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1.A clinicopathological study of bizarre leiomyoma.

Chinese Journal of Pathology 2002;31(5):404-406

OBJECTIVETo investigate the feature of histomorphology and biology of uterine bizarre leiomyoma from the clinical, pathological features as well as the immunohistochemical expression.

METHODSTotally 25 cases of leiomyomas were studied. Among them, immuno-histochemical staining (SP and ABC methods) for smooth muscle actin (SMA), proliferative cell nucleus antigen (PCNA), estrogen receptors (ER), and progesterone receptors (PR) were performed in 20 cases. The clinical features and follow-up records were analyzed.

RESULTSThe main clinical findings were irregular vaginal bleeding, pain and pelvic tumor. One case was with immense amount of ascitis and the other two were with pregnancy. All the cases had no history of taking pregestine. Light microscopy showed that part of all the cell nuclei were bizarre, accompanying with double or multiple nuclei in which rather big and reddish staining inclusion bodies were obtained (D = 7 - 26 micro m), and the mitotic figures were 0 - 2/10 HPF. Among 20 cases with immunohistochemical staining, markers indicating muscle cells in origin were positive in the bizarre cells, 15 of which (75%) with negative or weak positive PCNA, and 18 of which (90%) with negative ER. There were significant difference between the studied and control groups (P = 0.027, P < 0.005 respectively) and in addition, PR was positive in both these two groups. A majority of the nucleus inclusion bodies was SMA positive. Follow-up records demonstrated so far no recurrence cases obtained.

CONCLUSIONSUterine atypical leiomyoma belongs to benign tumor, although its shape is bizarre. In this group, the morphology changes are correlated with pregnancy, but not with pregestine. The expression of immunohistochemistry shows certain features, and is important to identify uterine bizarre leiomyoma with leiomyosarcoma and STUMP in pathological diagnosis.

Adult ; Female ; Humans ; Immunohistochemistry ; Leiomyoma ; metabolism ; pathology ; Middle Aged ; Pregnancy ; Uterine Neoplasms ; metabolism ; pathology

2.Study of gastrointestinal stromal tumors by light microscopy, electron microscopy and immunohistochemistry.

Ping LIU ; Jia NA ; Ying WANG ; Qun HE ; Ying ZHANG ; Xiuying TANG ; Wanzhong ZOU

Chinese Journal of Pathology 2002;31(3):199-203

OBJECTIVETo investigate the morphological features, immunohistochemical speciality of the gastrointestinal stromal tumors (GISTs), and its histogenesis as well.

METHODSThe morphologic characteristics of GISTs were studied in 65 cases using light microscopy and 17 cases by electron microscopy. The expression of c-kit (CD117), CD34, vimentin, SMA, actin, desmin, S-100 and MBP were detected in all the cases with EnVision trade mark staining.

RESULTSAmong 65 cases of GISTs, 46 were spindle cell type, 6 epithelioid cell type and 13 mixture type, equivalent to 85.5% (65 of 76) of all of the mesenchymal tumors of gastrointestinal tract admitted in the same period. The epithelioid cell type tumors composed of mainly the epithelioid cells, predominantly short spindle, oval or round in pattern, with an overall eosinophilic cytoplasm by hematoxylin-eosin stain. Focal cytoplasmic vacuolization was often seen. Sometimes signet-ring like cells and cells with a clear cytoplasm were seen in the epithelioid stromal tumor. The tumor cells arranged in interlacing fascicles forming whorls or sometimes cell clusters. Electronic microscopy showed the presence of interdigitating cell processes, in some areas, synapse-like structure and numerous desmosome-like junctions as well as a few gap junctions and small round neurosecretory granules. There were also abundant intermediate filaments and thin filaments of actin-type with longitudinal condensations (dense bodies). All of the 65 stromal tumors were strongly positive for vimentin (100%), 61 out of 65 tumors positive for CD117 (c-kit) (93.8%) and 51 out of 65 positive for CD34 (78.5%). Some cases also expressed SMA, actin, S-100 and MBP.

CONCLUSIONSGISTs were the most frequent mesenchymal tumor seen in the gastrointestinal tract. Under light microscope, the morphology of stromal tumors looks sometimes like a leiomyoma and Schwannoma. The application of immunohistochemical markers (particularly CD117 and CD34) and ultrastructural study are considered necessary for the differential diagnosis. GISTs may originate from the pluripotential precursor cells like the interstitial cells of Cajal.

Gastrointestinal Neoplasms ; Gastrointestinal Stromal Tumors ; Humans ; Immunohistochemistry ; Leiomyoma ; Microscopy, Electron ; Proto-Oncogene Proteins c-kit ; metabolism

1.A clinicopathological study of bizarre leiomyoma.

2.Study of gastrointestinal stromal tumors by light microscopy, electron microscopy and immunohistochemistry.

3.Leiomyosarcoma of mediastinum: report of a cases.

4.Renal schwannoma with peripheral lymphocytic cuffing: report of a case.

5.Primary spinal canal leiomyoma: report of a case.

6.Uterine smooth muscle tumors: relationship between morphology and biologic behavior.

7.Cellular angiofibroma of vulva: report of a case.

8.Plexiform fibromyxoma of stomach: a distinctive benign tumor of gastric antrum.

9.Primary smooth muscle tumor of thyroid: report of a case.

10.Highly cellular leiomyoma of uterus with diffuse plexiform pattern resembling sex-cord tumor: report of a case.

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