Difference between revisions of "Smooth muscle tumor"

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File:Histopathology of uterine leiomyoma.jpg|'''Leiomyoma'''s typically show smooth muscle in a whorled (fascicular) pattern<ref>{{cite web|url=http://www.pathologyoutlines.com/topic/uterusleiomyoma.html|title=Uterus - Stromal tumors - Leiomyoma|author=Mohamed Mokhtar Desouki|website=Pathology Outlines}} Topic Completed: 1 August 2011. Revised: 15 December 2019</ref>
 
File:Histopathology of uterine leiomyoma.jpg|'''Leiomyoma'''s typically show smooth muscle in a whorled (fascicular) pattern<ref>{{cite web|url=http://www.pathologyoutlines.com/topic/uterusleiomyoma.html|title=Uterus - Stromal tumors - Leiomyoma|author=Mohamed Mokhtar Desouki|website=Pathology Outlines}} Topic Completed: 1 August 2011. Revised: 15 December 2019</ref>
 
File:Histopathology of a leiomyoma in a postmenopausal uterus, intermediate magnification.jpg|'''Leiomyoma''', with areas where the cellularity is relatively lower (left) and higher (right).
 
File:Histopathology of a leiomyoma in a postmenopausal uterus, intermediate magnification.jpg|'''Leiomyoma''', with areas where the cellularity is relatively lower (left) and higher (right).
 +
File:Histopathology of leiomyoma with nuclear pleomorphism.jpg|thumb|'''Leiomyoma''' with nuclear pleomorphism, yet within benign limits.
 
File:Epithelioid Leiomyoma, Uterus (3) (2556674506).jpg|Epithelioid '''leiomyoma'''
 
File:Epithelioid Leiomyoma, Uterus (3) (2556674506).jpg|Epithelioid '''leiomyoma'''
 
File:Leiomyoma of Uterus with Palisading Pattern (5710417630).jpg|'''Leiomyoma''' with palisading pattern
 
File:Leiomyoma of Uterus with Palisading Pattern (5710417630).jpg|'''Leiomyoma''' with palisading pattern

Revision as of 17:37, 2 May 2021

Author: Mikael Häggström [note 1]

Smooth muscle tumor (in this case leiomyoma).

Comprehensiveness

On this resource, the following formatting is used for comprehensiveness:

  • Minimal depth
  • (Moderate depth)
  • ((Comprehensive))

Gross processing

Gross examination

Fibroid locations.

Examine and describe:[1]

  • Location. If in the uterus:
  • Intramural/submucosal/subserosal (see image)
  • (Posterior/anterior/right or left lateral.)
  • Number of tumors, if multiple
  • Size
  • (Presence or absence of any hemorrhage or necrosis.)
  • ((Demarcation))

Selection

In case of hysterectomy, submit pieces from all smooth muscle tumors >5 cm in diameter.[1]

Submit any macroscopically abnormal parts of the tumors (hemorrhagic, necrotic, brittle or softening areas, and areas with blurry delimitation).[1]

Microscopic examination

Distinguish leiomyoma (benign) from leiomyosarcoma (malignant) by looking at the latter's criteria:[2]

  • Marked cellular atypia
  • Mitoses: > 10 mitoses/10 high power fields
  • Necrosis

Diagnosis of conventional leiomyosarcoma requires 2 of these 3 histologic features.[2]

Further information: Evaluation of tumors

Microscopic report

Report:

  • Microscopic findings, including any visible linings
  • Diagnosis or most probable one
  • Any linings or borders.

Example, for a cervical polyp:

Polyp lined by a single layer of columnar epithelium consistent with endometrium. The interior consists of smooth muscles in a whorled pattern. No atypia. The finding is consistent with a pedunculated submucosal leiomyoma.

  See also: General notes on reporting


Notes

  1. For a full list of contributors, see article history. Creators of images are attributed at the image description pages, seen by clicking on the images. See Patholines:Authorship for details.

Main page

References

  1. 1.0 1.1 1.2 Monica Dahlgren, Janne Malina, Anna Måsbäck, Otto Ljungberg. Stora utskärningen. KVAST (Swedish Society of Pathology). Retrieved on 2019-09-26.
  2. 2.0 2.1 Paulette Mhawech-Fauceglia, M.D.. Uterus - Smooth muscle tumors - Leiomyosarcoma. Pathology Outlines. Topic Completed: 5 December 2019. Minor changes: 11 August 2020
  3. Mohamed Mokhtar Desouki. Uterus - Stromal tumors - Leiomyoma. Pathology Outlines. Topic Completed: 1 August 2011. Revised: 15 December 2019
  4. Vijay Shankar, M.D.. Soft tissue - Smooth muscle - Leiomyosarcoma - general. Pathology Outlines. Topic Completed: 1 November 2012. Revised: 11 September 2019

Image sources