Uterine leiomyoma - Revision history

Michael: /* Microscopic */ tweak

2022-09-15T17:26:24Z

Microscopic: tweak

← Older revision		Revision as of 17:26, 15 September 2022
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	DDx:		DDx:
	*[[Leiomyosarcoma]].		*[[Leiomyosarcoma]].
	*[[~~STUMP~~]].		*[[Smooth muscle tumour of uncertain malignant potential]] (STUMP).
	*[[Adenomatoid tumour]]/		*[[Adenomatoid tumour]].

	===Variants===		===Variants===

Michael at 16:44, 30 April 2021

2021-04-30T16:44:49Z

← Older revision		Revision as of 16:44, 30 April 2021
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	\| Micro = spindle cells arranged in fascicles, usually without atypia		\| Micro = spindle cells arranged in fascicles, usually without atypia
	\| Subtypes = atypical leiomyoma (symplastic leiomyoma), lipoleiomyoma, cellular leiomyoma, others		\| Subtypes = atypical leiomyoma (symplastic leiomyoma), lipoleiomyoma, cellular leiomyoma, others
	\| LMDDx =		\| LMDDx = [[leiomyosarcoma]], [[STUMP]], [[dermatomyofibroma]], [[adenomatoid tumour]]
	\| Stains =		\| Stains =
	\| IHC =		\| IHC =
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	* Few mitoses.		* Few mitoses.

	~~Images~~:		DDx:
	*[~~http://commons~~.~~wikimedia~~.~~org/w~~/~~index.php?title=File:Cutaneous_leiomyosarcoma_-_a_-_intermed_mag.jpg Fascicular pattern - leiomyosarcoma (WC)].~~		*[[Leiomyosarcoma]].
			*[[STUMP]].
			*[[Adenomatoid tumour]]/

	===Variants===		===Variants===
			<!-- variants https://www.ajronline.org/doi/full/10.2214/AJR.14.13946 -->
	*Lipoleiomyoma - with adipose tissue.		*Lipoleiomyoma - with adipose tissue.
	**Image: [http://commons.wikimedia.org/wiki/File:Lipoleiomyoma1.jpg Lipoleiomyoma - low mag. (WC)].		**Image: [http://commons.wikimedia.org/wiki/File:Lipoleiomyoma1.jpg Lipoleiomyoma - low mag. (WC)].

Michael: more

2021-04-30T16:42:21Z

← Older revision		Revision as of 16:42, 30 April 2021
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	{{ Infobox diagnosis		{{ Infobox diagnosis
	\| Name = {{PAGENAME}}		\| Name = {{PAGENAME}}
	\| Image =		\| Image = Histopathology of uterine leiomyoma.jpg
	\| Width =		\| Width =
	\| Caption =		\| Caption = Uterine leiomyoma. [[H&E stain]].
	\| Synonyms =		\| Synonyms = uterine fibroid
	\| Micro =		\| Micro = spindle cells arranged in fascicles, usually without atypia
	\| Subtypes =		\| Subtypes = atypical leiomyoma (symplastic leiomyoma), lipoleiomyoma, cellular leiomyoma, others
	\| LMDDx =		\| LMDDx =
	\| Stains =		\| Stains =
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	\| Molecular =		\| Molecular =
	\| IF =		\| IF =
	\| Gross =		\| Gross = sharply circumscribed lesion, gray-white, whorled appearance
	\| Grossing = [[Hysterectomy for fibroids grossing]]		\| Grossing = [[Hysterectomy for fibroids grossing]]
	\| Staging =		\| Staging =

Michael: +infobox

2021-04-30T16:37:58Z

+infobox

← Older revision		Revision as of 16:37, 30 April 2021
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			{{ Infobox diagnosis
			\| Name = {{PAGENAME}}
			\| Image =
			\| Width =
			\| Caption =
			\| Synonyms =
			\| Micro =
			\| Subtypes =
			\| LMDDx =
			\| Stains =
			\| IHC =
			\| EM =
			\| Molecular =
			\| IF =
			\| Gross =
			\| Grossing = [[Hysterectomy for fibroids grossing]]
			\| Staging =
			\| Site =
			\| Assdx =
			\| Syndromes =
			\| Clinicalhx =
			\| Signs =
			\| Symptoms =
			\| Prevalence = very common
			\| Bloodwork =
			\| Rads =
			\| Endoscopy =
			\| Prognosis = benign
			\| Other =
			\| ClinDDx = other [[uterine tumours]]
			\| Tx = surgical (myomectomy, hysterectomy) or medical
			}}
	'''Uterine leiomyoma''', commonly '''fibroid''', is a very common benign smooth muscle tumour of the [[uterus]].		'''Uterine leiomyoma''', commonly '''fibroid''', is a very common benign smooth muscle tumour of the [[uterus]].

Michael: /* Microscopic */

2017-10-30T19:33:23Z

Microscopic

← Older revision		Revision as of 19:33, 30 October 2017
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	* [[Necrosis]].		* [[Necrosis]].

	===Microscopic===		==Microscopic==
	Features:		Features:
	* Spindle cells arranged in fascicles.		* Spindle cells arranged in fascicles.

Michael at 19:32, 30 October 2017

2017-10-30T19:32:27Z

← Older revision		Revision as of 19:32, 30 October 2017
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	'''Uterine leiomyoma''', commonly '''fibroid''', is a very common benign smooth muscle tumour of the [[uterus]].		'''Uterine leiomyoma''', commonly '''fibroid''', is a very common benign smooth muscle tumour of the [[uterus]].

	~~Non-uterine leiomyomas are dealth with~~ in the article ''[[leiomyoma]]''.		The more general topic of leiomyoma is covered in the article ''[[leiomyoma]]''.

	==General==		==General==

Michael at 19:30, 30 October 2017

2017-10-30T19:30:30Z

← Older revision		Revision as of 19:30, 30 October 2017
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	'''Uterine leiomyoma''', commonly '''fibroid''', is a very common benign smooth muscle tumour of the [[uterus]].		'''Uterine leiomyoma''', commonly '''fibroid''', is a very common benign smooth muscle tumour of the [[uterus]].

			Non-uterine leiomyomas are dealth with in the article ''[[leiomyoma]]''.

	==General==		==General==

Michael: split out

2017-10-30T19:29:37Z

split out

← Older revision		Revision as of 19:29, 30 October 2017
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	~~#redirect~~ [[~~Uterine_tumours#Uterine_leiomyoma~~]]		'''Uterine leiomyoma''', commonly '''fibroid''', is a very common benign smooth muscle tumour of the [[uterus]].

			==General==
			*Extremely common... 40% of women by age 40.
			*Benign.
			**Can be a cause of [[abnormal uterine bleeding]] (commonly abbreviated ''AUB'').
			*Large & multiple associated with infertility.
			*May be treated medically with a [[selective progesterone receptor modulator]], e.g. ''[[ulipristal]]'' (''Fibristal'').<ref name=pmid24712276>{{Cite journal \| last1 = Delev \| first1 = DP. \| title = Ulipristal acetate--a review of the new therapeutic indications and future prospects. \| journal = Folia Med (Plovdiv) \| volume = 55 \| issue = 3-4 \| pages = 5-10 \| month = \| year = \| doi = \| PMID = 24712276 }}</ref>

			==Gross==
			Feature:
			* 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.

			Images:
			*[http://commons.wikimedia.org/w/index.php?title=File:Cutaneous_leiomyosarcoma_-_a_-_intermed_mag.jpg Fascicular pattern - leiomyosarcoma (WC)].

			===Variants===
			*Lipoleiomyoma - with adipose tissue.
			**Image: [http://commons.wikimedia.org/wiki/File:Lipoleiomyoma1.jpg Lipoleiomyoma - low mag. (WC)].
			*Hypercellular leiomyoma - hypercellularity associated with more mutations.<ref name=pmid_none>{{Cite journal \| last1 = Pandis \| first1 = N. \| last2 = Heim \| first2 = S. \| last3 = Willén \| first3 = H. \| last4 = Bardi \| first4 = G. \| last5 = Flodérus \| first5 = U-M. \| last6 = Mandahl \| first6 = N. \| last7 = Mitelman \| first7 = F. \| title = Histologic—cytogenetic correlations in uterine leiomyomas. \| journal = International Journal of Gynecological Cancer \| volume = 1 \| issue = 4 \| pages = 163-68 \| month = Jan \| year = 1991 \| doi = \| PMID = \|url=http://www3.interscience.wiley.com/journal/119360394/abstract }}</ref>
			*Atypical leiomyoma (AKA ''symplastic leiomyoma'') - leiomyoma with nuclear atypia.
			**Image: [http://commons.wikimedia.org/wiki/File:Atypical_leiomyoma_intermed_mag.jpg Atypical leiomyoma (WC)].
			*Benign metastasizing leiomyoma.<ref name=pmid16357844>{{Cite journal \| last1 = Patton \| first1 = KT. \| last2 = Cheng \| first2 = L. \| last3 = Papavero \| first3 = V. \| last4 = Blum \| first4 = MG. \| last5 = Yeldandi \| first5 = AV. \| last6 = Adley \| first6 = BP. \| last7 = Luan \| first7 = C. \| last8 = Diaz \| first8 = LK. \| last9 = Hui \| first9 = P. \| title = Benign metastasizing leiomyoma: clonality, telomere length and clinicopathologic analysis. \| journal = Mod Pathol \| volume = 19 \| issue = 1 \| pages = 130-40 \| month = Jan \| year = 2006 \| doi = 10.1038/modpathol.3800504 \| PMID = 16357844 \|url=http://www.nature.com/modpathol/journal/v19/n1/full/3800504a.html}}</ref>
			**This is just what it sounds like. Some believe these are low grade [[leiomyosarcoma]]s.

			==IHC==
			Work-up of suspicious leiomyomas:<ref>STC. 25 February 2009.</ref>
			*CD10 +ve.<ref name=pmid14751141>{{Cite journal \| last1 = Zhu \| first1 = XQ. \| last2 = Shi \| first2 = YF. \| last3 = Cheng \| first3 = XD. \| last4 = Zhao \| first4 = CL. \| last5 = Wu \| first5 = YZ. \| title = Immunohistochemical markers in differential diagnosis of endometrial stromal sarcoma and cellular leiomyoma. \| journal = Gynecol Oncol \| volume = 92 \| issue = 1 \| pages = 71-9 \| month = Jan \| year = 2004 \| doi = \| PMID = 14751141 }}</ref>
			*SMA +ve.
			*Desmin +ve.
			*[[Ki-67]] -ve.

			Others:
			*p16 usually -ve.<ref name=pmid18156978>{{Cite journal \| last1 = Gannon \| first1 = BR. \| last2 = Manduch \| first2 = M. \| last3 = Childs \| first3 = TJ. \| title = Differential Immunoreactivity of p16 in leiomyosarcomas and leiomyoma variants. \| journal = Int J Gynecol Pathol \| volume = 27 \| issue = 1 \| pages = 68-73 \| month = Jan \| year = 2008 \| doi = 10.1097/pgp.0b013e3180ca954f \| PMID = 18156978 }}</ref>
			**Often +ve in leiomyosarcoma.
			*H-caldesmon +ve.<ref name=pmid14751141/>

			==Sign out==
			<pre>
			Uterine Cervix, Uterus, Bilateral Tubes and IUD, Total Hysterectomy and Bilateral Salpingectomy:
			- Uterine leiomyomas.
			- Mild atherosclerosis.
			- Inactive endometrium.
			- Intrauterine device (IUD) - gross only.
			- Uterine cervix within normal limits.
			- Left uterine tube with small paratubal cyst, negative for
			significant pathology.
			- Right uterine tube with paratubal cyst, negative for significant pathology.
			- NEGATIVE for malignancy.
			</pre>

			===Block letters===
			<pre>
			UTERUS WITH CERVIX, UTERINE TUBES AND LEFT OVARY, TOTAL HYSTERECTOMY, BILATERAL SALPINGECTOMY
			AND LEFT OOPHRECTOMY:
			- LEIOMYOMATA WITH FOCAL CALCIFICATION AND HYALINE CHANGE.
			- SECRETORY PHASE ENDOMETRIUM.
			- LEFT OVARY WITHIN NORMAL LIMITS.
			- UTERINE TUBES WITHIN NORMAL LIMITS.
			- UTERINE CERVIX WITHIN NORMAL LIMITS.
			</pre>

			===Myomectomy===
			<pre>
			UTERINE MASSES ("FIBROIDS"), MYOMECTOMY:
			- LEIOMYOMATA.
			</pre>

			<pre>
			UTERINE MASS, HYSTEROSCOPIC MYOMECTOMY:
			- BENIGN SMOOTH MUSCLE FRAGMENTS COMPATIBLE WITH LEIOMYOMA.
			- SECRETORY PHASE ENDOMETRIUM.
			</pre>

			===Micro===
			The sections show bland spindle cells within a fascicular architecture. Hyaline change is present. No necrosis is seen. Mild proliferative activity is seen (~ 2 mitoses/10 HPFs, 1 HPF ~0.2376 mm*mm). No cytologic atypia is apparent.

			==See also==
			*[[Uterine tumours]].

			==References==
			{{Reflist\|1}}

			[[Category:Gynecologic pathology]]
	[[Category:Diagnosis]]		[[Category:Diagnosis]]

Michael: redirect

2012-01-13T03:45:40Z

redirect

New page

#redirect [[Uterine_tumours#Uterine_leiomyoma]]

[[Category:Diagnosis]]