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Leiomyoma with Degeneration (Low Power)
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Leiomyoma with Degeneration (Low Power)

This low power image shows spindly cells arranged in loose bundles on the left.
On the right side of the picture is a predominantly acellular eosinophilic field.
No mitotic activity or cellular atypia is seen.
(Description By:Melinda Sanders,M.D. )
(Image Contrib. by:Melinda Sanders,M.D. UCHC )
Leiomyoma
Etiology

unknown
Pathogenesis

unknown
clonal, estrogen sensitive,
Epidemiology

extremely common neoplasm affecting 25% of reproductive age women
vast majority are asymptomatic
General Gross Description

solitary or multiple well circumscribed neoplasms
may be submucosal, intramural or subserosal with pedunculation
whorled, bulging, rubbery, white cut surface
variety of degenerative changes including hemorrhagic, cystic, mucinous, fatty, myxoid, or fibrotic may be found
General Microscopic Description

composed of spindle cells with blunt ended elongate bland nuclei and thin elongated cytoplasm
cells arranged in interlacing bundles
may see cytological atypia which is acceptable in the absence of mitoses
may see necrosis or hemorrhage
Clinical Correlation

most patients are completely asymptomatic
symptoms, if present, include heavy, painful menses, pelvic fullness, infertility, spontaneous miscarriage and urinary symptoms due to pressure on bladder
estrogen sensitive with occasional rapid growth during pregnancy; atrophy after menopause
References

Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 1059-60
Leiomyoma
Synopsis by: Melinda Sanders M.D. (T85000M88900)[24]
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