Cytology of Renal Angiomyolipoma with Predominant Epithelioid Cell Component - A Report of Two Cases with Review of Literature

Renal Angiomyolipoma (AML) is a benign lesion with a variable admixture of fat cells, thick walled blood vessels, smooth muscle and polygonal epithelioid cells. The lesion can be diagnosed with certainty in the presence of all the components on fine needle aspiration, supported by CT findings. However the presence of predominant population of epithelioid cells with paucity or absence of other components can be particularly worrisome, especially if radiological findings are noncontributory. These large cells with low N:C ratio and frothy cytoplasm and anisonucleosis require detailed evaluation and careful search for typical background cytology. Two such cases of AML with a predominant population of epithelioid cells are being described with their cytological and histological findings with a review of literature to highlight the diagnostic dilemma and emphasize the utility of HMB-45 immunostaining in such cases. Journal of Cytology 2007; 24 (2) : 92-95