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| ===Differential diagnosis=== | | ===Differential diagnosis=== |
| {{hidden|Differential diagnosis|<center>[[Leiomyosarcoma]]</center>}} | | {{hidden|Differential diagnosis|<center>[[leiomyosarcoma]], [[smooth muscle tumour of uncertain malignant potential]], [[leiomyoma]]</center>}} |
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| ===Additional tests=== | | ===Additional tests=== |
Revision as of 02:18, 27 September 2015
Provided clinical history
52 year old woman, hysterectomy done for leiomyoma
Site
Uterus- myometrium
Primary image
Low magnification. H&E stain.
Differential diagnosis
Additional tests
More history
Expand More history
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MORE HISTORY HERE
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Ask a colleague
Expand Ask a colleague
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COLLEAGUE'S ADVICE HERE
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Stains
ExpandAlcian blue/PAS to Bilirubin |
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Alcian blue/PAS | Expand Dr Torres would ask why! |
Alican blue pH 1.0 | Expand Dr Torres would ask why! |
Alcian blue pH 2.5 | Expand Dr Torres would ask why! |
Auramine | Expand Dr Torres would ask why! |
Bielchowsky | Expand Dr Torres would ask why! |
Bilirubin | Expand Dr Torres would ask why! |
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ExpandColloidal iron to Fontana-Masson |
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Colloidal iron | Expand Dr Torres would ask why! |
Congo red | Expand Dr Torres would ask why! |
Cresyl violet | Expand Dr Torres would ask why! |
Dieterle | Expand Dr Torres would ask why! |
Diff Quik | Expand Dr Torres would ask why! |
Fontana-Masson | Expand Dr Torres would ask why! |
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ExpandGallyas to Gremelius |
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Gallyas | Expand Dr Torres would ask why! |
Giemsa | Expand Dr Torres would ask why! |
GMS | Expand Dr Torres would ask why! |
Gomori's trichrome | Expand Dr Torres would ask why! |
Gram | Expand Dr Torres would ask why! |
Gremelius | Expand Dr Torres would ask why! |
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ExpandJMS to Mucicarmine |
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JMS | Expand Dr Torres would ask why! |
Jones | Expand Dr Torres would ask why! |
Kinyoun | Expand Dr Torres would ask why! |
Luxol fast blue | Expand Dr Torres would ask why! |
Masson trichrome | Expand Dr Torres would ask why! |
M-MAS | Expand Dr Torres would ask why! |
Movat | Expand Dr Torres would ask why! |
Mucicarmine | Expand Dr Torres would ask why! |
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ExpandOil red O to Prussian blue |
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Oil red O | Expand Dr Torres would ask why! |
Orecein | Expand Dr Torres would ask why! |
PAS | Expand Dr Torres would ask why! |
PASD | Expand Dr Torres would ask why! |
PASF | Expand Dr Torres would ask why! |
PTAH | Expand Dr Torres would ask why! |
Prussian blue | Expand Dr Torres would ask why! |
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ExpandReticulin to Ziehl-Neelsen |
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Reticulin | Expand Dr Torres would ask why! |
Sudan black B | Expand Dr Torres would ask why! |
Toluidine blue | Expand Dr Torres would ask why! |
Verhoeff | Expand Dr Torres would ask why! |
Von Kossa | Expand Dr Torres would ask why! |
Warthin-Starry | Expand Dr Torres would ask why! |
Ziehl-Neeslen | Expand Dr Torres would ask why! |
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IHC
ExpandAlpha-1 AT to Cathepsin K |
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alpha-1 AT | Expand Dr Torres would ask why! |
ACTH | Expand Dr Torres would ask why! |
AE1/AE1 | Expand Dr Torres would ask why! |
alpha-fetoprotein | Expand Dr Torres would ask why! |
Alk-I | Expand Dr Torres would ask why! |
AMACR | Expand Dr Torres would ask why! |
AR | Expand Dr Torres would ask why! |
ATRX | Expand Dr Torres would ask why! |
Beta2-microglobulin | Expand Dr Torres would ask why! |
B72.3 | Expand Dr Torres would ask why! |
Beta-catenin | Expand Dr Torres would ask why! |
BCL2 | Expand Dr Torres would ask why! |
BCL6 | Expand Dr Torres would ask why! |
BCLxL | Expand Dr Torres would ask why! |
C3 comp | Expand Dr Torres would ask why! |
CA9 | Expand Dr Torres would ask why! |
Calcitonin | Expand Dr Torres would ask why! |
Calponin | Expand Dr Torres would ask why! |
Calretinin | Expand Dr Torres would ask why! |
CAM5.2 | Expand Dr Torres would ask why! |
Cathepsin K | Expand Dr Torres would ask why! |
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ExpandCD10 to Chromogranin |
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CD10 | Expand Dr Torres would ask why! |
CD117 | Expand Dr Torres would ask why! |
CD138 | Expand Dr Torres would ask why! |
CD15 | Expand Dr Torres would ask why! |
CD1a | Expand Dr Torres would ask why! |
CD20 | Expand Dr Torres would ask why! |
CD21 | Expand Dr Torres would ask why! |
CD23 | Expand Dr Torres would ask why! |
CD3 | Expand Dr Torres would ask why! |
CD30 | Expand Dr Torres would ask why! |
CD31 | Expand Dr Torres would ask why! |
CD34 | Expand Dr Torres would ask why! |
CD35 | Expand Dr Torres would ask why! |
CD4 | Expand Dr Torres would ask why! |
CD43 | Expand Dr Torres would ask why! |
CD45 (LCA) | Expand Dr Torres would ask why! |
CD5 | Expand Dr Torres would ask why! |
CD56 | Expand Dr Torres would ask why! |
CD57 | Expand Dr Torres would ask why! |
CD68 | Expand Dr Torres would ask why! |
CD7 | Expand Dr Torres would ask why! |
CD79a | Expand Dr Torres would ask why! |
CD8 | Expand Dr Torres would ask why! |
CD99 | Expand Dr Torres would ask why! |
CDX2 | Expand Dr Torres would ask why! |
CEA-m | Expand Dr Torres would ask why! |
Chromogranin | Expand Dr Torres would ask why! |
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ExpandCK17 to Glypican 3 |
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CK17 | Expand Dr Torres would ask why! |
CK19 | Expand Dr Torres would ask why! |
CK20 | Expand Dr Torres would ask why! |
CK34betaE12 | Expand Dr Torres would ask why! |
CK5/6 | Expand Dr Torres would ask why! |
CK7 | Expand Dr Torres would ask why! |
CMV | Expand Dr Torres would ask why! |
c-MYC | Expand Dr Torres would ask why! |
Cyclin D1 | Expand Dr Torres would ask why! |
D2-40 | Expand Dr Torres would ask why! |
Desmin | Expand Dr Torres would ask why! |
DOG1 | Expand Dr Torres would ask why! |
EBV | Expand Dr Torres would ask why! |
EMA | Expand Dr Torres would ask why! |
ER and PR | Expand Dr Torres would ask why! |
Factor VIII | Expand Dr Torres would ask why! |
Factor XIIIa | Expand Dr Torres would ask why! |
Fascin | Expand Dr Torres would ask why! |
FH | Expand Dr Torres would ask why! |
FSH | Expand Dr Torres would ask why! |
Gastrin | Expand Dr Torres would ask why! |
GATA3 | Expand Dr Torres would ask why! |
GCDFP-15 (BRST2) | Expand Dr Torres would ask why! |
GFAP | Expand Dr Torres would ask why! |
GH | Expand Dr Torres would ask why! |
Glucagon | Expand Dr Torres would ask why! |
Glypican-3 | Expand Dr Torres would ask why! |
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ExpandHBME-1 to IgM |
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HBME-1 | Expand Dr Torres would ask why! |
HBV core | Expand Dr Torres would ask why! |
HBV surface | Expand Dr Torres would ask why! |
H-caldesmon | Expand Dr Torres would ask why! |
HCG | Expand Dr Torres would ask why! |
Helicobacter | Expand Dr Torres would ask why! |
Hepatocyte | Expand Dr Torres would ask why! |
HER2/neu | Expand Dr Torres would ask why! |
HHV-8 | Expand Dr Torres would ask why! |
HMB-45 | Expand Dr Torres would ask why! |
HNF1beta | Expand Dr Torres would ask why! |
HPV | Expand Dr Torres would ask why! |
HSV-I | Expand Dr Torres would ask why! |
HSV-II | Expand Dr Torres would ask why! |
IDH-1 | Expand Dr Torres would ask why! |
Inhibin | Expand Dr Torres would ask why! |
INI1 (BAF47) | Expand Dr Torres would ask why! |
Insulin | Expand Dr Torres would ask why! |
Kappa | Expand Dr Torres would ask why! |
Ki-67 | Expand Dr Torres would ask why! |
Lambda | Expand Dr Torres would ask why! |
Leu 7 | Expand Dr Torres would ask why! |
IgA | Expand Dr Torres would ask why! |
IgG | Expand Dr Torres would ask why! |
IgM | Expand Dr Torres would ask why! |
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ExpandLH to PDGFR |
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LH | Expand Dr Torres would ask why! |
LIN28 | Expand Dr Torres would ask why! |
Lysozyme | Expand Dr Torres would ask why! |
mammoglobin | Expand Dr Torres would ask why! |
MAP2 | Expand Dr Torres would ask why! |
MCV | Expand Dr Torres would ask why! |
Melanin A | Expand Dr Torres would ask why! |
MHC class I | Expand Dr Torres would ask why! |
MITF | Expand Dr Torres would ask why! |
MUM1 | Expand Dr Torres would ask why! |
Myeloperoxidase | Expand Dr Torres would ask why! |
MYO D1 | Expand Dr Torres would ask why! |
Myoglobin | Expand Dr Torres would ask why! |
Napsin | Expand Dr Torres would ask why! |
NF | Expand Dr Torres would ask why! |
NKX3.1 | Expand Dr Torres would ask why! |
NSE | Expand Dr Torres would ask why! |
OCT3/4 | Expand Dr Torres would ask why! |
p16 | Expand patchy positive |
P501S | Expand Dr Torres would ask why! |
p53 | Expand Dr Torres would ask why! |
p57 | Expand Dr Torres would ask why! |
p63 | Expand Dr Torres would ask why! |
Pankeratin | Expand Dr Torres would ask why! |
PAX2 | Expand Dr Torres would ask why! |
PAX5 | Expand Dr Torres would ask why! |
PAX8 | Expand Dr Torres would ask why! |
PCNA | Expand Dr Torres would ask why! |
PDGFR | Expand Dr Torres would ask why! |
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ExpandPLAP to WT1 |
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PLAP | Expand Dr Torres would ask why! |
PNL-2C | Expand Dr Torres would ask why! |
Prolactin | Expand Dr Torres would ask why! |
PSA | Expand Dr Torres would ask why! |
PSAP | Expand Dr Torres would ask why! |
RCC | Expand Dr Torres would ask why! |
S-100 | Expand Dr Torres would ask why! |
SALL4 | Expand Dr Torres would ask why! |
Smooth muscle actin | Expand Dr Torres would ask why! |
Somatostatin | Expand Dr Torres would ask why! |
STAT6 | Expand Dr Torres would ask why! |
Synaptophysin | Expand Dr Torres would ask why! |
TdT | Expand Dr Torres would ask why! |
TFE3 | Expand Dr Torres would ask why! |
TFEB | Expand Dr Torres would ask why! |
Thyroglobulin | Expand Dr Torres would ask why! |
Toxoplasma | Expand Dr Torres would ask why! |
TSH | Expand Dr Torres would ask why! |
TTF-1 | Expand Dr Torres would ask why! |
Ubiquitin | Expand Dr Torres would ask why! |
UCHL1 (PGP9.5) | Expand Dr Torres would ask why! |
Ulex Europaeus | Expand Dr Torres would ask why! |
Vimentin | Expand Dr Torres would ask why! |
VIP | Expand Dr Torres would ask why! |
VZV | Expand Dr Torres would ask why! |
WT-1 | Expand Dr Torres would ask why! |
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Molecular testing
Chromosomal translocations
ExpandTranslocations Chr 1-10 |
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t(1;13) PAX7-FKHR | Expand Dr Torres would ask why! |
t(2,13) PAX3-FKHR | Expand Dr Torres would ask why! |
t(8;14) MYC-IGH | Expand Dr Torres would ask why! |
t(9;22) BCR-ABL | Expand Dr Torres would ask why! |
t(9;22) CHN-EWS | Expand Dr Torres would ask why! |
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ExpandTranslocations Chr 11-13 |
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t(11;14) CCND1-IGH | Expand Dr Torres would ask why! |
t(11;22) EWS-WT1 | Expand Dr Torres would ask why! |
t(11;22) FLI1-EWS | Expand Dr Torres would ask why! |
t(12;15) ETV6-NTRK3 | Expand Dr Torres would ask why! |
t(12;16) FUS-ATF1 | Expand Dr Torres would ask why! |
t(12;16) CHOP-TLS | Expand Dr Torres would ask why! |
t(12;22) EWS-ATF1 | Expand Dr Torres would ask why! |
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ExpandTranslocations Chr 14-22 |
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t(14,18) IGH-BCL2 | Expand Dr Torres would ask why! |
t(15;17) PML-RARA | Expand Dr Torres would ask why! |
t(16;21) FUS-ERG | Expand Dr Torres would ask why! |
t(17;22) COLA1-PDGFB | Expand Dr Torres would ask why! |
t(21;22) EWS-ERG | Expand Dr Torres would ask why! |
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ExpandTranslocations Chr X & Y |
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t(X;1) PRCC-TFE3 | Expand Dr Torres would ask why! |
t(X;17) TFE3-ASPL | Expand Dr Torres would ask why! |
t(X;18) SYT-SSX | Expand Dr Torres would ask why! |
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Other molecular tests
ExpandMolecular tests (A-B) |
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ALK sequencing | Expand Dr Torres would ask why! |
B cell clonality Southern / PCR | Expand Dr Torres would ask why! |
BCL2 PCR | Expand Dr Torres would ask why! |
BRAF sequencing | Expand Dr Torres would ask why! |
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ExpandMolecular tests (C-H) |
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EBV PCR | Expand Dr Torres would ask why! |
EGRF sequencing | Expand Dr Torres would ask why! |
H3F3A sequencing | Expand Dr Torres would ask why! |
HHV-8 PCR | Expand Dr Torres would ask why! |
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ExpandMolecular tests (K-Z) |
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KIT sequencing | Expand Dr Torres would ask why! |
LOH 1p/19q PCR | Expand Dr Torres would ask why! |
T cell clonality Southern / PCR | Expand Dr Torres would ask why! |
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Diagnosis
Expand Diagnosis
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ATYPICAL LEIOMYOMA WITH BIZARRE NUCLEI
This smooth muscle tumor shows markedly atypical nuclei, some of which are multinucleate. The nuclei are smudgy and hyperchromatic, raising concern. However, here is no increase in mitotic activity; necrosis is absent. The edge of the tumor is rounded and there is no invasion of surrounding myometrium. These lesions are benign.[1][2]
References
- ↑ Ly, A.; Mills, AM.; McKenney, JK.; Balzer, BL.; Kempson, RL.; Hendrickson, MR.; Longacre, TA. (May 2013). "Atypical leiomyomas of the uterus: a clinicopathologic study of 51 cases.". Am J Surg Pathol 37 (5): 643-9. doi:10.1097/PAS.0b013e3182893f36. PMID 23552381.
- ↑ Croce, S.; Young, RH.; Oliva, E. (Oct 2014). "Uterine leiomyomas with bizarre nuclei: a clinicopathologic study of 59 cases.". Am J Surg Pathol 38 (10): 1330-9. doi:10.1097/PAS.0000000000000249. PMID 25140893.
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Other cases
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| Number | |
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| Subspecialty (Difficulty) |
Autopsy pathology (jr,sr, f/e)
Breast pathology (jr,sr, f/e)
Cardiovascular pathology (jr,sr, f/e)
Cytopathology (jr,sr, f/e)
Dermatopathology (jr,sr, f/e)
Endocrine pathology (jr,sr, f/e)
Forensic pathology (jr,sr, f/e)
Gastrointestinal pathology (jr,sr, f/e)
Genitourinary pathology (jr,sr, f/e)
Gynecologic pathology (jr,sr, f/e)
Hematopathology (jr,sr, f/e)
Head and neck pathology (jr,sr, f/e)
Lymph node pathology (jr,sr, f/e)
Medical kidney pathology (jr,sr, f/e)
Molecular pathology (jr,sr, f/e)
Neuropathology (jr,sr, f/e)
Pediatric pathology (jr,sr, f/e)
Pulmonary pathology (jr,sr, f/e)
Placental pathology (jr,sr, f/e)
Soft tissue pathology (jr,sr, f/e) |
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| Difficulty | |
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