Curr Urol Rep (2015) 16: 12 DOI 10.1007/s11934-015-0484-z

NEW IMAGING TECHNIQUES (A RASTINEHAD AND S RAIS-BAHRAMI, SECTION EDITORS)

Renal Angiomyolipoma: Preoperative Identification of Atypical Fat-Poor AML Crystal Farrell & Sabrina L. Noyes & Mouafak Tourojman & Brian R. Lane

Published online: 13 February 2015 # Springer Science+Business Media New York 2015

Abstract The preoperative distinction between benign and malignant renal masses is a well-known radiographic diagnostic challenge. With angiomyolipoma (AML) and renal cell carcinoma (RCC) representing the most common benign and malignant renal parenchymal lesions, respectively, differentiating these two entities is especially important due to their vastly different treatments and prognoses. Renal AML is typically composed of smooth muscle cells, dysmorphic blood vessels, and varying amounts of adipose tissue. In most cases, Btypical^ AML can be diagnosed by identifying macroscopic fat with ultrasound, computed tomography, or magnetic resonance imaging. However, approximately 4–5 % of AML tumors have fat that is grossly undetectable by conventional techniques, precluding a straightforward diagnosis. The overlapping radiographic features between Batypical^ or “fat-poor” AML and RCC, especially in smaller (7.5 HU [13•] • Long-to-short-axis ratio >1.23 [13•] • High 11 C-acetate avidity (SUV ratio >3.71) [17] • Negative FDG uptake [17] • Variable signal drop out with fat suppression or CSI [9] • Tumor-to-kidney SI ratio

Renal angiomyolipoma: preoperative identification of atypical fat-poor AML.

The preoperative distinction between benign and malignant renal masses is a well-known radiographic diagnostic challenge. With angiomyolipoma (AML) an...
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