leiomyoma


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  • Gross

    • well circumscribed
    • firm, whirled
    • can have degenerative changes
      • necrosis
      • hemorrhage
      • cysts
      • calcifications

  • Histology

    • spindle cells
    • degenerative changes
      • hyaline fibrosis
      • necrosis, hemorrhage, inflammation
      • calcification
      • edema, myxoid change
    • hormonal changes
      • hypercellular foci
      • cellular hypertrophy

  • Histological variants

  • Growth pattern variants

  • Stains

    • positive: SMA, desmin, h-caldesmon, ER/PR, WT1
    • p53, p16 can be positive in atypical cells, but not used to diagnose leiomyosarcoma
    • may have aberrant CK and focal CD10
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