Case 117 - Revision history

Michael: /* Diagnosis */ note about p16

2015-09-27T03:31:26Z

Diagnosis: note about p16

← Older revision		Revision as of 03:31, 27 September 2015
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	<br>		<br>
	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.<ref>{{Cite journal \| last1 = Ly \| first1 = A. \| last2 = Mills \| first2 = AM. \| last3 = McKenney \| first3 = JK. \| last4 = Balzer \| first4 = BL. \| last5 = Kempson \| first5 = RL. \| last6 = Hendrickson \| first6 = MR. \| last7 = Longacre \| first7 = TA. \| title = Atypical leiomyomas of the uterus: a clinicopathologic study of 51 cases. \| journal = Am J Surg Pathol \| volume = 37 \| issue = 5 \| pages = 643-9 \| month = May \| year = 2013 \| doi = 10.1097/PAS.0b013e3182893f36 \| PMID = 23552381 }}</ref><ref>{{Cite journal \| last1 = Croce \| first1 = S. \| last2 = Young \| first2 = RH. \| last3 = Oliva \| first3 = E. \| title = Uterine leiomyomas with bizarre nuclei: a clinicopathologic study of 59 cases. \| journal = Am J Surg Pathol \| volume = 38 \| issue = 10 \| pages = 1330-9 \| month = Oct \| year = 2014 \| doi = 10.1097/PAS.0000000000000249 \| PMID = 25140893 }}</ref>		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.<ref>{{Cite journal \| last1 = Ly \| first1 = A. \| last2 = Mills \| first2 = AM. \| last3 = McKenney \| first3 = JK. \| last4 = Balzer \| first4 = BL. \| last5 = Kempson \| first5 = RL. \| last6 = Hendrickson \| first6 = MR. \| last7 = Longacre \| first7 = TA. \| title = Atypical leiomyomas of the uterus: a clinicopathologic study of 51 cases. \| journal = Am J Surg Pathol \| volume = 37 \| issue = 5 \| pages = 643-9 \| month = May \| year = 2013 \| doi = 10.1097/PAS.0b013e3182893f36 \| PMID = 23552381 }}</ref><ref>{{Cite journal \| last1 = Croce \| first1 = S. \| last2 = Young \| first2 = RH. \| last3 = Oliva \| first3 = E. \| title = Uterine leiomyomas with bizarre nuclei: a clinicopathologic study of 59 cases. \| journal = Am J Surg Pathol \| volume = 38 \| issue = 10 \| pages = 1330-9 \| month = Oct \| year = 2014 \| doi = 10.1097/PAS.0000000000000249 \| PMID = 25140893 }}</ref>

			[[p16]] immunostaining may be useful for differentiating leiomyoma (weak) from [[uterine leiomyosarcoma\|leiomyosarcoma]] (strong).<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>
	===References===		===References===
	{{Reflist\|1}}		{{Reflist\|1}}
	}}		}}
	<br>		<br>

	===Other cases===		===Other cases===
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Michael: /* Ask a colleague */

2015-09-27T03:25:01Z

Ask a colleague

← Older revision		Revision as of 03:25, 27 September 2015
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	====Ask a colleague====		====Ask a colleague====
	{{hidden\|Ask a colleague\|<center>~~COLLEAGUE~~'~~S ADVICE HERE~~</center>}}		{{hidden\|Ask a colleague\|<center>I don't see a lot of mitoses. Did you try a p16 immunostain?</center>}}

	====Stains====		====Stains====

Michael: /* More history */

2015-09-27T03:23:10Z

More history

← Older revision		Revision as of 03:23, 27 September 2015
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	===Additional tests===		===Additional tests===
	====More history====		====More history====
	{{hidden\|More history\|<center>~~abdominal discomfort,~~ on exam 14 week fibroid</center>}}		{{hidden\|More history\|<center>on exam 14 week fibroid, 8cm uterine mass on ultrasound, abdominal discomfort</center>}}

	====Ask a colleague====		====Ask a colleague====

Michael: /* More history */

2015-09-27T02:21:26Z

More history

← Older revision		Revision as of 02:21, 27 September 2015
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	===Additional tests===		===Additional tests===
	====More history====		====More history====
	{{hidden\|More history\|<center>~~MORE HISTORY HERE~~</center>}}		{{hidden\|More history\|<center>abdominal discomfort, on exam 14 week fibroid</center>}}

	====Ask a colleague====		====Ask a colleague====

Michael: /* Differential diagnosis */

2015-09-27T02:18:52Z

Differential diagnosis

← Older revision		Revision as of 02:18, 27 September 2015
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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>}}

	===Additional tests===		===Additional tests===

Michael: tweak

2015-09-27T02:15:07Z

tweak

← Older revision		Revision as of 02:15, 27 September 2015
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	===Differential diagnosis===		===Differential diagnosis===
	{{hidden\|Differential diagnosis\|<center>Leiomyosarcoma</center>}}		{{hidden\|Differential diagnosis\|<center>[[Leiomyosarcoma]]</center>}}

	===Additional tests===		===Additional tests===
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	===Diagnosis===		===Diagnosis===
	{{hidden\|Diagnosis\|<center>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. {{Cite journal \| last1 = Ly \| first1 = A. \| last2 = Mills \| first2 = AM. \| last3 = McKenney \| first3 = JK. \| last4 = Balzer \| first4 = BL. \| last5 = Kempson \| first5 = RL. \| last6 = Hendrickson \| first6 = MR. \| last7 = Longacre \| first7 = TA. \| title = Atypical leiomyomas of the uterus: a clinicopathologic study of 51 cases. \| journal = Am J Surg Pathol \| volume = 37 \| issue = 5 \| pages = 643-9 \| month = May \| year = 2013 \| doi = 10.1097/PAS.0b013e3182893f36 \| PMID = 23552381 }} {{Cite journal \| last1 = Croce \| first1 = S. \| last2 = Young \| first2 = RH. \| last3 = Oliva \| first3 = E. \| title = Uterine leiomyomas with bizarre nuclei: a clinicopathologic study of 59 cases. \| journal = Am J Surg Pathol \| volume = 38 \| issue = 10 \| pages = 1330-9 \| month = Oct \| year = 2014 \| doi = 10.1097/PAS.0000000000000249 \| PMID = 25140893 }}		{{hidden\|Diagnosis\|<center>[[symplastic leiomyoma\|ATYPICAL LEIOMYOMA WITH BIZARRE NUCLEI]]</center>
	</~~center~~>}}		<br>
			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.<ref>{{Cite journal \| last1 = Ly \| first1 = A. \| last2 = Mills \| first2 = AM. \| last3 = McKenney \| first3 = JK. \| last4 = Balzer \| first4 = BL. \| last5 = Kempson \| first5 = RL. \| last6 = Hendrickson \| first6 = MR. \| last7 = Longacre \| first7 = TA. \| title = Atypical leiomyomas of the uterus: a clinicopathologic study of 51 cases. \| journal = Am J Surg Pathol \| volume = 37 \| issue = 5 \| pages = 643-9 \| month = May \| year = 2013 \| doi = 10.1097/PAS.0b013e3182893f36 \| PMID = 23552381 }}</ref><ref>{{Cite journal \| last1 = Croce \| first1 = S. \| last2 = Young \| first2 = RH. \| last3 = Oliva \| first3 = E. \| title = Uterine leiomyomas with bizarre nuclei: a clinicopathologic study of 59 cases. \| journal = Am J Surg Pathol \| volume = 38 \| issue = 10 \| pages = 1330-9 \| month = Oct \| year = 2014 \| doi = 10.1097/PAS.0000000000000249 \| PMID = 25140893 }}</ref>
			===References===
			{{Reflist\|1}}
			}}
	<br>		<br>
	===Other cases===		===Other cases===
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	[[Category:Cases]]		[[Category:Cases]]

	~~<!-- SELECT A CATEGORY~~
	[[Category:Cases in gynecologic pathology]]		[[Category:Cases in gynecologic pathology]]
	-->		[[Category:Cases in gynecologic pathology - junior]]


	[[Category:Cases difficulty 2]] <!-- difficulty 1-7 -- should roughly correspond to the PGY level -->		[[Category:Cases difficulty 2]] <!-- difficulty 1-7 -- should roughly correspond to the PGY level -->

Michael: Michael moved page CASE 117 to Case 117: make it like other

2015-09-27T01:41:50Z

Michael moved page CASE 117 to Case 117: make it like other

← Older revision

Revision as of 01:41, 27 September 2015

Vinita: Created page with "===Provided clinical history=== 52 year old woman, hysterectomy done for leiomyoma ===Site=== Uterus- myometrium ===Primary image=== Image: Atypical leiomyoma with bizarre..."

2015-09-26T14:09:25Z

Created page with "===Provided clinical history=== 52 year old woman, hysterectomy done for leiomyoma ===Site=== Uterus- myometrium ===Primary image=== Image: Atypical leiomyoma with bizarre..."

New page

===Provided clinical history===
52 year old woman, hysterectomy done for leiomyoma

===Site===
Uterus- myometrium

===Primary image===
[[Image: Atypical leiomyoma with bizarre nuclei low magnification.jpg |500px|link=|center|]]
<center>Low magnification. [[H&E stain]].</center>

{{hidden|Intermediate magnification|[[Image: Atypical leiomyoma with bizarre nuclei low magnification 2.jpg|500px|link=|center|]]
<center>Intermediate magnification. [[H&E stain]].</center>}}

{{hidden|High magnification|[[Image: Atypical leiomyoma with bizarre nuclei high magnification.jpg |500px|link=|center|]]
<center>High magnification. [[H&E stain]].</center>}}

===Differential diagnosis===
{{hidden|Differential diagnosis|<center>Leiomyosarcoma</center>}}

===Additional tests===
====More history====
{{hidden|More history|<center>MORE HISTORY HERE</center>}}

====Ask a colleague====
{{hidden|Ask a colleague|<center>COLLEAGUE'S ADVICE HERE</center>}}

====Stains====
{{Case Stains
| blank=Dr Torres would ask why!
| alcpas=
| alc1=
| alc25=
| aur=
| biel=
| bili=
| iron=
| congored=
| cresylv=
| dieterle=
| diffquik=
| fontana=
| gallyas=
| giemsa=
| gms=
| gomori=
| gram=
| gremelius=
| jms=
| jones=
| kinyoun=
| luxol=
| masson=
| mmas=
| movat=
| mucicar=
| oilredo=
| orecein=
| pas=
| pasd=
| pasf=
| ptah=
| prussian=
| reticulin=
| sudanblackb=
| toluidine=
| verhoeff=
| vonkossa=
| warthinstarry=
| zn=
}}
====IHC====
{{Case IHC
| blank=Dr Torres would ask why!
| a1at=
| acth=
| ae1ae3=
| afp=
| alk1=
| amacr=
| ar=
| atrx=
| b2microglobulin=
| b72_3=
| bcatenin=
| bcl2=
| bcl6=
| bclxl=
| c3=
| ca9=
| calcitonin=
| calponin=
| calretinin=
| cam5p2=
| cathepsink=
| cd10=
| cd117=
| cd138=
| cd15=
| cd1a=
| cd20=
| cd21=
| cd23=
| cd3=
| cd30=
| cd31=
| cd34=
| cd35=
| cd4=
| cd43=
| cd45=
| cd5=
| cd56=
| cd57=
| cd68=
| cd7=
| cd79a=
| cd8=
| cd99=
| cdx2=
| cea=
| chromo=
| ck17=
| ck19=
| ck20=
| ck34be12=
| ck5_6=
| ck7=
| cmv=
| cmyc=
| cyclin_d1=
| d2_40=
| desmin=
| dog1=
| ebv=
| ema=
| erpr=
| f_viii=
| f_xiiia=
| fascin=
| fh=
| fsh=
| gastrin=
| gata3=
| gcdfp=
| gfap=
| gh=
| glucagon=
| glypican3=
| hbme1=
| hbv_core=
| hbv_surf=
| hcaldesmon=
| hcg=
| helicobacter=
| hepatocyte=
| her2=
| hhv8=
| hmb45=
| hnf1beta=
| hpv=
| hsv1=
| hsv2=
| Idh-1=
| inhibin=
| ini1=
| insulin=
| kappa=
| ki67=
| lambda=
| leu7=
| lga=
| lgg=
| lgm=
| lh=
| lysozyme=
| mammogl=
| map2=
| mcv=
| melanin_a=
| mitf=
| mum1=
| myleoperox=
| myo_d1=
| myog=
| napsin=
| nf=
| nkx3_1=
| nse=
| oct3_4=
| p16= patchy positive
| p501s=
| p53=
| p57=
| p63=
| panker=
| pax2=
| pax5=
| pax8=
| pcna=
| pdgfr=
| plap=
| pnl-2c=
| prolactin=
| psa=
| psap=
| rcc=
| s100=
| sma=
| somatsatin=
| synapto=
| tdt=
| tfe3=
| tfeb=
| thyrogl=
| toxopl=
| tsh=
| ttf1=
| ubiquitin=
| uchl1=
| ulex_europe=
| vim=
| vip=
| vzv=
| wt1=
}}

====Molecular testing====
=====Chromosomal translocations=====
{{Case Translocations
| blank=Dr Torres would ask why!
| t1_13=
| t2_13=
| t8_14=
| t9_22bcr_abl=
| t9_22chn_ews=
| t11_14=
| t11_22dsrct=
| t11_22ews=
| t12_15=
| t12_16afh=
| t12_16liposar=
| t12_22=
| t14_18=
| t15_17=
| t16_21=
| t17_22=
| t21_22=
| tx_1=
| tx_17=
| tx_18=
}}
=====Other molecular tests=====
{{Case Molecular
| blank=Dr Torres would ask why!
| alk =
| b_cell_clone =
| bcl2 =
| braf =
| EBV_pcr =
| egrf =
| h3f3a =
| hhv8_pcr =
| identity_test =
| idh1_2 =
| jak2_v617f =
| kit =
| loh_1p19q =
| t_cell_clone =
}}

===Diagnosis===
{{hidden|Diagnosis|<center>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. {{Cite journal | last1 = Ly | first1 = A. | last2 = Mills | first2 = AM. | last3 = McKenney | first3 = JK. | last4 = Balzer | first4 = BL. | last5 = Kempson | first5 = RL. | last6 = Hendrickson | first6 = MR. | last7 = Longacre | first7 = TA. | title = Atypical leiomyomas of the uterus: a clinicopathologic study of 51 cases. | journal = Am J Surg Pathol | volume = 37 | issue = 5 | pages = 643-9 | month = May | year = 2013 | doi = 10.1097/PAS.0b013e3182893f36 | PMID = 23552381 }} {{Cite journal | last1 = Croce | first1 = S. | last2 = Young | first2 = RH. | last3 = Oliva | first3 = E. | title = Uterine leiomyomas with bizarre nuclei: a clinicopathologic study of 59 cases. | journal = Am J Surg Pathol | volume = 38 | issue = 10 | pages = 1330-9 | month = Oct | year = 2014 | doi = 10.1097/PAS.0000000000000249 | PMID = 25140893 }}
</center>}}
<br>
===Other cases===
{{Cases navigation}}

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[[Category:Cases difficulty 2]]