Diagnosis of a hepatic angiomyolipoma by fine-needle aspiration: A case report

Hepatic angiomyolipomas (AML) diagnosed by fine-needle aspiration biopsy have only been reported sporadically. In this article, we present a case of hepatic angiomyolipoma diagnosed by fine-needle aspiration in a 55-year-old woman with an unexplained hepatic mass. The smears showed numerous arborizing capillary vessels transgressing sheets of cells with fibrillary cytoplasm and indistinct cytoplasmic border. Cell block sections showed sheets of epithelioid cells with eosinophilic granular cytoplasm or vacuolated. clear cytoplasm. Minimal amount of adipose tissue also was seen. Immunohistochemical stains revealed epithelioid tumor cells to be positive for HMB-45 and smooth muscle actin and negative for cytokeratin, supporting the diagnosis of angiomyolipoma. AML should be considered in the differential diagnosis when one encounters a tumor composed of epithelioid cells in a liver aspirate. Awareness of the rare occurrence of AML in the liver and demonstration of a characteristic immunohistochemical profile are necessary for an accurate diagnosis.