Recent advances in the pathology of smooth muscle tumours of the uterus

Wilkinson, Nafisa; Rollason, T. P.

doi:10.1046/j.1365-2559.2001.01300.x

Cited by 62 publications

(33 citation statements)

References 70 publications

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“…However, cases of uterine leiomyosarcoma arising in leiomyoma have been reported, suggesting that leiomyosarcomas may arise from preexisting leiomyomas. 2,[11][12][13] In this study, we found benign-looking leiomyoma-like areas in 18 of the 26 cases of uterine leiomyosarcoma. The immunohistochemical profile of these benign-looking areas in this study was similar to that reported for leiomyomas previously.…”

Section: Discussionmentioning

confidence: 84%

“…These are aggressive tumors that may be a diagnostic challenge at times. [1][2][3][4][5][6][7] We have previously noted the origin of leiomyosarcoma within a leiomyoma, 8 as well as the presence of leiomyoma-like areas associated with some uterine leiomyosarcomas. 9 In this study, we examined cases of uterine leiomyosarcoma associated with leiomyomalike areas at the histological, immunohistochemical and DNA level to further evaluate if benign-looking leiomyoma-like and uterine leiomyosarcoma areas are related.…”

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confidence: 98%

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Molecular and immunohistochemical evidence for the origin of uterine leiomyosarcomas from associated leiomyoma and symplastic leiomyoma-like areas

et al. 2009

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It is uncertain whether uterine leiomyosarcoma arises de novo or in preexisting leiomyoma. Leiomyoma-like areas can be seen associated with uterine leiomyosarcoma, raising the possibility of precursor lesions for uterine leiomyosarcoma. In this study, we examined cases of uterine leiomyosarcoma associated with leiomyoma-like areas at the histological, immunohistochemical and DNA level to further evaluate if benignlooking leiomyoma-like and uterine leiomyosarcoma areas are related. Cases of uterine leiomyosarcoma observed at the New York University Medical Center from 1994 to 2007 were reviewed for the presence of leiomyoma-like areas. Of the 26 cases of uterine leiomyosarcoma observed during this period, 18 cases had an associated leiomyoma-like area (five cellular leiomyoma, four symplastic leiomyoma, four cellular and symplastic leiomyoma and five usual type leiomyoma). Sixteen of the 18 cases were examined immunohistochemically for Ki-67, for estrogen receptor, progesterone receptor and for p53. Immunohistochemical profiles were as expected for leiomyoma-like (the mean expression of p53, ER, PR and Ki-67 at 0.3, 63, 75 and 0.6%, respectively), symplastic leiomyoma-like areas (the mean expression of p53, ER, PR and Ki-67 at 0.6, 85, 89 and 5.5%, respectively) and uterine leiomyosarcoma areas (the mean expression of p53, ER, PR and Ki-67 at 52, 38, 39 and 61%, respectively). In six cases, the leiomyoma-like and uterine leiomyosarcoma areas from each case were examined using high-density oligonucleotide array-CGH to determine genetic aberrations in the two areas. Nearly all the genetic aberrations found in leiomyoma-like areas were also found in the corresponding uterine leiomyosarcoma areas. In addition, uterine leiomyosarcoma areas had additional genetic aberrations. The immunohistochemical profiles and genetic aberrations of the examined cases suggest that uterine leiomyosarcoma could arise from the preexisting leiomyoma-like areas that often have a symplastic or cellular morphology.

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Section: Discussionmentioning

confidence: 84%

mentioning

confidence: 98%

Molecular and immunohistochemical evidence for the origin of uterine leiomyosarcomas from associated leiomyoma and symplastic leiomyoma-like areas

et al. 2009

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“…Parasitic leiomyomas: These present as pelvic tumors separated from the uterus, with a similar clinical behavior to that of uterine leiomyomas and similar response to a gonadotropin-A c c e p t e d M a n u s c r i p t releasing hormone suppressive treatment 27 . In general, it is considered that this type of leiomyoma is associated with a history of morcellation and has an iatrogenic origin.…”

Section: Pathogenesis Of Parasitic Leiomyomamentioning

confidence: 99%

Parasitic leiomyomas: a systematic review

Lete

González

Ugarte

et al. 2016

European Journal of Obstetrics & Gynecology and Reproductiv

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“…9 In contrast, cellular leiomyomata (CL) represent a variant that is significantly more cellular and occurs in <5% of cases. 9,10 …”

Section: Introductionmentioning

confidence: 99%

Uterine cellular leiomyomata with chromosome 1p deletions represent a distinct entity

Hodge¹,

Pearce²,

Clayton³

et al. 2014

American Journal of Obstetrics and Gynecology

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OBJECTIVE This study aims to determine whether 1p deletion defines a subset of cellular leiomyomata (CL), a hypercellular variant of uterine leiomyomata (UL) that may have delayed malignant potential, and correlate this genetic change with clinical and pathologic characteristics including those present in uterine sarcomas. STUDY DESIGN Available CL cases at Mayo Clinic (n=101) and variant cases reported by Giuntoli et al. (n=16) were identified. Each case with sufficient tissue that met histologic criteria for CL when reviewed by a single pathologist underwent interphase FISH to determine the presence of 1p deletion. Clinical characteristics of women with confirmed CL were compared on the basis of 1p deletion status using univariate analysis. RESULTS Of the Mayo cohort of histologically confirmed CL, 23% had deletion of 1p. Women with this subset of CL when compared to those without 1p deletion were more likely to be postmenopausal (P=0.049) and their uteri tended to be heavier (P=0.039) with a larger dominant leiomyoma (P=0.030). The pathological features associated with 1p deletion were high cellularity (P=0.036) and hyaline necrosis (P=0.047), which remained significant after inclusion of the CL cases from the Giuntoli et al. series. CONCLUSION Deletion of 1p occurs in approximately one-quarter of CL. This genetic alteration is potentially associated with clinicopathologic features present in uterine sarcomas, suggesting a distinct clinical entity that may have malignant potential. Our findings are particularly pertinent considering the increased preference for uterine-sparing options in leiomyoma treatment, suggesting assessment of 1p deletion status in CL may influence clinical surveillance decisions.

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Recent advances in the pathology of smooth muscle tumours of the uterus

Cited by 62 publications

References 70 publications

Molecular and immunohistochemical evidence for the origin of uterine leiomyosarcomas from associated leiomyoma and symplastic leiomyoma-like areas

Molecular and immunohistochemical evidence for the origin of uterine leiomyosarcomas from associated leiomyoma and symplastic leiomyoma-like areas

Parasitic leiomyomas: a systematic review

Uterine cellular leiomyomata with chromosome 1p deletions represent a distinct entity

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