Hepatic angiomyolipoma is a rare mesenchymal tumor with a broad spectrum of histological appearance. A 44-year-old female presented with abdominal discomfort. MRI revealed a 3.6 cm well-defined hepatic lesion. Ultrasound-guided core biopsy with imprint smears was performed. The smears showed histiocytes with a few epithelioid cells, mimicking an inflammatory lesion. The biopsy showed proliferation of epithelioid cells with aggregates of foamy histiocytes and scattered adipocyts, resembling hepatocellular neoplasm. The diagnosis of angiomyolipoma was clinched by the immunoprofile of the epithelioid cells, which were diffusely positive for HMB45, Mart-1 and focally positive for smooth muscle actin. To our best knowledge, this is the first reported case of biopsy diagnosed hepatic inflammatory angiomyolipoma with an unusual inflammatory infiltrate composed mainly of aggregates of foamy histiocytes.
Adult Angiomyolipoma