Difference between revisions of "Leiomyoma"

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Revision as of 04:49, 3 June 2011

Leiomyomas are very common benign smooth muscle tumours. They fit into the soft tissue group of lesions.

General

  • Often called "fibroids".
  • Extremely common... 40% of women by age 40.
  • Benign.
    • Can be a cause of AUB (abnormal uterine bleeding).
    • Large & multiple associated with infertility.

Gross

  • Sharply circumscribed.
  • Gray-white.
  • Whorled appearance.

Factor 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

IHC

Work-up of suspicious leiomyomas:[2]

  • CD10 (+ve).
  • Ki-67 (-ve).
  • SMA (+ve).
  • Desmin (+ve).

See also

References