Imaging features of hepatic monotypic epithelioid angiomyolipoma

Abstract

Objective To improve diagnosis of hepatic monotypic epithelioid angiomyolipoma (HMEA)by correlative analysis of imaging findings and pathological characters of the disease.Methods Four cases of pathohistologically proved HEMA were retrospectively analyzed.The correlation between the imaging findings and pathological results was discussed.Results Among the 4 cases of HMEA,2 cases were misdiagnosed as hepatic cell carcinoma presurgically,1 case as focal nodular hyperplasia,and 1 case accurately diagnosed.The main imaging findings were as follows:(1)Plain CT scan showed isodense/ hypodense lesion or isodense/hypodense lesions in 2 cases,which had the enhancement mode of quick wash- in and slow wash-out.The corresponding pathological findings were profuse sinusoid microvasculature with thin septa.No mature fat cells were present.One tumor had thick-walled vessels.(2)There were 2 cases with lesions hypodense in CT and hypointensive in MR T_1 WI,which had the enhancement mode of quick wash-in and quick wash-out.Central dilated arteries were present in the lesions.The corresponding pathological findings were central abnormally dilated thick-walled arteries,with no mature fat cells. Conclusion The imaging findings of HMEA were directly correlated to the pathology.Combining the imaging finding with clinical data,the primary diagnosis of HEMA could be made.The final diagnosis of HMEA relies on histopathological results.