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CT Differentiation of Large Exophytic Renal Angiomyolipomas and Perirenal Liposarcomas

Gary M. Israel1, Morton A. Bosniak, Chrystia M. Slywotzky and Robert J. Rosen

1 All authors: Department of Radiology, Division of Abdominal Imaging, HW 202, New York University Medical Center, 560 First Ave., New York, NY 10016.



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  		Fig. 1A. —53-year-old woman with 20 x 15 cm angiomyolipoma. Contrast-enhanced CT scan shows large predominately fat-containing mass arising from left kidney with sharp defect in renal parenchyma (black arrow) and enlarged vessels measuring up to 1.5 cm (white arrow). Findings are characteristic of angiomyolipoma.

 


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  		Fig. 1B. —53-year-old woman with 20 x 15 cm angiomyolipoma. Contrast-enhanced CT scan obtained inferior to A shows additional enlarged vessels (arrows) and further extent of lesion.

 


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  		Fig. 2. —39-year-old man with 10 x 10 cm angiomyolipoma. Contrast-enhanced CT scan shows well-demarcated defect in renal parenchyma (black arrows). Enlarged vessels (white arrows) are also visible within fatty tumor.

 


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  		Fig. 3A. —68-year-old man with 25 x 12 cm pathologically proven liposarcoma. Contrast-enhanced CT scan shows large fatty tumor compressing kidney parenchyma with smooth interface (arrows) and without evidence of parenchymal defect. These findings are indicative of well-differentiated liposarcoma. Note mild hydronephrosis.

 


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  		Fig. 3B. —68-year-old man with 25 x 12 cm pathologically proven liposarcoma. Contrast-enhanced CT scan obtained inferior to A shows extent of neoplasm. No evidence of enlarged vessels is seen.

 


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  		Fig. 4A. —67-year-old woman with 16 x 13 cm pathologically proven liposarcoma. Contrast-enhanced CT scan shows displacement of left kidney from renal fossa by large encapsulated retroperitoneal fatty mass. No evidence is seen of renal parenchymal defect or enlarged vessels, and interface of tumor with kidney is smooth.

 


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  		Fig. 4B. —67-year-old woman with 16 x 13 cm pathologically proven liposarcoma. Contrast-enhanced CT scan obtained inferior to A confirms absence of enlarged vessels in extensive fatty mass. Well-defined capsule (arrows) can be seen.

 


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  		Fig. 5. —67-year-old woman with 14 x 13 cm pathologically proven liposarcoma. Contrast-enhanced CT scan shows that neoplasm displaces, compresses, and distorts right kidney, but interface of kidney with tumor (arrow) is smooth. Most of neoplasm is seen on other sections (not shown) that reveal sparsity of vessels.

 


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  		Fig. 6A. —76-year-old woman with 16 x 15 cm pathologically proven angiomyolipoma. Contrast-enhanced CT scan obtained at level of upper pole of left kidney shows large fatty tumor in retroperitoneum surrounding kidney (K) and displacing spleen (S) anteriorly. Defect in upper pole of renal parenchyma is probably present (long straight arrow). Enlarged vessels (short straight arrow) and surrounding hemorrhage (curved arrow) can be seen. Note inferior vena cava filter in place.

 


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  		Fig. 6B. —76-year-old woman with 16 x 15 cm pathologically proven angiomyolipoma. Contrast-enhanced CT scan obtained inferior to A further reveals fatty tumor surrounding kidney (K) with associated enlarged vessels (straight arrow) and surrounding hemorrhage (curved arrow). S = spleen.

 

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