PMC3253408_01
Aggressive angiomyxoma in 37-year-old woman.. A. Unenhanced CT image shows large abdominal mass (stars) being hypo-attenuated in relation to surrounding muscular tissue. B. Contrast-enhanced CT image shows large homogeneous abdominal mass (stars). It directly invades inferior vena cava (long arrow), causing obstruction of inferior vena cava and formation of periaortic venous collaterals (short arrow). C. Coronal reconstruction image from contrast-enhanced CT shows mass encasing colon (long arrow) and causing portion of loop of small bowel to deviate superiorly (short arrow). D. Coronal reconstruction image from contrast-enhanced CT shows inferior vena cava filling defect (long black arrow) extending superiorly to level of right atrium (short black arrow). Image also shows prominent enhancing nodules within inferior vena cava (black arrowheads) and collateral vessels around aorta (white arrow). E. Contrast-enhanced CT image shows heterogeneously enhancing mass in left lower lobe (long arrow) and apparent inferior vena cava filling defect (short arrow). F. Low-power view shows vascular appearance of tumor, against myxoid, hypocellular background. G. Medium-power view shows bland cytological appearance of spindle cells.
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F1
The mass caused a portion of the loop of the small bowel to deviate superiorly, encase the ureters and colon, and invade the inferior vena cava (Fig. 1A-C). On unenhanced images, the mass was hypo-attenuated in relation to the surrounding muscular tissue (Fig. 1A). The mass displayed heterogeneous moderate enhancement following contrast material administration (Fig. 1B). A continuous tubular filling defect projected within the lumen of the inferior vena cava and extended superiorly to the level of the right atrium (Fig. 1D, E). There were intensely enhancing nodules within the dilated inferior vena cava and enhancing collateral vessels around the aorta during contrast-enhanced arterial and late phases (Fig. 1B, D). The largest one measured 4.2 x 3.1 cm and was located in the left lower lobe (Fig. 1E). The lesion showed numerous, thin-to-thick wall vessels of different sizes (Fig. 1F, G).