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| =Common benign= | | =Common benign= |
| ==Uterine leiomyoma== | | ==Uterine leiomyoma== |
| {{Main|Leiomyoma}}
| | *Often called ''fibroids''. |
| *Often called "fibroids". | | {{Main|Uterine leiomyoma}} |
| ===General===
| |
| *Extremely common... 40% of women by age 40.
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| *Benign.
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| **Can be a cause of abnormal uterine bleeding (commonly abbreviated ''AUB'').
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| *Large & multiple associated with infertility.
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| | |
| ===Gross===
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| Feature:
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| * Sharply circumscribed.
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| * Gray-white.
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| * Whorled appearance.
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| | |
| Factor that raise concern for leiomyosarcoma:
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| * Haemorrhage.
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| * Cystic degeneration.
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| * [[Necrosis]].
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| | |
| ===Microscopic===
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| Features:
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| * Spindle cells arranged in fascicles.
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| ** Fascicular appearance: adjacent groups of cells have their long axis perpendicular to one another; looks somewhat like a braided hair that was cut.
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| * Whorled arrangement of cells.
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| | |
| Negatives:
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| * Necrosis (low power) - suggestive of leiomyosarcoma.
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| * Hypercellularity.
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| * Nuclear atypia seen at low power.
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| * Few mitoses.
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| | |
| Images:
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| *[http://commons.wikimedia.org/w/index.php?title=File:Cutaneous_leiomyosarcoma_-_a_-_intermed_mag.jpg Fascicular pattern - leiomyosarcoma (WC)].
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| | |
| ====Variants====
| |
| *Lipoleiomyoma - with adipose tissue.
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| **Image: [http://commons.wikimedia.org/wiki/File:Lipoleiomyoma1.jpg Lipoleiomyoma - low mag. (WC)].
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| *Hypercellular leiomyoma - hypercellularity associated with more mutations.<ref name=pmid_none>{{Cite journal | last1 = Pandis | first1 = N. | last2 = Heim | first2 = S. | last3 = Willén | first3 = H. | last4 = Bardi | first4 = G. | last5 = Flodérus | first5 = U-M. | last6 = Mandahl | first6 = N. | last7 = Mitelman | first7 = F. | title = Histologic—cytogenetic correlations in uterine leiomyomas. | journal = International Journal of Gynecological Cancer | volume = 1 | issue = 4 | pages = 163-68 | month = Jan | year = 1991 | doi = | PMID = |url=http://www3.interscience.wiley.com/journal/119360394/abstract }}</ref>
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| *Atypical leiomyoma (AKA ''symplastic leiomyoma'') - leiomyoma with nuclear atypia.
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| **Image: [http://commons.wikimedia.org/wiki/File:Atypical_leiomyoma_intermed_mag.jpg Atypical leiomyoma (WC)].
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| *Benign metastasizing leiomyoma.<ref name=pmid16357844>{{Cite journal | last1 = Patton | first1 = KT. | last2 = Cheng | first2 = L. | last3 = Papavero | first3 = V. | last4 = Blum | first4 = MG. | last5 = Yeldandi | first5 = AV. | last6 = Adley | first6 = BP. | last7 = Luan | first7 = C. | last8 = Diaz | first8 = LK. | last9 = Hui | first9 = P. | title = Benign metastasizing leiomyoma: clonality, telomere length and clinicopathologic analysis. | journal = Mod Pathol | volume = 19 | issue = 1 | pages = 130-40 | month = Jan | year = 2006 | doi = 10.1038/modpathol.3800504 | PMID = 16357844 |url=http://www.nature.com/modpathol/journal/v19/n1/full/3800504a.html}}</ref>
| |
| **This is just what it sounds like. Some believe these are low grade [[leiomyosarcoma]]s.
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| | |
| ===IHC===
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| Work-up of suspicious leiomyomas:<ref>STC. 25 February 2009.</ref>
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| *CD10 +ve.<ref name=pmid14751141>{{Cite journal | last1 = Zhu | first1 = XQ. | last2 = Shi | first2 = YF. | last3 = Cheng | first3 = XD. | last4 = Zhao | first4 = CL. | last5 = Wu | first5 = YZ. | title = Immunohistochemical markers in differential diagnosis of endometrial stromal sarcoma and cellular leiomyoma. | journal = Gynecol Oncol | volume = 92 | issue = 1 | pages = 71-9 | month = Jan | year = 2004 | doi = | PMID = 14751141 }}</ref>
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| *SMA +ve.
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| *Desmin +ve.
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| *Ki-67 -ve.
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| | |
| Others:
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| *p16 usually -ve.<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>
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| **Often +ve in leiomyosarcoma.
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| *H-caldesmon +ve.<ref name=pmid14751141/>
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| | |
| ===Sign out===
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| <pre>
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| UTERUS, UTERINE TUBES AND LEFT OVARY, TOTAL HYSTERECTOMY, BILATERAL SALPINGECTOMY AND RIGHT OOPHRECTOMY:
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| - LEIOMYOMATA WITH FOCAL CALCIFICATION AND HYALINE CHANGE.
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| - SECRETORY PHASE ENDOMETRIUM.
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| - RIGHT OVARY WITHIN NORMAL LIMITS.
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| - UTERINE TUBES WITHIN NORMAL LIMITS.
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| - UTERINE CERVIX WITHIN NORMAL LIMITS.
| |
| </pre>
| |
| | |
| ====Myomectomy====
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| <pre>
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| UTERINE MASSES ("FIBROIDS"), MYOMECTOMY:
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| - LEIOMYOMATA.
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| </pre>
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|
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|
| =Uncommon benign= | | =Uncommon benign= |
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|
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| Images: | | Images: |
| *[http://www.webpathology.com/image.asp?n=6&Case=572 Adenofibroma of the uterus - low mag. (webpathology.com)]. | | *[https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5496288/figure/F2/ Adenofibroma (nlm.nih.gov)].<ref>{{cite journal |authors=Chawla L, Vatsa R, Roy KK, Kumar S |title=Uterine Adenofibroma: An Unsual Cause of Nonpuerperal Uterine Inversion in Postmenopausal Female |journal=J Midlife Health |volume=8 |issue=2 |pages=95–97 |date=2017 |pmid=28706412 |pmc=5496288 |doi=10.4103/jmh.JMH_27_17 |url=}}</ref> |
| *[http://www.webpathology.com/image.asp?n=7&Case=572 Adenofibroma of the uterus - high mag. (webpathology.com)].
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|
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|
| ==Adenomatoid tumour== | | ==Adenomatoid tumour== |
| :Should '''not''' be confused with ''[[Adamantinoma]]'' - a bone tumour. | | :Should '''not''' be confused with the [[bone tumour]] ''[[adamantinoma]]''. |
| ===General===
| | {{Main|Adenomatoid tumour}} |
| *Grossly mimics leiomyoma.<ref name=pmid8543111>{{Cite journal | last1 = Huang | first1 = CC. | last2 = Chang | first2 = DY. | last3 = Chen | first3 = CK. | last4 = Chou | first4 = YY. | last5 = Huang | first5 = SC. | title = Adenomatoid tumor of the female genital tract. | journal = Int J Gynaecol Obstet | volume = 50 | issue = 3 | pages = 275-80 | month = Sep | year = 1995 | doi = | PMID = 8543111 }}
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| </ref>
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| *Benign tumour - derived from mesothelium.
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| *May be seen paratesticular.<ref name=pmid20223139>{{Cite journal | last1 = González Resina | first1 = R. | last2 = Carranza Carranza | first2 = A. | last3 = Congregado Córdoba | first3 = J. | last4 = Conde Sánchez | first4 = JM. | last5 = Congregado Ruiz | first5 = CB. | last6 = Medina López | first6 = R. | title = [Paratesticular adenomatoid tumor: a report of nine cases]. | journal = Actas Urol Esp | volume = 34 | issue = 1 | pages = 95-100 | month = Jan | year = 2010 | doi = | PMID = 20223139 }}
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| </ref>
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| | |
| ===Microscopic===
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| Features:<ref>{{Ref GP|346}}</ref>
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| *Well-circumscribed lesion; however, ''not'' encapsulated.
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| *Small tubulocystic spaces lined by cytologically normal mesothelium.
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| **These pseudotubular spaces are crossed by "thread-like bridging strands" - '''key feature'''.<ref name=pmid19543245>{{Cite journal | last1 = Sangoi | first1 = AR. | last2 = McKenney | first2 = JK. | last3 = Schwartz | first3 = EJ. | last4 = Rouse | first4 = RV. | last5 = Longacre | first5 = TA. | title = Adenomatoid tumors of the female and male genital tracts: a clinicopathological and immunohistochemical study of 44 cases. | journal = Mod Pathol | volume = 22 | issue = 9 | pages = 1228-35 | month = Sep | year = 2009 | doi = 10.1038/modpathol.2009.90 | PMID = 19543245 }}</ref><ref name=pmid14571427>{{Cite journal | last1 = Hes | first1 = O. | last2 = Perez-Montiel | first2 = DM. | last3 = Alvarado Cabrero | first3 = I. | last4 = Zamecnik | first4 = M. | last5 = Podhola | first5 = M. | last6 = Sulc | first6 = M. | last7 = Hora | first7 = M. | last8 = Mukensnabl | first8 = P. | last9 = Zalud | first9 = R. | title = Thread-like bridging strands: a morphologic feature present in all adenomatoid tumors. | journal = Ann Diagn Pathol | volume = 7 | issue = 5 | pages = 273-7 | month = Oct | year = 2003 | doi = | PMID = 14571427 }}</ref>
| |
| | |
| DDx:
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| *[[Lymphangioma]].
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| *[[Leiomyoma]].
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| | |
| ====Images====
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| <gallery>
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| Image:Adenomatoid_tumour_-_low_mag.jpg | Adenomatoid tumour - low mag. (WC)
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| Image:Adenomatoid_tumour_-_intermed_mag.jpg | Adenomatoid tumour - intermed. mag. (WC)
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| Image:Adenomatoid_tumour_-_high_mag.jpg | Adenomatoid tumour - high mag. (WC)
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| Image:Adenomatoid_tumour_-b-_very_high_mag.jpg | Adenomatoid tumour - very high mag. (WC)
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| </gallery>
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| | |
| ===IHC===
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| Features:<ref name=pmid16548294>{{Cite journal | last1 = Canedo-Patzi | first1 = AM. | last2 = León-Bojorge | first2 = B. | last3 = de Ortíz-Hidalgo | first3 = C. | title = [Adenomatoid tumor of the genital tract. Clinical, pathological and immunohistochemical study in 9 cases] | journal = Gac Med Mex | volume = 142 | issue = 1 | pages = 59-66 | month = | year = | doi = | PMID = 16548294 }}
| |
| </ref>
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| *Calretinin +ve.
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| *AE1/AE3 +ve.
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| *CD31 -ve.
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| *CK7 +ve.<ref>Latta, E. 9 December 2009.</ref>
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|
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|
| =Uncertain malignant potential= | | =Uncertain malignant potential= |
| ==Smooth muscle tumour of uncertain malignant potential== | | ==Smooth muscle tumour of uncertain malignant potential== |
| *Abbreviated ''STUMP''. | | *Abbreviated ''STUMP''. |
| ===General===
| | {{Main|Smooth muscle tumour of uncertain malignant potential}} |
| *Like ''[[ASAP]]'' and ''[[ASCUS]]'' - a [[waffle diagnosis|waffle category]]... when one isn't sure it is a ''leiomyoma'' vs. ''leiomyosarcoma''.
| |
| *Clinical behaviour: usually benign.<ref name=pmid19417585>{{cite journal |author=Ip PP, Cheung AN, Clement PB |title=Uterine smooth muscle tumors of uncertain malignant potential (STUMP): a clinicopathologic analysis of 16 cases |journal=Am. J. Surg. Pathol. |volume=33 |issue=7 |pages=992–1005 |year=2009 |month=July |pmid=19417585 |doi=10.1097/PAS.0b013e3181a02d1c |url=}}</ref>
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| *Can be subclassified into four groups - as per Stanford.
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| | |
| Management:
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| *Long-term follow-up.<ref name=pmid19417585/>
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| | |
| ===Microscopic===
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| Features associated with recurrence:<ref name=pmid19417585/>
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| *Nuclear atypia.
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| DDx:
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| *[[Uterine leiomyoma]].
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| *[[Uterine leiomyosarcoma]].
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| | |
| ===IHC===
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| Features associated with recurrence:<ref name=pmid19417585/>
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| *p16 +ve.
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| *p53 +ve.
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|
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|
| =Malignant= | | =Malignant= |
| ==Uterine carcinosarcoma== | | ==Uterine carcinosarcoma== |
| * [[AKA]] ''malignant mixed muellerian tumour'', abbreviated ''MMMT''. | | * [[AKA]] ''malignant mixed muellerian tumour'', abbreviated ''MMMT''. |
| | | {{Main|Uterine carcinosarcoma}} |
| ===General===
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| * Associated with previous radiation exposure.
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| * Metstasize as adenocarcinoma.
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| * Aggressive/poor prognosis;<ref name=pmid15688674>{{Cite journal | last1 = Ivy | first1 = JJ. | last2 = Unger | first2 = JB. | title = Malignant mixed mullerian sarcomas of the uterus--the LSUHSC Shreveport experience. | journal = J La State Med Soc | volume = 156 | issue = 6 | pages = 324-6 | month = | year = | doi = | PMID = 15688674 }}</ref> in one series 5 year survival ~= 30-35%.<ref name=pmid14967435>{{Cite journal | last1 = Callister | first1 = M. | last2 = Ramondetta | first2 = LM. | last3 = Jhingran | first3 = A. | last4 = Burke | first4 = TW. | last5 = Eifel | first5 = PJ. | title = Malignant mixed Müllerian tumors of the uterus: analysis of patterns of failure, prognostic factors, and treatment outcome. | journal = Int J Radiat Oncol Biol Phys | volume = 58 | issue = 3 | pages = 786-96 | month = Mar | year = 2004 | doi = 10.1016/S0360-3016(03)01561-X | PMID = 14967435 }}</ref>
| |
| *Considered to be a poorly differentiated endometrial carcinoma with metaplastic changes.<ref name=pmid19853898>{{Cite journal | last1 = D'Angelo | first1 = E. | last2 = Prat | first2 = J. | title = Uterine sarcomas: a review. | journal = Gynecol Oncol | volume = 116 | issue = 1 | pages = 131-9 | month = Jan | year = 2010 | doi = 10.1016/j.ygyno.2009.09.023 | PMID = 19853898 }}</ref>
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| *Case reports of MMMT in [[ovary]] and [[fallopian tube]].
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| | |
| ===Microscopic===
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| Features:<ref name=Ref_WMSP428>{{Ref WMSP|428}}</ref>
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| *Biphasic tumour:
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| *#Malignant glandular component (adenocarcinoma).
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| *#Malignant stromal component (one of the following):
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| *#*Homologous type (tissue native to uterus):
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| *#*#Smooth muscle ([[leiomyosarcoma]]).
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| *#*#Fibrous tissue ([[fibrosarcoma]]).
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| *#*Heterologous type (tissue not native to the uterus):
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| *#*#Skeletal muscle ([[rhabdomyosarcoma]]).
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| *#*#Cartilage ([[chondrosarcoma]]).
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| *#*#Bone ([[osteosarcoma]]).
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| *#*Undifferentiated sarcoma ([[pleomorphic undifferentiated sarcoma]]).
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| | |
| DDx:
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| *[[Undifferentiated endometrial sarcoma]].
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| *[[Adenosarcoma of the uterus]].
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| | |
| ====Images====
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| <gallery>
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| Image:Carcinosarcoma_-_low_mag.jpg | MMMT - low mag. (WC)
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| Image:Carcinosarcoma_-_high_mag.jpg | MMMT - high mag. (WC)
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| Image:MalignantMixedMullerianTumor.JPG | MMMT - crappy (WC)
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| </gallery>
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| www:
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| *[http://path.upmc.edu/cases/case227.html MMMT - case 1 - several images (upmc.edu)].
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| *[http://path.upmc.edu/cases/case328.html MMMT - case 2 - several images (upmc.edu)].
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|
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|
| ==Adenosarcoma of the uterus== | | ==Adenosarcoma of the uterus== |
| *[[AKA]] ''uterine adenocarcinoma''. | | *[[AKA]] ''uterine adenosarcoma''. |
| ===General===
| | {{Main|Adenosarcoma of the uterus}} |
| Features:<ref name=pmid20179434>{{Cite journal | last1 = McCluggage | first1 = WG. | title = Mullerian adenosarcoma of the female genital tract. | journal = Adv Anat Pathol | volume = 17 | issue = 2 | pages = 122-9 | month = Mar | year = 2010 | doi = 10.1097/PAP.0b013e3181cfe732 | PMID = 20179434 }}</ref>
| |
| *Uncommon.
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| *May prolapse through cervical os and thus present as [[cervical polyp]].
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| *Most commonly uterine corpus, occasionally cervix and ovary, rarely in the vagina, fallopian tube, peritoneal surfaces, intestine.
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| *Typically 30-40 years old.
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| | |
| Clinical:<ref name=pmid17506376>{{Cite journal | last1 = Abu | first1 = J. | last2 = Ireland | first2 = D. | last3 = Brown | first3 = L. | title = Adenosarcoma of an endometrial polyp in a 27-year-old nulligravida: a case report. | journal = J Reprod Med | volume = 52 | issue = 4 | pages = 326-8 | month = Apr | year = 2007 | doi = | PMID = 17506376 }}</ref>
| |
| *Most common presentations of Müllerian adenosarcoma (percentages based on series of 41 individuals<ref name=pmid9625851>{{Cite journal | last1 = Verschraegen | first1 = CF. | last2 = Vasuratna | first2 = A. | last3 = Edwards | first3 = C. | last4 = Freedman | first4 = R. | last5 = Kudelka | first5 = AP. | last6 = Tornos | first6 = C. | last7 = Kavanagh | first7 = JJ. | title = Clinicopathologic analysis of mullerian adenosarcoma: the M.D. Anderson Cancer Center experience. | journal = Oncol Rep | volume = 5 | issue = 4 | pages = 939-44 | month = | year = | doi = | PMID = 9625851 }}</ref>):
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| **Vaginal bleeding ~ 70%.
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| **Pelvic mass ~ 40%.
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| **Uterine polyp ~ 30%.
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| *Prognosis (based on series of ~500 individuals<ref name=pmid20688363>{{Cite journal | last1 = Arend | first1 = R. | last2 = Bagaria | first2 = M. | last3 = Lewin | first3 = SN. | last4 = Sun | first4 = X. | last5 = Deutsch | first5 = I. | last6 = Burke | first6 = WM. | last7 = Herzog | first7 = TJ. | last8 = Wright | first8 = JD. | title = Long-term outcome and natural history of uterine adenosarcomas. | journal = Gynecol Oncol | volume = 119 | issue = 2 | pages = 305-8 | month = Nov | year = 2010 | doi = 10.1016/j.ygyno.2010.07.001 | PMID = 20688363 }}</ref>):
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| **Favourable outcome - most detected at an early stage.
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| ***~80% five year survival for stage I tumours.
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| **Outcome better than [[uterine carcinosarcoma|carcinosarcoma]].
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| | |
| Treatment:
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| *TAH-BSO.
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| **Tumours are estrogen responsive.
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| *Chemotherapy (platin-based).<ref name=pmid9625851/>
| |
| | |
| ===Microscopic===
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| Features:<ref name=Ref_PBoD1089>{{Ref PBoD|1089}}</ref><ref name=pmid20179434/>
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| *"Malignant stroma" - '''key feature'''.
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| **Stromal nuclear pleomorphism - usually low grade.
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| **WHO criteria: 2+ mitoses / 10 HPF -- definition suffers from [[HPFitis]].
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| ***Mitotic rate criteria often ignored as mitotically inactive tumours metastasize.<ref name=pmid20179434/>
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| *Benign glands with an abnormal shape.
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| *"Cambium layer" = increased cellularity around the epithelial elements.<ref name=pmid20179434/><ref name=medilexicon_cambium/>
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| | |
| Notes:
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| *Tumour may vaguely resemble a [[phyllodes tumour]].<ref name=pmid20179434/>
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| *''Cambium layer'' - seen in: adenosarcoma, botryoid [[RMS]].<ref name=medilexicon_cambium>URL: [http://www.medilexicon.com/medicaldictionary.php?t=48297 http://www.medilexicon.com/medicaldictionary.php?t=48297]. Accessed on: 9 August 2011.</ref>
| |
| | |
| DDx:
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| *[[Benign endometrial polyp]].
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| *[[Uterine adenofibroma]].
| |
| | |
| ====Images====
| |
| <gallery>
| |
| Image:Uterine_adenosarcoma_-_low_mag.jpg | Uterine adenosarcoma - low mag. (WC)
| |
| Image:Uterine_adenosarcoma_-_intermed_mag.jpg | Uterine adenosarcoma - intermed. mag. (WC)
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| Image:Uterine_adenosarcoma_-_high_mag.jpg | Uterine adenosarcoma - high mag. (WC)
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| </gallery>
| |
| | |
| ===IHC===
| |
| *CD10 +ve.<ref name=pmid20179434/>
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| *ER +ve.
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| *PR +ve.
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|
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|
| ==Uterine leiomyosarcoma== | | ==Uterine leiomyosarcoma== |
| Line 283: |
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| *#**Zonal necrosis may be seen in (benign) leiomyomas. | | *#**Zonal necrosis may be seen in (benign) leiomyomas. |
| *#Mitoses. | | *#Mitoses. |
| *#*10 mitoses/HPF. | | *#*10 mitoses/10 HPF. |
| *#*5 mitoses/HPF - if epithelioid. | | *#*5 mitoses/10 HPF - if epithelioid. |
| *#*2 mitoses/HPF - if [[myxoid]]. | | *#*2 mitoses/10 HPF - if [[myxoid]]. |
|
| |
|
| Note: | | Note: |
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| ==Endometrial stromal sarcoma== | | ==Endometrial stromal sarcoma== |
| *Abbreviated ESS. | | *Abbreviated ESS. |
| *[[AKA]] ''low-grade endometrial stromal sarcoma''. | | *Previously known as ''low-grade endometrial stromal sarcoma''. |
| ===General===
| | {{Main|Endometrial stromal sarcoma}} |
| *Rare.<ref name=pmid20179433> {{Cite journal | last1 = Chew | first1 = I. | last2 = Oliva | first2 = E. | title = Endometrial stromal sarcomas: a review of potential prognostic factors. | journal = Adv Anat Pathol | volume = 17 | issue = 2 | pages = 113-21 | month = Mar | year = 2010 | doi = 10.1097/PAP.0b013e3181cfb7c2 | PMID = 20179433 }}</ref>
| |
| | |
| ===Microscopic===
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| Features:
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| *Highly cellular Islands with a wavy irregular border.
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| **Border has finger-like projections/[[tongue]]-like projections.
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| **Benign uterine smooth muscle between islands of tumour cells.
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| *Epithelioid cells.
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| *High [[NC ratio]].
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| *Thin blood vessels within islands of cells.
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| **Tumour cells pallisade around the vessels.
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| | |
| Notes:
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| *Vaguely resembles the stroma of proliferative endometrium.
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| | |
| DDx:
| |
| *[[Leiomyoma]].
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| *[[Endometrial stromal nodule]].
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| *[[Uterine leiomyosarcoma]].
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| | |
| Images:
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| *[http://commons.wikimedia.org/wiki/File:EndometrialStromalSarcoma.JPG ESS (WC)].
| |
| *[http://commons.wikimedia.org/wiki/File:EndometrialStromalSarcomaLowGrade.JPG Endometrial stromal sarcoma - low grade (WC)].
| |
| *[http://jcp.bmj.com/content/60/3/235/F5.large.jpg ESS in an article with many crappy images].<ref name=pmid17347285>{{Cite journal | last1 = Baker | first1 = P. | last2 = Oliva | first2 = E. | title = Endometrial stromal tumours of the uterus: a practical approach using conventional morphology and ancillary techniques. | journal = J Clin Pathol | volume = 60 | issue = 3 | pages = 235-43 | month = Mar | year = 2007 | doi = 10.1136/jcp.2005.031203 | PMID = 17347285 | url = http://jcp.bmj.com/content/60/3/235.full }}</ref>
| |
| *[http://radiographics.rsna.org/content/25/1/21/F42.expansion.html ESS (rsna.org)].
| |
| | |
| ===IHC===
| |
| Features:<ref name=pmid14751141>{{Cite journal | last1 = Zhu | first1 = XQ. | last2 = Shi | first2 = YF. | last3 = Cheng | first3 = XD. | last4 = Zhao | first4 = CL. | last5 = Wu | first5 = YZ. | title = Immunohistochemical markers in differential diagnosis of endometrial stromal sarcoma and cellular leiomyoma. | journal = Gynecol Oncol | volume = 92 | issue = 1 | pages = 71-9 | month = Jan | year = 2004 | doi = | PMID = 14751141 }}</ref>
| |
| *CD10 +ve.
| |
| *h-caldesmin -ve.
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| **[[Leiomyoma]]s +ve.
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| *PR +/-ve.
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| *ER +/-ve.
| |
| | |
| ===Molecular===
| |
| May be associated a recurrent [[translocation]]:<ref name=pmid12648605>{{Cite journal | last1 = Amant | first1 = F. | last2 = Moerman | first2 = P. | last3 = Cadron | first3 = I. | last4 = Hagemeijer | first4 = A. | last5 = Vergote | first5 = I. | last6 = Debiec-Rychter | first6 = M. | title = Endometrial stromal sarcoma with a sole t(X;17) chromosome change: report of a case and review of the literature. | journal = Gynecol Oncol | volume = 88 | issue = 3 | pages = 459-62 | month = Mar | year = 2003 | doi = | PMID = 12648605 | URL = http://www.sciencedirect.com/science/article/pii/S0090825802000963 }}</ref>
| |
| *t(7;17)(p15;q21).
| |
| **JAZF1 - chromosome 7.<ref name=omim606246>{{OMIM|606246}}</ref>
| |
| **SUZ12 - chromosome 17.<ref name=omim606245>{{OMIM|606245}}</ref>
| |
|
| |
|
| ==Undifferentiated endometrial sarcoma== | | ==Undifferentiated endometrial sarcoma== |
| *Abbreviated as ''UES''. | | *Abbreviated as ''UES''. |
| | *Previously known as ''high-grade endometrial stromal sarcoma''.<ref name=pmid24146786>{{Cite journal | last1 = Feng | first1 = W. | last2 = Malpica | first2 = A. | last3 = Skaland | first3 = I. | last4 = Gudlaugsson | first4 = E. | last5 = Robboy | first5 = SJ. | last6 = Dalen | first6 = I. | last7 = Hua | first7 = K. | last8 = Zhou | first8 = X. | last9 = Baak | first9 = JP. | title = Can proliferation biomarkers reliably predict recurrence in world health organization 2003 defined endometrial stromal sarcoma, low grade? | journal = PLoS One | volume = 8 | issue = 10 | pages = e75899 | month = | year = 2013 | doi = 10.1371/journal.pone.0075899 | PMID = 24146786 }}</ref> |
| ===General=== | | ===General=== |
| *Malignant. | | *Malignant. |
| Line 421: |
Line 181: |
| *[[Placental site trophoblastic tumour]]. | | *[[Placental site trophoblastic tumour]]. |
|
| |
|
| ==Uterine tumors resembling ovarian sex cord tumours== | | ==Uterine tumour resembling an ovarian sex cord stromal tumour== |
| *Abbreviated ''UTROSCT''. | | *Abbreviated ''UTROSCT''. |
| | | {{Main|Uterine tumour resembling an ovarian sex cord stromal tumour}} |
| ===General===
| |
| *Super rare.
| |
| | |
| ===Microscopic===
| |
| Features:
| |
| *Look like sex cord tumour:<ref>URL: [http://www.nature.com/modpathol/journal/v19/n1/full/3800475a.html http://www.nature.com/modpathol/journal/v19/n1/full/3800475a.html]. Accessed on: 5 August 2010.</ref>
| |
| **May have: anastomosing cords, [[trabeculae]], small nests and/or tubules.
| |
|
| |
|
| ==Atypical polypoid adenomyoma of the uterus== | | ==Atypical polypoid adenomyoma of the uterus== |
| *Abbreviated ''APA''. | | *Abbreviated ''APA''. |
| *[[AKA]] ''atypical polypoid adenomyoma''. | | *[[AKA]] ''atypical polypoid adenomyoma''. |
| ===General===
| | {{Main|Atypical polypoid adenomyoma of the uterus}} |
| *Very rare.<ref name=pmid21684185>{{Cite journal | last1 = Terada | first1 = T. | title = Atypical polypoid adenomyoma of the uterus: an immunohistochemical study on 5 cases. | journal = Ann Diagn Pathol | volume = 15 | issue = 5 | pages = 338-41 | month = Oct | year = 2011 | doi = 10.1016/j.anndiagpath.2011.03.008 | PMID = 21684185 }}</ref>
| |
| *Benign.<ref name=pmid17050990/>
| |
| *Reproductive age women.
| |
| | |
| ===Gross===
| |
| *Lower uterine segment.
| |
| | |
| ===Microscopic===
| |
| Features:<ref name=pmid17050990>{{Cite journal | last1 = Jakus | first1 = S. | last2 = Edmonds | first2 = P. | last3 = Dunton | first3 = C. | last4 = Holland | first4 = G. | title = Atypical polypoid adenomyoma mimicking cervical adenocarcinoma. | journal = J Low Genit Tract Dis | volume = 6 | issue = 1 | pages = 33-8 | month = Jan | year = 2002 | doi = | PMID = 17050990 }}</ref>
| |
| *Glands with irregular (non-ovoid) shapes.
| |
| *Benign smooth muscle around the glands - '''key feature'''.
| |
| *Morular squamous metaplasia - balls of squamous cells - very common.
| |
| *Nuclear atypia (mild).
| |
| | |
| DDx:
| |
| *[[Endometrioid endometrial carcinoma]].
| |
| *Endocervical adenocarcinoma.
| |
| | |
| ====Images====
| |
| <gallery>
| |
| Image:Atypical_polypoid_adenomyoma_-_intermed_mag.jpg | APA - intermed. mag. (WC)
| |
| Image:Atypical_polypoid_adenomyoma_-_high_mag.jpg | APA - high mag. (WC)
| |
| Image:Atypical_polypoid_adenomyoma_-_very_high_mag.jpg | APA - very high mag. (WC)
| |
| </gallery>
| |
| www:
| |
| *[http://www.pathologypics.com/PictView.aspx?ID=1220 APA (pathologypics.com)].
| |
| | |
| ===IHC===
| |
| Features (glandular component):<ref name=pmid21684185/>
| |
| *AE1/AE3 +ve.
| |
| *CK7 +ve.
| |
| *ER +ve.
| |
| *PR +ve.
| |
| | |
| Significant negative (glandular component):<ref name=pmid21684185/>
| |
| *CK20 -ve.
| |
| *CEA -ve.
| |
|
| |
|
| =See also= | | =See also= |
