Case seriesPatient: Male, 36 • Female, 61Final Diagnosis: Adrenal angiomyolipomaSymptoms: AsymptomaticMedication: —Clinical Procedure: —Specialty: RadiologyObjective:Rare diseaseBackground:Angiomyolipoma is a benign tumor composed of blood vessels, smooth muscle cells, and adipose tissue and has been described as belonging to the group of tumors of perivascular epithelioid cell origin (PEComa), commonly found in the kidneys and strongly associated with tuberous sclerosis. Only a few cases of extra-renal angiomyolipoma have previously been reported in the literature, most commonly in the liver. Adrenal angiomyolipoma is very rare, is usually asymptomatic, and is often found incidentally, with only 14 previously reported cases identified in the literature.Case Reports:We report two cases of adrenal angiomyolipoma that were identified by abdominal computed tomography (CT). The first case presented in a 36-year-old man and was an oval-shaped adrenal mass, measuring 5.2×4.2×3.1 cm. The second case presented in a 61-year-old woman and was a round-shaped mass measuring 8.6×9.5×8.1 cm. Both patients underwent adrenalectomy. Histopathology and immunohistochemistry confirmed the diagnosis of benign angiomyolipoma composed of adipose tissues, blood vessels, and smooth muscle cells.Conclusions:We present two rare cases of adrenal angiomyolipoma. We have reviewed the literature and identified 14 other cases of adrenal angiomyolipoma, and discuss the clinical, radiological, and pathological features of this rare tumor.

Background:Catheter-related thrombotic complications(TCs) can occur during the long term use of a chronic dialysis catheter (CDC), including fibrin sheath (FS), mural thrombosis (MT), venous thrombosis (VT), and intraluminal clots (IC), which has not been reported with MRI. The aim of our study was to evaluate the determination of catheter tip position (TP) and resolution of TCs in patients with transjugular CDC scheduled into the superior vena cava using high resolution magnetic resonance cholangiopancreatography (HR-MRCP) and T2-weighted imaging (HR-T2WI).Methods:The study protocol was approved by the local Research Ethics Committee. Informed consent was obtained from all patients. In total, 41 consecutively enrolled transjugular CDC patients with suspected catheter dysfunction were scanned with HRMRCP and HR-T2WI. The distance from the top to the tip of the catheter and the presence and nature of catheter TCs were assessed by 2 experienced radiologists. Chest x-ray was taken within 1 to 2 days and CDC was withdrawn within 3 to 10 days from those patients with TCs identified by HR-MRI.Results:A total of 38 subjects successfully underwent HR-MRI, including 13 normal and 25 with TCs (fibrin sheath [FS]: n = 21, mural thrombosis [MT]: n = 7, venous thrombosis [VT]: n = 3, intraluminal clots [IC]: n = 4). There was no significant difference between HR-MRCP and chest x-ray in catheter TP determination (P = .124). Normal catheter appeared as “double eyes” on HR-T2WI and “double tracks” on HR-MRCP. TCs appeared as follows: FS displayed as a “thin ring” (<1mm) around the catheter, MT as patchy hyperintensity and VT as a “thick ring” (>5mm) on HR-T2WI. Unilateral IC appeared as a “single eye” on HR-T2WI and a “single track” on HR-MRCP (n = 3). Bilateral IC appeared as neither “eye” nor “track” (n = 1). Catheter withdrawal confirmed FS (n = 16), MT (n = 6), VT (n = 1), and IC (n = 4).Conclusion:HR-MRCP and HR-T2WI are promising methods for visualizing TP and TCs in CDC patients, and are helpful in adjusting the treatment plan and avoiding the risk of pulmonary embolism.