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. 2009 Jul 21;15(27):3417-20.
doi: 10.3748/wjg.15.3417.

Hepatic angiomyolipoma: dynamic computed tomography features and clinical correlation

Bin Yang  1 , Wen-Hui Chen, Qiao-Yun Li, Jing-Jing Xiang, Ru-Jun Xu
Affiliations

Hepatic angiomyolipoma: dynamic computed tomography features and clinical correlation

Bin Yang et al. World J Gastroenterol. .

Abstract

Aim: To study the dynamic computed tomography (CT) features of hepatic angiomyolipoma (AML) in patients with or without tuberous sclerosis complex (TSC).

Methods: The clinical information, CT findings and histopathological results of hepatic AML were analyzed retrospectively in 10 patients.

Results: Hepatic AML was prone to occur in female patients (7/10), and most of the patients (8/10) had no specific symptoms. All tumors presented as well-defined, unenveloped nodules in the liver. Six patients with sporadic hepatic AML had a solitary hepatic nodule with a definite fat component. Non-fat components of the hepatic lesions were enhanced earlier and persistently. Prominent central vessels were noted in the portal venous phase in three patients. In four patients with hepatic AML and TSC, most of the nodules were within the peripheral liver. Seven fat-deficient nodules were found with earlier contrast enhancement and rapid contrast material washout in two patients. Lymphangioleiomyomatosis was found in one patient.

Conclusion: Imaging features of hepatic AML are characteristic. Correct diagnosis preoperatively can be made in combination with clinical features.

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Figures

Figure 1
Figure 1
Patient with sporadic hepatic angiomyolipoma. A: Enhanced CT showed one well-defined, fat-containing nodule with prominent central vessels in the arterial phase; B: Enhanced CT showed sustained contrast enhancement of the intratumoral non-fat component in the portal venous phase.
Figure 2
Figure 2
Patient with hepatic angiomyolipoma and TSC. A: Plain CT showed two fat-containing nodules in the right liver lobe, and one unenveloped fat-deficient nodule in the left liver lobe; B: Enhanced CT showed a fat-deficient nodule with marked hyperdensity, with intratumoral vessels in the arterial phase; C: Enhanced CT showed a fat-deficient nodule with mild hypodensity, with prominent central vessels in the portal venous phase; D: Enhanced CT showed a fat-deficient nodule with homogeneous hypodensity in the delayed phase; E: Microscopic examination demonstrated vacuolated lipocytes, blood vessels and scattered epithelioid cells with eosinophilic cytoplasm and peripherally located nuclei (HE, original magnification × 40).
Figure 3
Figure 3
Patient with TSC and hepatic angiomyolipoma and LAM. A: Enhanced CT showed multiple fat-containing nodules in the liver; B: Enhanced CT showed an intra-portal-venous lesion and several enlarged periaortic lymph nodes; C: Chest CT showed multiple, thin-walled lung cysts and right hydrothorax.
See this image and copyright information in PMC

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