Difference between revisions of "Case 117"
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Low magnification. H&E stain.
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===Differential diagnosis=== | ===Differential diagnosis=== | ||
{{hidden|Differential diagnosis|<center>[[ | {{hidden|Differential diagnosis|<center>[[leiomyosarcoma]], [[smooth muscle tumour of uncertain malignant potential]], [[leiomyoma]]</center>}} | ||
===Additional tests=== | ===Additional tests=== | ||
====More history==== | ====More history==== | ||
{{hidden|More history|<center> | {{hidden|More history|<center>on exam 14 week fibroid, 8cm uterine mass on ultrasound, abdominal discomfort</center>}} | ||
====Ask a colleague==== | ====Ask a colleague==== | ||
{{hidden|Ask a colleague|<center> | {{hidden|Ask a colleague|<center>I don't see a lot of mitoses. Did you try a p16 immunostain?</center>}} | ||
====Stains==== | ====Stains==== | ||
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<br> | <br> | ||
This smooth muscle tumor shows markedly atypical nuclei, some of which are multinucleate. The nuclei are smudgy and hyperchromatic, raising concern. However, here is no increase in mitotic activity; necrosis is absent. The edge of the tumor is rounded and there is no invasion of surrounding myometrium. These lesions are benign.<ref>{{Cite journal | last1 = Ly | first1 = A. | last2 = Mills | first2 = AM. | last3 = McKenney | first3 = JK. | last4 = Balzer | first4 = BL. | last5 = Kempson | first5 = RL. | last6 = Hendrickson | first6 = MR. | last7 = Longacre | first7 = TA. | title = Atypical leiomyomas of the uterus: a clinicopathologic study of 51 cases. | journal = Am J Surg Pathol | volume = 37 | issue = 5 | pages = 643-9 | month = May | year = 2013 | doi = 10.1097/PAS.0b013e3182893f36 | PMID = 23552381 }}</ref><ref>{{Cite journal | last1 = Croce | first1 = S. | last2 = Young | first2 = RH. | last3 = Oliva | first3 = E. | title = Uterine leiomyomas with bizarre nuclei: a clinicopathologic study of 59 cases. | journal = Am J Surg Pathol | volume = 38 | issue = 10 | pages = 1330-9 | month = Oct | year = 2014 | doi = 10.1097/PAS.0000000000000249 | PMID = 25140893 }}</ref> | This smooth muscle tumor shows markedly atypical nuclei, some of which are multinucleate. The nuclei are smudgy and hyperchromatic, raising concern. However, here is no increase in mitotic activity; necrosis is absent. The edge of the tumor is rounded and there is no invasion of surrounding myometrium. These lesions are benign.<ref>{{Cite journal | last1 = Ly | first1 = A. | last2 = Mills | first2 = AM. | last3 = McKenney | first3 = JK. | last4 = Balzer | first4 = BL. | last5 = Kempson | first5 = RL. | last6 = Hendrickson | first6 = MR. | last7 = Longacre | first7 = TA. | title = Atypical leiomyomas of the uterus: a clinicopathologic study of 51 cases. | journal = Am J Surg Pathol | volume = 37 | issue = 5 | pages = 643-9 | month = May | year = 2013 | doi = 10.1097/PAS.0b013e3182893f36 | PMID = 23552381 }}</ref><ref>{{Cite journal | last1 = Croce | first1 = S. | last2 = Young | first2 = RH. | last3 = Oliva | first3 = E. | title = Uterine leiomyomas with bizarre nuclei: a clinicopathologic study of 59 cases. | journal = Am J Surg Pathol | volume = 38 | issue = 10 | pages = 1330-9 | month = Oct | year = 2014 | doi = 10.1097/PAS.0000000000000249 | PMID = 25140893 }}</ref> | ||
[[p16]] immunostaining may be useful for differentiating leiomyoma (weak) from [[uterine leiomyosarcoma|leiomyosarcoma]] (strong).<ref name=pmid18156978>{{Cite journal | last1 = Gannon | first1 = BR. | last2 = Manduch | first2 = M. | last3 = Childs | first3 = TJ. | title = Differential Immunoreactivity of p16 in leiomyosarcomas and leiomyoma variants. | journal = Int J Gynecol Pathol | volume = 27 | issue = 1 | pages = 68-73 | month = Jan | year = 2008 | doi = 10.1097/pgp.0b013e3180ca954f | PMID = 18156978 }}</ref> | |||
===References=== | ===References=== | ||
{{Reflist|1}} | {{Reflist|1}} | ||
}} | }} | ||
<br> | <br> | ||
===Other cases=== | ===Other cases=== | ||
{{Cases navigation}} | {{Cases navigation}} | ||
Latest revision as of 03:31, 27 September 2015
Provided clinical history
52 year old woman, hysterectomy done for leiomyoma
Site
Uterus- myometrium
Primary image
Intermediate magnification
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High magnification
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Differential diagnosis
Differential diagnosis
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Additional tests
More history
More history
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Ask a colleague
Ask a colleague
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Stains
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IHC
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Molecular testing
Chromosomal translocations
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Other molecular tests
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Diagnosis
Diagnosis
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p16 immunostaining may be useful for differentiating leiomyoma (weak) from leiomyosarcoma (strong).[3] References
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