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LETTER TO EDITOR Table of Contents   
Year : 2010  |  Volume : 53  |  Issue : 4  |  Page : 859
Jejunal angiomyolipoma


Super Religare Laboratories (formerly SRL Ranbaxy Pvt Ltd), Regional Reference Lab, Udyog Vihar, Sector 18, Gurgaon, India

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Date of Web Publication27-Oct-2010
 

How to cite this article:
Andaleeb A, Sachdev R. Jejunal angiomyolipoma. Indian J Pathol Microbiol 2010;53:859

How to cite this URL:
Andaleeb A, Sachdev R. Jejunal angiomyolipoma. Indian J Pathol Microbiol [serial online] 2010 [cited 2019 Dec 13];53:859. Available from: http://www.ijpmonline.org/text.asp?2010/53/4/859/72004


Sir,

We read the article by Padua et al. [1] with great interest. We recently had a case of jejunal angiomyolipoma presenting as a mass lesion. Angiomyolipomas are benign mesenchymal hamartomas commonly occurring in kidney with an association with tuberous sclerosis. Primary intestinal location is rare with few reported cases in literature. We report a case of jejunal angiomyolipoma presenting as a mass lesion in a 34-year male.

The mass was resected with the segment of small intestine. It measured 4 × 3 × 3 cm, with mucosal indentation and was circumscribed, noninfiltrative. Microscopy revealed a mass incorporating the muscularis and consisting of intimately admixed smooth muscle, ectatic tortuous vessels, lacking elastic lamina and adipose tissue. There was no evidence of smooth muscle atypia, aberrant endothelium or lipoblasts [Figure 1]a-c. The mucosa was only indented but not infiltrated by the mass [Figure 1]d. Based on these features, a diagnosis of angiomyolipoma was made.
Figure 1: (a) Jejunal angiomyolipoma with admixture of vascular channels, adipose tissue. (H and E, ×100), (b) Blood vessels, some of which display thrombosis. (H and E, ×100), (c) Smooth muscle component with admixed vascular spaces. (H and E ×100), (d) Angiomyolipoma, submucosal location and mucosal indentation. (H and E, ×100)

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Angiomyolipomas of intestine are rare and usually present with anemia, melena, diarrhea, abdominal pain, or may even be asymptomatic. [1] They are benign and usually seen in females, though ours was a male patient. Thick-walled, ill-formed vessels, which lack an elastic lamina, usually help in differentiating from lipoleiomyoma. Angiolipomas are a differential but show lack of conspicuous smooth muscle component. Absence of any lipoblasts/atypia helps rule out liposarcoma. [2] On immunohistochemistry, angiomyolipomas express HMB 45. SMA for smooth muscle component and S 100 for adipose elements may be additionally helpful.

 
   References Top

1.De Padua M, Gupta N, Broor SL, Govil D. Duodenal angiomyolipoma: A case report. Indian J Pathol Microbiol 2007;50:568-9.  Back to cited text no. 1
    
2.Lee CH, Kim JH, Yang DH, Hwang Y, Kang MJ, Kim YK, Lee MR. Ileal angiomyolipoma manifested by small intestinal intussusception. World J Gastroenterol 2009;15:1398-400.  Back to cited text no. 2
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Correspondence Address:
Ritesh Sachdev
A 803, Plot 7A, Navrattan Apartments, Sector 23, Dwarka, New Delhi-110 075
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0377-4929.72004

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