Multicentric Aggressive Angiomyolipomas: A Rare Form of PEComas

Virtual Touch quantification using acoustic radiation force impulse (ARFI) technology for the evaluation of focal solid renal lesions: preliminary findings

“…6 Minimal-fat AML may pose a significant diagnostic dilemma, given its hypoechogenicity on ultrasound imaging, a feature also characteristic of RCCs 7 ; however, surgical intervention is not required for AML, unless symptoms develop. 8 Because patient management in this setting relies heavily on histological subtyping, accuracy in characterisation and classifying focal renal tumours is an important goal of currently available imaging techniques. Use of contrast agents, as in contrast-enhanced computed tomography (CT) and magnetic resonance imaging (MRI), enhances tumour definition (i.e., morphology and vascularisation) for high diagnostic accuracy, owing to unique and well-described features of specific lesions.…”

Histotype differentiation of hypo-echoic renal tumors on CEUS: usefulness of enhancement homogeneity and intensity

“…An additional sonologist experienced in real-time CEUS description and interpretation performed the quantitative analysis using SonoLiver (Bracco Research SA, Geneva, Switzerland and TomTec Imaging Systems GmbH, Unterschleissheim, Germany), which included three consecutive steps [8]. First, out-of-plane images and images preceding contrast arrival in the renal interlobular artery were excluded from processing.…”

“…Second, a representative image, which served as a reference position for motion compensation, equipped with SonoLiver, to automatically minimize the influence of slight breathing on the analysis, was selected where the lesion was well delineated, generally at peak enhancement. Last, two regions of interests (ROIs) were manually drawn on the reference frame, avoiding artifacts, calcification, and the renal capsule [8]. The analysis ROI, representing the area in which the quantitative analysis was to be computed, encompassed as much of the major enhanced portion of the lesions as possible, regardless of the degree of enhancement.…”

Aggressive Angiomyolipomas: the Clandestine Epithelioid Variant

“…Thought to be a variant of classical angiomyolipoma, a benign tumor, its malignant potential has been highlighted by case reports of loco-regional and distant metastasis [2,3,4]. Given the potentially adverse clinical course associated with EAML compared to classical angiomyolipoma, the distinction and comprehensive histological characterisation of this rare entity is essential.…”