Difference between revisions of "Case 105"

{{hidden|Differential diagnosis|<center>Endometrial stromal neoplasm - nodule vs sarcoma </center>}}

{{hidden|Ask a colleague|<center> Would immunostains help? </center>}}

{{hidden|Diagnosis|<center>HIGHLY CELLULAR LEIOMYOMA.  The differential diagnosis is between an endometrial stromal tumor (nodule or sarcoma) and a highly cellular leiomyoma. Although the immunohistochemical stains can be helpful if CD10 negative, a high percentage of cellular leiomyoma mark with CD10, a stain traditionally assumed to marker stromal tumor. Likewise, if the endometrial stromal neoplasm has smooth muscle differentiation, those areas will mark with muscle markers.  The characteristic feature is the cleft like spaces at the edge of the tumor, the thickwalled vessels within the tumor, and the spindled spindle cells as opposed to rounded spindled cells.  Endometrial stromal neoplasms will have the characteristic spiral arterioles also. The edge of a cellular leiomyoma is often irregular sometimes raising the concern not for a nodule but for an endometrial stromal sarcoma.  However, the tongues of tumor are generally small, do not extend for more than a few millimeters and "fade" into the surrounding myometrium.  These tongues are sharply circumscribed in stromal neoplasms.  </center>}}