平滑肌瘤病
平滑肌瘤
医学
放射科
平滑肌
病理
内科学
作者
Amandeep Singh,Asokan Pasupathy
出处
期刊:Pathology
[Elsevier]
日期:2015-01-01
卷期号:47: S75-S76
标识
DOI:10.1097/01.pat.0000461531.46202.25
摘要
Background Intravascular leiomyomatosis (IVL) is an intraluminal growth of benign smooth muscle cells in the uterine or pelvic lymphatic or venous vessels beyond the confines of a leiomyoma. Case report A 35-year-old female was admitted for elective total abdominal hysterectomy for menorrhagia secondary to a fibroid uterus. Macroscopically, the fibroid measured 130 mm and had a smooth whorled cut surface. Histological examination confirmed the presence of a cellular leiomyoma with degenerative changes and multiple intravascular permeations outside the confines of the leiomyoma consistent with IVL. No necrosis, atypia or excessive mitotic activity was seen. The leiomyoma was positive for smooth muscle, oestrogen and progesterone markers. CD31 and CD34 positivity confirmed vascular permeation. Endometrial stromal sarcoma and leiomyosarcoma were subsequently excluded. Discussion Intravascular leiomyomatosis is a growth pattern variant of benign uterine leiomyoma. Benign leiomyomas with IVL should be especially distinguished from endometrial stromal sarcoma and also leiomyosarcoma, as they differ in their behaviour, management and prognosis. The main treatment modality is hysterectomy and excision of any uterine or extra-uterine tumour if feasible. Anti-oestrogen therapy is recommended for controlling the growth of an unresectable tumour.
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