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Difference between revisions of "Leiomyoma"
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| Micro = spindle cells arranged in fascicles, +/-nuclear atypia, rare mitoses (allowable mitotic rate dependent on specific site) | | Micro = spindle cells arranged in fascicles, +/-nuclear atypia, rare mitoses (allowable mitotic rate dependent on specific site) | ||
| Subtypes = lipoleiomyoma, hypercellular leiomyoma, atypical leiomyoma (symplastic leiomyoma), benign metastasizing leiomyoma | | Subtypes = lipoleiomyoma, hypercellular leiomyoma, atypical leiomyoma (symplastic leiomyoma), benign metastasizing leiomyoma | ||
| LMDDx = [[leiomyosarcoma]], [[STUMP]], [[dermatomyofibroma]] | | LMDDx = [[leiomyosarcoma]], [[STUMP]], [[dermatomyofibroma]], [[adenomatoid tumour]] | ||
| Stains = | | Stains = | ||
| IHC = | | IHC = | ||
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| Site = [[skin]], [[uterus]], others | | Site = [[skin]], [[uterus]], others | ||
| Assdx = | | Assdx = | ||
| Syndromes = hereditary leiomyomatosis and renal cell cancer (cutaneous leiomyomas) | | Syndromes = [[hereditary leiomyomatosis and renal cell cancer]] (cutaneous & uterine leiomyomas) | ||
| Clinicalhx = | | Clinicalhx = | ||
| Signs = | | Signs = | ||
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===Cutaneous leiomyomas=== | ===Cutaneous leiomyomas=== | ||
*May be part of '' | *May be part of ''[[hereditary leiomyomatosis and renal cell cancer]]'' (HLRCC).<ref>URL: [http://www.ncbi.nlm.nih.gov/books/NBK1252/ http://www.ncbi.nlm.nih.gov/books/NBK1252/]. Accessed on: 2 September 2011.</ref><ref>URL: [http://ccr.cancer.gov/staff/gallery.asp?profileid=12822 http://ccr.cancer.gov/staff/gallery.asp?profileid=12822]. Accessed on: 2 September 2011.</ref> | ||
*[[Painful skin lesion]]. | *[[Painful skin lesion]]. | ||
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*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). | *Can be a cause of [[AUB]] ([[abnormal uterine bleeding]]). | ||
*Large & multiple leiomyomas are associated with infertility. | *Large & multiple leiomyomas are associated with infertility. | ||
*May be part of ''[[hereditary leiomyomatosis and renal cell cancer]]'' (HLRCC). | |||
**In one series, 68% with HLRCC were diagnosed at age <=30 years.<ref name=pmid16597677>{{Cite journal | last1 = Pithukpakorn | first1 = M. | last2 = Wei | first2 = MH. | last3 = Toure | first3 = O. | last4 = Steinbach | first4 = PJ. | last5 = Glenn | first5 = GM. | last6 = Zbar | first6 = B. | last7 = Linehan | first7 = WM. | last8 = Toro | first8 = JR. | title = Fumarate hydratase enzyme activity in lymphoblastoid cells and fibroblasts of individuals in families with hereditary leiomyomatosis and renal cell cancer. | journal = J Med Genet | volume = 43 | issue = 9 | pages = 755-62 | month = Sep | year = 2006 | doi = 10.1136/jmg.2006.041087 | PMID = 16597677 }} | |||
</ref> | |||
===Colonic leiomyoma=== | ===Colonic leiomyoma=== | ||
{{Main|Colonic leiomyoma}} | {{Main|Colonic leiomyoma}} | ||
===Renal leiomyoma=== | |||
{{Main|Renal leiomyoma}} | |||
==Gross== | ==Gross== | ||
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*Dermatomyofibroma.<ref name=Ref_Derm533>{{Ref Derm|533}}</ref> | *Dermatomyofibroma.<ref name=Ref_Derm533>{{Ref Derm|533}}</ref> | ||
*[[Myopericytoma]] / [[myofibroma]]. | *[[Myopericytoma]] / [[myofibroma]]. | ||
*[[Adenomatoid tumour]] - esp. for lipoleiomyoma. | |||
*[[Smooth muscle tumour of uncertain malignant potential]] (STUMP) - do not fulfill criteria for leiomyosarcoma. | *[[Smooth muscle tumour of uncertain malignant potential]] (STUMP) - do not fulfill criteria for leiomyosarcoma. | ||
*[[Epstein-Barr virus-associated smooth muscle tumour]] - very rare. | |||
===Variants=== | ===Variants=== | ||
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===Micro=== | ===Micro=== | ||
The section shows unremarkable hair-bearing skin with a well-circumscribed subcutaneous lesion with a fascicular architecture. The lesion has no nuclear atypia and no mitotic activity is identified. At the periphery of the lesion is a medium-sized muscular artery from which the lesion appears to arise. | The section shows unremarkable hair-bearing skin with a well-circumscribed subcutaneous lesion with a fascicular architecture. The lesion has no nuclear atypia and no mitotic activity is identified. At the periphery of the lesion is a medium-sized muscular artery from which the lesion appears to arise. | ||
====Alternate==== | |||
The sections show a spindle cell lesion with a fascicular architecture. Focal hyaline | |||
change is seen. No nuclear atypia is apparent. Mitotic activity is not readily identified. No necrosis is identified. The lesion extends to the edge of the tissue fragments. | |||
==See also== | ==See also== | ||