Computed tomographic distinction of perirenal liposarcoma from exophytic angiomyolipoma

A feature analysis study

James J. Ellingson, Fergus Coakley, Bonnie N. Joe, Aliya Qayyum, Antonio C. Westphalen, Benjamin M. Yeh

Research output: Contribution to journalArticle

26 Citations (Scopus)

Abstract

PURPOSE: To identify computed tomographic (CT) findings that distinguish perirenal liposarcomas from exophytic angiomyolipomas. MATERIALS AND METHODS: We identified CT scans of 20 patients (13 women and 7 men; mean age, 63 years) with either perirenal liposarcoma (n = 11) proven at histopathology or large exophytic angiomyolipomas (n = 9) determined by 2-year stability (n = 6) or histopathology (n = 3). Two independent readers unaware of the final diagnoses recorded the presence of the following CT findings: (1) tumoral vessel extending into the renal cortex, (2) tumoral vessel extending into the renal hilum, (3) renal parenchymal defect at the site of tumor contact, (4) intratumoral hemorrhage, (5) nonfat attenuating intratumoral nodules, and (6) calcification. RESULTS: A tumoral vessel extending into the renal cortex was seen only in angiomyolipomas (7 and 6 of 9 patients versus 0 and 0 of 11 liposarcomas for readers 1 and 2, respectively; P <0.005 for both). A parenchymal defect was more commonly seen in angiomyolipomas (7 and 6 of 9 angiomyolipomas versus 1 and 1 of 11 liposarcomas for readers 1 and 2, respectively; P <0.05 for both). Calcifications were seen by both readers in 6 of 11 liposarcomas but not in any angiomyolipomas (P <0.05). The other recorded findings were not useful in distinguishing CT features (P > 0.1 for both readers). CONCLUSIONS: In the evaluation of a fatty perinephric mass at CT, the presence of a tumoral vessel extending into the renal cortex or a renal parenchymal defect at the site of tumor contact strongly favors the diagnosis of exophytic angiomyolipoma, whereas calcifications suggest liposarcoma.

Original languageEnglish (US)
Pages (from-to)548-552
Number of pages5
JournalJournal of Computer Assisted Tomography
Volume32
Issue number4
DOIs
StatePublished - Jul 2008
Externally publishedYes

Fingerprint

Angiomyolipoma
Liposarcoma
Kidney
Neoplasms
Hemorrhage

Keywords

  • Angiomyolipoma
  • CT
  • Kidney
  • Neoplasms
  • Retroperitoneal liposarcoma

ASJC Scopus subject areas

  • Radiology Nuclear Medicine and imaging
  • Radiological and Ultrasound Technology

Cite this

Computed tomographic distinction of perirenal liposarcoma from exophytic angiomyolipoma : A feature analysis study. / Ellingson, James J.; Coakley, Fergus; Joe, Bonnie N.; Qayyum, Aliya; Westphalen, Antonio C.; Yeh, Benjamin M.

In: Journal of Computer Assisted Tomography, Vol. 32, No. 4, 07.2008, p. 548-552.

Research output: Contribution to journalArticle

Ellingson, James J. ; Coakley, Fergus ; Joe, Bonnie N. ; Qayyum, Aliya ; Westphalen, Antonio C. ; Yeh, Benjamin M. / Computed tomographic distinction of perirenal liposarcoma from exophytic angiomyolipoma : A feature analysis study. In: Journal of Computer Assisted Tomography. 2008 ; Vol. 32, No. 4. pp. 548-552.
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abstract = "PURPOSE: To identify computed tomographic (CT) findings that distinguish perirenal liposarcomas from exophytic angiomyolipomas. MATERIALS AND METHODS: We identified CT scans of 20 patients (13 women and 7 men; mean age, 63 years) with either perirenal liposarcoma (n = 11) proven at histopathology or large exophytic angiomyolipomas (n = 9) determined by 2-year stability (n = 6) or histopathology (n = 3). Two independent readers unaware of the final diagnoses recorded the presence of the following CT findings: (1) tumoral vessel extending into the renal cortex, (2) tumoral vessel extending into the renal hilum, (3) renal parenchymal defect at the site of tumor contact, (4) intratumoral hemorrhage, (5) nonfat attenuating intratumoral nodules, and (6) calcification. RESULTS: A tumoral vessel extending into the renal cortex was seen only in angiomyolipomas (7 and 6 of 9 patients versus 0 and 0 of 11 liposarcomas for readers 1 and 2, respectively; P <0.005 for both). A parenchymal defect was more commonly seen in angiomyolipomas (7 and 6 of 9 angiomyolipomas versus 1 and 1 of 11 liposarcomas for readers 1 and 2, respectively; P <0.05 for both). Calcifications were seen by both readers in 6 of 11 liposarcomas but not in any angiomyolipomas (P <0.05). The other recorded findings were not useful in distinguishing CT features (P > 0.1 for both readers). CONCLUSIONS: In the evaluation of a fatty perinephric mass at CT, the presence of a tumoral vessel extending into the renal cortex or a renal parenchymal defect at the site of tumor contact strongly favors the diagnosis of exophytic angiomyolipoma, whereas calcifications suggest liposarcoma.",
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T1 - Computed tomographic distinction of perirenal liposarcoma from exophytic angiomyolipoma

T2 - A feature analysis study

AU - Ellingson, James J.

AU - Coakley, Fergus

AU - Joe, Bonnie N.

AU - Qayyum, Aliya

AU - Westphalen, Antonio C.

AU - Yeh, Benjamin M.

PY - 2008/7

Y1 - 2008/7

N2 - PURPOSE: To identify computed tomographic (CT) findings that distinguish perirenal liposarcomas from exophytic angiomyolipomas. MATERIALS AND METHODS: We identified CT scans of 20 patients (13 women and 7 men; mean age, 63 years) with either perirenal liposarcoma (n = 11) proven at histopathology or large exophytic angiomyolipomas (n = 9) determined by 2-year stability (n = 6) or histopathology (n = 3). Two independent readers unaware of the final diagnoses recorded the presence of the following CT findings: (1) tumoral vessel extending into the renal cortex, (2) tumoral vessel extending into the renal hilum, (3) renal parenchymal defect at the site of tumor contact, (4) intratumoral hemorrhage, (5) nonfat attenuating intratumoral nodules, and (6) calcification. RESULTS: A tumoral vessel extending into the renal cortex was seen only in angiomyolipomas (7 and 6 of 9 patients versus 0 and 0 of 11 liposarcomas for readers 1 and 2, respectively; P <0.005 for both). A parenchymal defect was more commonly seen in angiomyolipomas (7 and 6 of 9 angiomyolipomas versus 1 and 1 of 11 liposarcomas for readers 1 and 2, respectively; P <0.05 for both). Calcifications were seen by both readers in 6 of 11 liposarcomas but not in any angiomyolipomas (P <0.05). The other recorded findings were not useful in distinguishing CT features (P > 0.1 for both readers). CONCLUSIONS: In the evaluation of a fatty perinephric mass at CT, the presence of a tumoral vessel extending into the renal cortex or a renal parenchymal defect at the site of tumor contact strongly favors the diagnosis of exophytic angiomyolipoma, whereas calcifications suggest liposarcoma.

AB - PURPOSE: To identify computed tomographic (CT) findings that distinguish perirenal liposarcomas from exophytic angiomyolipomas. MATERIALS AND METHODS: We identified CT scans of 20 patients (13 women and 7 men; mean age, 63 years) with either perirenal liposarcoma (n = 11) proven at histopathology or large exophytic angiomyolipomas (n = 9) determined by 2-year stability (n = 6) or histopathology (n = 3). Two independent readers unaware of the final diagnoses recorded the presence of the following CT findings: (1) tumoral vessel extending into the renal cortex, (2) tumoral vessel extending into the renal hilum, (3) renal parenchymal defect at the site of tumor contact, (4) intratumoral hemorrhage, (5) nonfat attenuating intratumoral nodules, and (6) calcification. RESULTS: A tumoral vessel extending into the renal cortex was seen only in angiomyolipomas (7 and 6 of 9 patients versus 0 and 0 of 11 liposarcomas for readers 1 and 2, respectively; P <0.005 for both). A parenchymal defect was more commonly seen in angiomyolipomas (7 and 6 of 9 angiomyolipomas versus 1 and 1 of 11 liposarcomas for readers 1 and 2, respectively; P <0.05 for both). Calcifications were seen by both readers in 6 of 11 liposarcomas but not in any angiomyolipomas (P <0.05). The other recorded findings were not useful in distinguishing CT features (P > 0.1 for both readers). CONCLUSIONS: In the evaluation of a fatty perinephric mass at CT, the presence of a tumoral vessel extending into the renal cortex or a renal parenchymal defect at the site of tumor contact strongly favors the diagnosis of exophytic angiomyolipoma, whereas calcifications suggest liposarcoma.

KW - Angiomyolipoma

KW - CT

KW - Kidney

KW - Neoplasms

KW - Retroperitoneal liposarcoma

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