Ultrasound images of Angiomyolipoma

This is a homogeneous, highly echogenic, usually rounded lesion in the renal parenchyma containing blood vessels, muscle tissue and fat, as the name
suggests. They are usually solitary, asymptomatic lesions, found incidentally on the scan, although the larger lesions can haemorrhage, causing haematuria and pain. Angiomyolipomas are also associated with tuberose sclerosis, when they are often multiple and bilateral (Fig. 7.8).
Because the contrast between the hypoechoic renal parenchyma and the hyperechoic angiomyolipoma is so great, very small lesions in the order of
a few millimetres can easily be recognized.
It may be difficult confidently to differentiate an angiomyolipoma from a malignant renal neoplasm, particularly in a patient with haematuria. Angiomyolipomas tend to be smaller and more echogenic than renal cell carcinomas, and sometimes demonstrate shadowing, which is not normally seen in
small carcinomas.5 When doubt persists, CT is often able to differentiate in these cases by identifying the fat content of the lesion.
Ultrasound images Angiomyolipoma in the RK
ultrasound images Multiple, small angiomyolipomas in a patient with tuberose sclerosis
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