RCPA Examinations in Anatomical pathology - Questions ... - Rcpa.tv

Case 5: Male 38 – right
retroperitoneal mass
• MICROSCOPIC
• The section shows predominantly adipose tissue with mild variation in the size of the
adipocytes. . In places there is a suggestion of increased interstitial tissue sue comprising
spindle cells between the adipocytes. . In other areas there are interlacing bundles of
spindle cells. The spindle cells appear to show a degree of cytoplasmic vacuolation.
Thick walled vessels are not prominent however there is a background of small
capillaries and larger thin walled vessels.
• Comment
• The combination of fat, smooth muscle and slightly abnormal vessels els indicates an
angiomyolipoma. Immunoperoxidase stains for S100 and HMB45 as well as muscle
specific actin would help confirm this diagnosis as these lesions s show positive staining
for HMB45 and to a lesser degree S100. The smooth muscle shows positive staining
ing
for muscle specific actin. This lesion may be seen in patients with tuberous sclerosis
and clinical correlation is required
• SUMMARY
• Right retroperitoneal mass: Angiomyolipoma