The use of the Ki-67 marker in the pathological diagnosis of the epithelioid variant of renal angiomyolipoma

Objective:Epithelioid angiomyolipoma (EAML) is a rare malignant variant of renal angiomyolipoma (AML). There were 34 cases of EAML reported in 25 studies (including this present study) over the past decade. About 68% were females and 32% males. The mean age was 40.1 years, 53% developed metastatic disease after nephrectomy, and eight patients had TSC. All cases are reported positive when stained with HMB-45 which also labels all classical AML. This study evaluates the use of Ki-67 (proliferation marker) in the pathological diagnosis of EAML and distinction from classical AML.Method:Immunohistochemical reactions for Ki-67 were generated on multiple representative blocks of tissue obtained from two cases of HMB-45 positive EAML and four cases of classic AML and the percentage of positively staining cells estimated.Results:Both cases of EAML were strongly positive for Ki-67 while all four classic AML were completely negative.Conclusion:The Ki67 is a useful marker in which distinguishes the malignant epithelioid variant of AML from classic AML.

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