Two cases of hepatic angiomyolipoma with difficulty for imaging differential diagnosis with hepatocellular carcinoma

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Case1 was a 79-year-old male with liver tumor. Dynamic CT showed a high density lesion in early phase and low in equilibrant phase. Gd-EOB-DTPA-enhanced MRI showed a high intensity lesion in arterial phase and a low intensity lesion in hepatobiliary phase. US-guided biopsy led to histopathological diagnosis as hepatic angiomyolipoma. Case2 was a 40-year-old with liver tumor. Dynamic CT showed a high density lesion in early phase, low with coronal enhancement in portal phase and low in equilibrant phase. Gd-EOB-DTPA-enhanced MRI showed a high intensity area in arterial phase, low with coronal enhancement in portal phase and low in hepatobiliary phase. Both CT and MRI showed peritumoral coronal enhancement in portal phase. Histological diagnosis of laparoscopic surgery was hepatic angiomyolipoma. Immunohistochemical examination showed OATP was negative in the tumor but the cellular membranes of adjacent normal hepatocytes were positive. We also detected immunostaining of CD34 in the dilated vessels in fibrous capsule around the tumor and in the adjacent normal liver.