Gyn

Question 1

smooth muscle tumor criteria for malignancy (3)

Answer 1

• tumor necrosis
• mitotic activity (10/10 HPF)
• Cytologic Atypia

Question 2

Hydropic Leiomyoma

• Histological features
• Ddx

Answer 2

• Loose, white edematous stroma; hypocellular

- Ddx: Myxoid leiomyoma

Question 3

Leiomyoma with nuclear palisading

- Ddx

Answer 3

• Ddx: Nerve sheath tumor of the uterus

Question 4

Apopleptic Leiomyoma

• Histological features
• Clinical

Answer 4

• Hemorrhagic necrosis with areas of ischemia

- A/w reproductive age women with exogenous progesterone or post-partum

Question 5

Cellular Leiomyoma
- Ddx
- IHC:
 CD10?
Desmin?
H-CD?

Answer 5

• Low Grade Endometrial stromal sarcoma

- CD10 +/-, Desmin+++, Caldesmon ++

Question 6

Mitotically Active Leimyoma

- Histological features

Answer 6

• Mitosis in absence of any tumor necrosis and cytologic atypia > benign

Question 7

Hereditary Leomyomatosis Renal Cell Carcinoma Syndrome (HLRCC)

Answer 7

• Uterine Leiomyomas (Fumarate Dehydrogenase)
• Cutaneous Leimyomas
• RCC

Question 8

Benign Leimyoma with “quasi-malignant” behavior (x3)

Answer 8

• Intravenous Leimyomatosis (IVL)
• Disseminated (Peritoneal) Leimyomatosis (DPL)
• Benign Metastasizing Leiomyoma (BML)