Renal epithelioid angiomyolipoma with epithelial cysts: demonstration of melan A and HMB45 positivity in the cystic epithelial lining

Pereira Filho, Jos?? do Egypto
Amorim, Daniele Meneses de
Sweet, Gloria Maria Maranh??o
Freitas, Luiz Antonio Rodrigues de
Athanazio, Paulo Roberto Fontes
Athanazio, Daniel Abensur

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Publication date

January 2012

DOI

10.1016/j.anndiagpath.2011.03.004

Publisher

Elsevier Inc

ISSN

1092-9134

Citation count (estimate)

Abstract

Renal angiomyolipoma (AML) may present as rare variants such as epithelioid and AML with epithelial cysts posing difficulties for the diagnosis to the surgical pathologist. We report a case of a 46-year-old male patient presenting a 5-cm solid tumor in the lower pole of the left kidney, with cystic changes at cut surface. The tumor exhibited 95% of epithelioid cells with atypical nuclei. A small focus of typical AML was observed. The immunoprofile of tumor cells was classical of AML including expression of melanocytic markers such as HMB45 and Melan A. We report the immunohistochemical study of the cystic component in an epithelioid AML. In contrast to the immunoreactivity reported in typical AML, the present case shows obvious expression o...