PMC6633875_01
MRI. FIESTA (right) and T1-weighted images (left) revealed a 3.1 x 3.4 x 2 cm mass in the left lateral lobe of the liver. The lesion is hypervascular with washout of contrast on delayed post-contrast enhanced sequences.
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MRI showed a 3.4 cm mass with arterial phase enhancement and contrast washout in delayed sequences (Figure 1).
Gross specimen. On gross examination of the liver specimen, the cut surface of liver showed a well-demarcated, glistening, tan-yellow, lobular mass, measuring 3.0 x 2.5 x 2.0 cm. Final surgical pathology confirmed the diagnosis of epithelioid angiomyolipoma with no evidence of malignancy and 2.2 cm surgical margins.
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Pathologic gross examination revealed a 3.0 x 2.5 x 2.0 cm mass, well-demarcated from adjacent hepatic parenchyma (Figure 2).
Histopathologic features of epithelioid angiomyolipoma. (a) Well-circumscribed mass with adjacent, mildly steatotic liver parenchyma (H&E; 20x). (b) The tumor is composed of eosinophilic cells, mature adipocytes, and thick walled vessels (center) (H&E; 100x). (c) The smooth muscle component includes a mixture of large epithelioid cells with abundant eosinophilic cytoplasm and prominent nucleoli, with interspersed smaller epithelioid cells and spindle cells (H&E; 400x). Immunohistochemistry performed on the biopsy of this lesion for HMB45 (200x) (d) and Smooth Muscle Actin (200x) (e) showed patchy, strong positivity in the lesional cells.
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S100, confirming the diagnosis (Figure 3). She was discharged after an uneventful hospital course.