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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====
{{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====
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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}}
}}
}}
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===Other cases===
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Latest revision as of 03:31, 27 September 2015
Provided clinical history
52 year old woman, hysterectomy done for leiomyoma
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]
p16 immunostaining may be useful for differentiating leiomyoma (weak) from leiomyosarcoma (strong).[3]
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 Pathol37 (5): 643-9. doi:10.1097/PAS.0b013e3182893f36. PMID23552381.
↑Croce, S.; Young, RH.; Oliva, E. (Oct 2014). "Uterine leiomyomas with bizarre nuclei: a clinicopathologic study of 59 cases.". Am J Surg Pathol38 (10): 1330-9. doi:10.1097/PAS.0000000000000249. PMID25140893.
↑Gannon, BR.; Manduch, M.; Childs, TJ. (Jan 2008). "Differential Immunoreactivity of p16 in leiomyosarcomas and leiomyoma variants.". Int J Gynecol Pathol27 (1): 68-73. doi:10.1097/pgp.0b013e3180ca954f. PMID18156978.
