Difference between revisions of "Leiomyoma"
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A '''leiomyoma''' is a very common benign tumour of smooth muscle. Leiomyomas fit into the ''[[soft tissue lesions|soft tissue]]'' group of lesions. They are extremely common in the [[uterus]]. They may also be seen in the [[skin]]. | |||
==General== | ==General== | ||
Revision as of 14:39, 19 July 2011
A leiomyoma is a very common benign tumour of smooth muscle. Leiomyomas fit into the soft tissue group of lesions. They are extremely common in the uterus. They may also be seen in the skin.
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.