A Case Report of Giant Hepatic Angiomyolipoma with Extramedullary Hematopoiesis

Shigeki Murakami, Nobushi Ishiga, Tatsuo Sho, Kiyohiro Inhihara, Kunihiko Sakai, Masaharu Iwado, Yasuhiro Hujii, Yasuhisa Yamamoto

Oomoto Hospital

The case of a 27-year-old woman who complained of epigastralgia with giant hepatic angiomyolipoma is reported. This tumor occupied her whole right lobe. The typical medical findings of hepatic angiomyolipoma were a marked hyperechoic mass on US, a low density mass on plain CT, and a hypervascular mass on contrastenhanced CT and angiography. But the findings varied with the ratio of adipose tissue to muscle. This case has the upper typical medical findings, but it was necessary to diagnose from the giant hemangioma. It was especially difficult to differentiate hepatic angiomyolipoma from small hepatocellular carcinoma (≤2 cm) undergoing fatty degeneration. Histologically they were characterrized by an admixture of blood vessels, adipose tissue and smooth muscle, but in addition to these components, extramedullary hematopoiesis was seen especially in hepatic angiomyolipoma. This finding was seen in this one. No case of malignant hepatic angiomyolipoma has been reported, however malignant transformation of renal angiomyolipoma was recently reported, so it is necessary to provide careful follow-up.

Key words
hepatic angiomyolipoma, extramedullary hematopoiesis

Reprint requests
Shigeki Murakami Oomoto Hospital
1-1-5 Oomoto, Okayama-shi, 700 JAPAN

Accepted
September 8, 1993

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