Transcervical needle biopsy for the differential diagnosis between uterine sarcoma and leiomyoma

Kawamura, Naoki; Ichimura, Tsuyoshi; Ito, Fumihiro; Shibata, Sachiko; Takahashi, Kumiyo; Tsujimura, Akemi; Ishiko, Osamu; Haba, Tomoko; Wakasa, Kenichi; Ogita, Sachio

doi:10.1002/cncr.10382

Cited by 78 publications

(49 citation statements)

References 24 publications

(23 reference statements)

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“…LM was identified on the basis of the pathological findings. This group was called the LM A group, and needed clinical differentiation from patients with LMS (15).…”

Section: Methodsmentioning

confidence: 99%

Use of 18F-fluorodeoxyglucose positron emission tomography for diagnosis of uterine sarcomas

Nagamatsu

Umesaki²,

Li³

et al. 2010

Oncol Rep

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Abstract. We evaluated the use of 18 F-fluorodeoxyglucose positron emission tomography (FDG-PET) for the diagnosis of uterine sarcomas. FDG-PET combined with serum lactate dehydrogenase (LDH) levels were compared with FDG-PET alone for the diagnosis of leiomyosarcomas (LMS), which are the most difficult uterine sarcomas to diagnose. FDG-PET imaging of endometrial cancer (EC) was used as a reference. Immunoreactivity for glucose transporter-1 (GLUT-I) correlated with FDG uptake was evaluated in sarcomas and leiomyomas (LM), including cases not examined by FDG-PET. FDG was injected after at least 5 h fasting and standardized uptake values (SUVs) were analyzed quantitatively 50-70 min after injection. Immunohistochemical expression of GLUT-1 was studied in paraffin sections of tumors using anti-GLUT-1 antibodies and GLUT-1 expression scores were derived based on staining intensities. FDG-PET was performed preoperatively in a total of 53 patients including 10 with sarcomas, 19 with EC and 24 with LM. Immunohistochemical examination was performed in 17 sarcomas, 6 EC and 9 LM [6 usual LM, 1 uterine smooth muscle tumor of uncertain malignant potential (UMP), and 2 bizarre LM (BLM)]. SUVs for uterine sarcomas and EC were significantly higher (p=0.0001) than those for LMs. There were no significant differences in SUVs among ECs, carcinosarcomas (CS) and LMS. Significant differences in SUVs existed between LM and LMS (p=0.003). However, the diagnostic accuracy for LMS was only 73%. The diagnostic accuracy of FDG-PET combined with serum LDH was 100%. GLUT-1 expression scores were significantly higher in sarcomas and EC than in LM (p<0.0001). Intermediate GLUT-1 scores were found in two of the three cases of UMP and BLM. In conclusion, FDG-PET is useful for diagnosing uterine sarcomas, while FDG-PET combined with serum LDH is useful for diagnosing LMS. Immunohistochemical examination of GLUT-1 confirmed the high FDG uptake in LMS patients.

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“…LM was identified on the basis of the pathological findings. This group was called the LM A group, and needed clinical differentiation from patients with LMS (15).…”

Section: Methodsmentioning

confidence: 99%

Use of 18F-fluorodeoxyglucose positron emission tomography for diagnosis of uterine sarcomas

Nagamatsu

Umesaki²,

Li³

et al. 2010

Oncol Rep

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“…We carried out transcervical needle biopsy, which has been previously described,7, 8 to differentiate between leiomyoma and other malignant tumors of the myometrium.…”

Section: Case Reportmentioning

confidence: 99%

“…We have performed 885 transcervical needle biopsies since 1994 7, 8. Almost all patients undergo the biopsy with minimal pain, using diclofenac sodium (25 mg suppository).…”

Section: Case Reportmentioning

confidence: 99%

“…The surgery for diagnosis and treatment often leads to major bleeding 5, 6. The transcervical uterine biopsies described in this report are prevalently performed for the purpose of diagnosing tumors in myometrial lesions,7, 8 but this is an unusual method. In this report, we suggest that transcervical needle biopsy is suitable for the diagnosis of uterine ML.…”

Section: Introductionmentioning

confidence: 99%

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Two cases of uterine malignant lymphoma diagnosed by needle biopsy

Kasai

Ichimura

Murakami

et al. 2015

J of Obstet and Gynaecol

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The incidence of primary malignant lymphoma arising in the female genital tract is extremely rare and constitutes approximately 0.05% of malignant tumors. Uterine malignant lymphoma develops in the endometrial stroma, causing minimal necrosis. It is therefore difficult to diagnose malignant lymphoma, as it does not involve genital bleeding or epithelial defects. We have performed transcervical needle biopsies from deep in the myometrium, with the purpose of diagnosing uterine muscle layer lesions, such as leiomyosarcoma, but this is an unusual method. In this report, we suggest that transcervical needle biopsy is useful in the diagnosis of uterine malignant lymphoma.

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“…The most reliable preoperative diagnostic method is biopsy of the tumor. Since 1994, we have performed transcervical needle biopsy, a procedure infrequently performed, to improve preoperative differential diagnosis of these tumors (5,(7)(8)(9). Uterine smooth muscle tumors, as proposed by Bell et al, are diagnosed histopathologically by three criteria: degree of cytologic atypia (CA), mitotic index (MI) and presence or absence of coagulative tumor cell necrosis (CTCN) (10).…”

Section: Introductionmentioning

confidence: 99%

A scoring system for histopathologic and immunohistochemical evaluations of uterine leiomyosarcomas

Yoshida

Ichimura²,

Kawamura³

et al. 2009

Oncol Rep

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Abstract. Uterine leiomyosarcomas (LMS) are difficult to distinguish from benign leiomyomas without surgery. In this study we performed transcervical needle biopsy on 475 patients, 8 LMS patients and 467 patients with nonsarcomas (non-LMS) in a high-risk group for LMS, and evaluated whether examinations performed with Ki-67 and CD34 immunohistochemical analyses in addition to the standard hematoxylin-eosin (H&E)-stained sections would improve preoperative diagnostic precision of the uterine smooth muscle tumors. Histopathologic analysis included three factors: degree of cytologic atypia, mitotic index and coagulative tumor cell necrosis (CTCN). We also evaluated cell proliferation with Ki-67 expression. In cases of suspected CTCN, we examined CD34 expression and counted positive blood vessels in the necrotic area. Three of the 8 LMS cases satisfied the diagnostic criteria of LMS by histopathologic evaluation with H&E-stained sections. We made a score list based on these analyses; scores for LMS specimens ranged from 6-14 points; non-LMS specimens scored 0-2 points. At the cut-off score of 6 points, the positive predictive value to distinguish LMS from non-LMS was 100%, showing that this scoring system, is a useful method for preoperative differentiation between LMS and non-LMS tumors.

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Transcervical needle biopsy for the differential diagnosis between uterine sarcoma and leiomyoma

Cited by 78 publications

References 24 publications

Use of 18F-fluorodeoxyglucose positron emission tomography for diagnosis of uterine sarcomas

Use of 18F-fluorodeoxyglucose positron emission tomography for diagnosis of uterine sarcomas

Two cases of uterine malignant lymphoma diagnosed by needle biopsy

A scoring system for histopathologic and immunohistochemical evaluations of uterine leiomyosarcomas

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