Diagnosis:
 
Angiomyolipoma (AML) arising from kidney.

Tumour was actually adjacent to the adrenal gland (upon reviewing the imaging). The history given was misleading...
 
#BSTpath #GUpqth
1/ This tumour is part of the PEComa family.

2/ Half of AMLs arise sporadically, while the other are associated with tuberous sclerosis.

3/  PEComas (thus AMLs) are a result of genetic alterations of the tuberous sclerosis complex (TSC).
 
pubmed.ncbi.nlm.nih.gov/27494029/
4/ There is growing evidence that these tumours arise from lymphatic endothelium cells.
 
ncbi.nlm.nih.gov/pmc/articles/P…
5/ Classic AMLs are composed of fat, smooth muscle, and thick-walled blood vessels. These elements vary from tumour to tumour.

pubmed.ncbi.nlm.nih.gov/10478660/
6/ Care needs to be taken, especially with small Bx, as only one or two components may be present.

7/ Typical positive for melanocytic and smooth muscle markers.

pubmed.ncbi.nlm.nih.gov/11800647/
8/ Primary AMLs of the adrenal gland are very rare and a tumour arising from the adjacent kidney should be considered as part of the DDx.

ncbi.nlm.nih.gov/pmc/articles/P…
9/ Talking about diagnostic issues, epithelioid AMLs can also cause diagnostic confusion (due to appearance and possible resemblance to a carcinoma).

10/ Lastly, these variants have malignant potential and thus important to recognise.
 
pubmed.ncbi.nlm.nih.gov/21263237/

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More from @TristanRutland7

18 Sep
Further Hx for @Meghna0630

Male,
PMHx: skin cancer, DM type2, BPH

Presents with SBO. Nodule in stomach and small bowel (below).
Read 15 tweets
31 Jul
Immunohistochemistry: CK7, PAX-8
This is an example of a metastatic carcinoma to the umbilicus (the favoured diagnosis was HG serous carcinoma) aka Sister Mary Joseph nodule.

No clinical pictures were available but the example is from the below referenced paper (with a case report)

ncbi.nlm.nih.gov/pmc/articles/P…
Read 6 tweets

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