preoperative diagnosis of AML, and allow consideration of a conservative approach in selected cases.
肾血管平滑肌脂肪瘤（AML）的术前诊断对于正确处理患有这种肿瘤的患者非常重要。事实上，当病变较小且无症状时，可以考虑采取保守治疗方法。我们评估了8例AML患者的影像学和细针穿刺细胞学检查（FNAB）结果。3例患者的影像学和细胞学检查结果均提示为癌，因此这些患者接受了手术治疗。1例患者的两种检查技术均提示为AML，但由于病变较大且有症状，仍进行了手术。在4例影像学和细胞学检查均提示为AML的患者中，未进行手术。随访数据与病变的良性性质相符。用包括角蛋白、波形蛋白、肌动蛋白和HMB-45在内的一组抗体对FNAB进行免疫细胞化学分析，8例中有7例提示为AML，其中包括3例被误诊为癌的患者中的2例。FNAB中存在HMB-45阳性的血管周围上皮样细胞是最显著的发现。结论是，用该单克隆抗体组对FNAB进行免疫细胞化学分析可提高AML术前诊断的准确性，并在某些病例中考虑采取保守治疗方法。
