A case of angiomyo-myolipoma of the liver.
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A rare case of angiomyolipoma with extramedullary hematopoiesis in the liver (hepatic angiomyo-myelolipoma) is reported with special reference to the findings of imprint cytology.<BR>The patient, a 48-year-old male, complained of upper abdominal pain and was found to have hepatic dysfunction. Abdominal CT showed a low-density area in the caudate lobe and selective hepatic arteriography demonstrated it to be a hypervascular tumor.<BR>The removed tumor was solid in consistency, fairly well demarcated and 5.7×7.0×4.0 cm in size. The liver itself showed no evidence of cirrhosis.<BR>Histologically, the tumor consisted of abundant blood vessels with various calibers, oval or spindle-shaped smooth muscle cells and mature fat cells. Hematopoietic cells such as megakaryocytes, erythroblasts and granulocytes were also present in the interstitium and intravascular spaces. The histological findings were almost the same as those of imprint cytology: the exfoliated cells were mainly composed of oval or spindle-shaped smooth muscle cells, which appeared in either planar cell clusters or groups of scattered cells. The vascular endothelial cells showed tubular or fibrous structures, and were intermingled with the smooth muscle cell clusters. Scattered fat cells, foamy cells, erythroblasts and megakaryocytes were also seen. In some of the smooth muscle cells, there were signs of cellular atypia such as nuclei with various sizes and irregular shapes and swollen nucleoli. The findings are indicative of hepatocellular carcinoma and other malignant non-epithelial tumors.<BR>A diagnosis of hepatic angiomyo-myelolipoma can, however, be made from cytological findings elements such as smooth muscle cells, vascular endothelial cells, fat cells and additional hematopoietic cells are mainly detected in the imprint specimens.
- 特定非営利活動法人 日本臨床細胞学会の論文
特定非営利活動法人 日本臨床細胞学会 | 論文
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