Home Chapter Home Jobs Conferences Fellowships Books
Soft Tissue Tumors Part 3
Muscle, Vascular, Nerve, Other
Leiomyoma-Classic
Author: Nat Pernick, M.D, PathologyOutlines.com, Inc.
Revised: 9 August 2009, last major update - August 2009
Copyright: (c) 2002-2009, PathologyOutlines.com, Inc.
Leiomyoma: classic, bizarre, cutaneous, epithelioid, genital
See also: leiomyoma of deep soft tissue
Definition
=========================================================================
● Bland smooth muscle tumor without mitotic figures
Terminology
=========================================================================
● Not a WHO diagnosis (cutaneous and pilar tumors are described in the Skin volume)
● Some tumors previously considered to be leiomyomas are actually GI stromal (GIST) tumors
● See also Colon-tumor, Esophagus, Uterus chapters
Epidemiology
=========================================================================
● Skin and subcutis; also deep soft tissue, uterus (most common neoplasm in women)
● Patients with multiple cutaneous leiomyomas may have autosomal dominant disorder (described under Cutaneous leiomyoma)
Case reports
=========================================================================
● 34 year old man with sickle cell thalassemia and ossified leiomyoma (J Cutan Pathol 2005;32:696)
● 59 year old woman with finger lesion (Chang Gung Med J 2004;27:134)
Gross images
=========================================================================
Images: myxoid subcutaneous tumor
Micro description
=========================================================================
● Bundles or fascicles of spindled cells with eosinophilic and possibly fibrillary cytoplasm
● Nuclei are blunt ended and elongated with fine chromatin, indistinct nucleolus and variable cytoplasmic vacuole at one end
● Minimal atypia
● Few mitotic figures
● No coagulative tumor necrosis
Micro images
=========================================================================
Bundles of elongate cells Oblong nuclei
with eosinophilic cytoplasm have rounded ends
and oblong nuclei
Other images: calcified leiomyoma #1; #2; #3; #4
Positive stains
=========================================================================
● Desmin, alpha smooth muscle actin
● h-caldesmon, calponin, muscle specific actin, myosin
● ER and PR for uterine tumors
Negative stains
=========================================================================
● CD117, CD34, S100; low Ki-67 (<5%)
Differential diagnosis
=========================================================================
● Angiomyolipoma - usually prominent vascular and lipomatous component
● Leiomyosarcoma - more cellular, infiltrative, pleomorphic; mitotic activity and coagulative tumor cell necrosis
References
=========================================================================
End of Soft Tissue Tumors Part 3 - Muscle, Vascular, Nerve, Other > Classic leiomyoma
This information is intended for physicians and related personnel, who understand that medical information is often imperfect, and must also be interpreted in the context of a patient's clinical data using reasonable medical judgment. This website should not be used as a substitute for the advice of a licensed physician.
All information on this website is protected by Copyright, (c) 2001-2009, PathologyOutlines.com, Inc. Information from third parties may also be protected by copyright. Please contact us at copyrightPathOut@gmail.com with any questions.