PMC3952375_01
63-year-old woman with abdominal pain diagnosed with angiomyolipoma (AML) of the kidney and liver, and islet cell tumor of the pancreas. Contrast-enhanced computed tomography (a) Coronal reconstruction image obtained during the arterial phase of enhancement shows a large heterogeneously enhanced mass. Gastroduodenal artery is encased by the mass (arrows). Hyperenhancing lesion in the liver is also seen (arrow). (b) Axial image obtained in the venous phase of enhancement shows that the mass enhanced homogenously and had calcifications (arrow head). There are bilateral renal AMLs containing fat density (arrows). Note also discrete vertebral sclerotic lesions (dashed arrow).
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F1
The mass showed heterogeneous enhancement in the arterial phase and homogenous enhancement in the venous phase [Figure 1a and b]. AML [Figure 1b] as well as multiple small discrete sclerotic lesions in the vertebrae. A cranial CT revealed multiple calcified subependymal nodules [Figure 4].
63-year-old woman with abdominal pain diagnosed with angiomyolipoma (AML) of the kidney and liver, and islet cell tumor of the pancreas. Axial image obtained in arterial phase shows an AML in segment 2 of the liver containing homogenous fat density without enhancement (large arrow) and hyperenhancing small lesion (small arrow).
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F2
Lesions with homogenous fat-density did not show any enhancement in both the arterial and the venous phase images [Figure 2].
63-year-old woman with abdominal pain diagnosed with angiomyolipoma of the kidney and liver, and islet cell tumor of the pancreas. Axial image obtained in the arterial phase shows a hyperenhancing lesion in segment 3 of the liver (arrow).
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F3
These lesions had homogenous enhancement in the arterial phase image and became isohypodense in the venous phase image [Figure 3].
63-year-old woman with abdominal pain diagnosed with angiomyolipoma of the kidney and liver, and islet cell tumor of the pancreas. Axial computed tomography image of the brain shows calcified subependymal nodules (arrows).
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F4
AML [Figure 1b] as well as multiple small discrete sclerotic lesions in the vertebrae. A cranial CT revealed multiple calcified subependymal nodules [Figure 4].
63-year-old woman with abdominal pain diagnosed with angiomyolipoma of the kidney and liver, and islet cell tumor of the pancreas. H and E, stained specimen (a) x200 and (b) x400 show neoplastic cells forming solid sheets and also have large eosinophilic cytoplasm with moderate nuclear pleomorphism (arrows). Some neoplastic cells show binucleation.
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F5
Histological examination of the cell-block preparations of the mass showed solid sheets of neuroendocrine-appearing cells characterized by large eosinophilic cytoplasm with moderate nuclear pleomorphism [Figure 5].