Difference between revisions of "Leiomyoma"
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==General== | ==General== | ||
*Benign. | |||
===Uterine leiomyomas=== | |||
*Often called "fibroids". | *Often called "fibroids". | ||
*Extremely common... 40% of women by age 40. | *Extremely common... 40% of women by age 40. | ||
*Can be a cause of [[AUB]] (abnormal uterine bleeding). | |||
*Large & multiple leiomyomas are associated with infertility. | |||
==Gross== | ==Gross== | ||
| Line 13: | Line 15: | ||
* Whorled appearance. | * Whorled appearance. | ||
Factors that raise concern for [[leiomyosarcoma]]: | |||
* Haemorrhage. | * Haemorrhage. | ||
* Cystic degeneration. | * Cystic degeneration. | ||
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==IHC== | ==IHC== | ||
Work-up of suspicious leiomyomas:<ref>STC. 25 February 2009.</ref> | Work-up of suspicious leiomyomas:<ref>STC. 25 February 2009.</ref> | ||
*CD10 | *CD10 +ve. | ||
*Ki-67 | *Ki-67 -ve. | ||
*SMA | *SMA +ve. | ||
*Desmin | *Desmin +ve. | ||
==See also== | ==See also== | ||
| Line 51: | Line 53: | ||
==References== | ==References== | ||
{{Reflist| | {{Reflist|2}} | ||
[[Category:Soft tissue lesions]] | [[Category:Soft tissue lesions]] | ||
Revision as of 04:56, 3 June 2011
Leiomyomas are very common benign smooth muscle tumours. They fit into the soft tissue group of lesions.
General
- Benign.
Uterine leiomyomas
- Often called "fibroids".
- Extremely common... 40% of women by age 40.
- Can be a cause of AUB (abnormal uterine bleeding).
- Large & multiple leiomyomas are associated with infertility.
Gross
- Sharply circumscribed.
- Gray-white.
- Whorled appearance.
Factors that raise concern for leiomyosarcoma:
- Haemorrhage.
- Cystic degeneration.
- Necrosis.
Microscopic
Features:
- Spindle cells arranged in fascicles.
- Fascicular appearance: adjacent groups of cells have their long axis perpendicular to one another; looks somewhat like a braided hair that was cut.
- Whorled arrangement of cells.
Negatives:
- Necrosis (low power) - suggestive of leiomyosarcoma.
- Hypercellularity.
- Nuclear atypia seen at low power.
- Few mitoses.
Variants
- Lipoleiomyoma - with adipose tissue.
- Image: Lipoleiomyoma - low mag. (WC).
- Hypercellular leiomyoma - hypercellularity assoc. with more mutations.[1]
- Atypical leiomyoma (AKA symplastic leiomyoma) - leiomyoma with nuclear atypia.
- Image: Atypical leiomyoma (WC).
- Benign metastasizing leiomyoma.[2]
- This is just what it sounds like. Some believe these are low grade leiomyosarcomas
IHC
Work-up of suspicious leiomyomas:[3]
- CD10 +ve.
- Ki-67 -ve.
- SMA +ve.
- Desmin +ve.
See also
References
- ↑ http://www3.interscience.wiley.com/journal/119360394/abstract
- ↑ Patton, KT.; Cheng, L.; Papavero, V.; Blum, MG.; Yeldandi, AV.; Adley, BP.; Luan, C.; Diaz, LK. et al. (Jan 2006). "Benign metastasizing leiomyoma: clonality, telomere length and clinicopathologic analysis.". Mod Pathol 19 (1): 130-40. doi:10.1038/modpathol.3800504. PMID 16357844. http://www.nature.com/modpathol/journal/v19/n1/full/3800504a.html.
- ↑ STC. 25 February 2009.