Difference between revisions of "Leiomyosarcoma"

From Libre Pathology
Jump to navigation Jump to search
(wikify)
(→‎Microscopic: +images)
Line 29: Line 29:
*#*2 mitoses/HPF - if myxoid.
*#*2 mitoses/HPF - if myxoid.
*#*>=1 mitosis/HPF - if cutaneous.<ref name=pmid21358302>{{cite journal |author=Kraft S, Fletcher CD |title=Atypical intradermal smooth muscle neoplasms: clinicopathologic analysis of 84 cases and a reappraisal of cutaneous "leiomyosarcoma" |journal=Am. J. Surg. Pathol. |volume=35 |issue=4 |pages=599–607 |year=2011 |month=April |pmid=21358302 |doi=10.1097/PAS.0b013e31820e6093 |url=}}</ref>
*#*>=1 mitosis/HPF - if cutaneous.<ref name=pmid21358302>{{cite journal |author=Kraft S, Fletcher CD |title=Atypical intradermal smooth muscle neoplasms: clinicopathologic analysis of 84 cases and a reappraisal of cutaneous "leiomyosarcoma" |journal=Am. J. Surg. Pathol. |volume=35 |issue=4 |pages=599–607 |year=2011 |month=April |pmid=21358302 |doi=10.1097/PAS.0b013e31820e6093 |url=}}</ref>
Images:
*Uterine:
**[http://commons.wikimedia.org/wiki/File:Uterine_leiomyosarcoma_%281%29.jpg Uterine leiomyosarcoma 1 (WC)].
**[http://commons.wikimedia.org/wiki/File:Uterine_leiomyosarcoma_%282%29.jpg Uterine leiomyosarcoma 2 (WC)].
*Cutaneous:
**[http://commons.wikimedia.org/wiki/File:Cutaneous_leiomyosarcoma_-_intermed_mag.jpg Cutaneous leiomyosarcoma - intermed. mag. - shows fascicular pattern (WC)].
**[http://commons.wikimedia.org/w/index.php?title=File:Cutaneous_leiomyosarcoma_-_a_-_intermed_mag.jpg Cutaneous leiomyosarcoma - intermed. mag. (WC)].
**[http://commons.wikimedia.org/wiki/File:Cutaneous_leiomyosarcoma_-_high_mag.jpg Cutaneous leiomyosarcoma - high mag. (WC)].


===IHC===
===IHC===

Revision as of 14:28, 19 July 2011

Leiomyosarcoma is a malignant tumour of smooth muscle. It is seen in various places including the uterus and skin.

General

  • Poor prognosis.
  • Do not (generally) arise from leiomyomas.
  • Often singular, i.e. one tumour; unlike leiomyomas (which are often multiple).

Gross

Features:

  • "Fleshy" appearance.
  • Necrosis.
  • Large size.
  • Often singular, i.e. one lesion; leiomyomata are often multiple.

Microscopic

Features:

  • Cellular lesion.
  • Fasicular arrangement:
    • Whorled look at low power.
    • Groups of spindle cells cut peripendicular to their long axis adjacent to groups of spindle cells cut in the plane of their long axis.
  • Features of malignancy (need all three):
    1. Cellular atypia - common.
    2. Necrosis.
      • Should be patchy/multifocal.
        • Zonal necrosis is suggestive of vascular cause.
    3. Mitoses - key feature - definitions suffers from HPFitis:
      • 10 mitoses/HPF.
      • 5 mitoses/HPF - if epithelioid.
      • 2 mitoses/HPF - if myxoid.
      • >=1 mitosis/HPF - if cutaneous.[1]

Images:

IHC

  • CD10 -ve (important in the context of uterine lesions -- +ve in endometrial stromal sarcoma).
  • Positive for SMC markers.
    • Desmin - present in all three types of muscle.
    • Caldesmon.
    • Smooth muscle myosin.

See also

References

  1. ↑ Kraft S, Fletcher CD (April 2011). "Atypical intradermal smooth muscle neoplasms: clinicopathologic analysis of 84 cases and a reappraisal of cutaneous "leiomyosarcoma"". Am. J. Surg. Pathol. 35 (4): 599–607. doi:10.1097/PAS.0b013e31820e6093. PMID 21358302.
Retrieved from "https://librepathology.org/w/index.php?title=Leiomyosarcoma&oldid=5930"