Smooth muscle tumor of the uveal tract is rare, and mostly located in the ciliochoroidal area. We report a unique case of posterior choroidal leiomyoma in a 27-yr-old man. Ophthalmoscopic examination disclosed an 11 mm-sized mass on the fundus two-disc diameters apart from the optic disc. With a suspicion of amelanotic melanoma, the globe was enucleated. The mass occupied the whole thickness of choroidal stroma beneath the pigmented retinal epithelium and composed of spindle cells arranged in intersecting fascicles. Immunohistochemical studies demonstrated immunoreactivities of the tumor cells for smooth muscle actin, desmin, and vimentin. Ultrastructurally, numerous intracytoplasmic filaments with fusiform focal densities, scattered segmental external laminae, subplasmalemmal densities, and pinocytic vesicles were noted. The leiomyoma in this case had several unusual features in that it was confined to the posterior choroid with no relation to the ciliary body, occupied the whole stroma of the choroid instead of suprauveal location, and occurred in a young male. It is important to include choroidal leiomyoma in the differential diagnosis of choroidal tumors.
Actins/analysis ; Adult ; Choroid Neoplasms/chemistry/*pathology ; Desmin/analysis ; Humans ; Leiomyoma/chemistry/*pathology ; Male ; Uveal Neoplasms/chemistry/*pathology ; Vimentin/analysis

OBJECTIVETo study the role of mast cells in the differential diagnosis of cellular leiomyoma and endometrial stromal sarcoma of uterus and its mechanism.

METHODSUsing SP immunohistochemical technique, the expression of proliferating cell nuclear antigen (PCNA) and mast cells in 25 cellular leiomyoma (CL) and 26 endometrial stromal sarcoma (ESS) of uterus were examined. The expression of estrogen receptor (ER) and CD44v3 in cellular leiomyoma was also studied.

RESULTSThe expression of PCNA was not significantly different from CL or ESS (P > 0.05), while mast cell count was statistically different between them (P < 0.01). Using a value of less than 7 mast cells per high power field was useful for the diagnosis of ESS, yielding 100% sensitivity and 92.0% specificity. There was a positive correlation between the mast cell count and CD44v3 in CL (r(s) = 0.589, P < 0.01), though no correlation was observed between mast cell count and PCNA or ER.

CONCLUSIONNumber of mast cells is valuable for the discrimination of CL from ESS in the uterus. The mechanism and the role of higher quantity of mast cells in CL need further study.

Adult ; Aged ; Female ; Humans ; Hyaluronan Receptors ; analysis ; Leiomyoma ; chemistry ; pathology ; Mast Cells ; pathology ; Middle Aged ; Proliferating Cell Nuclear Antigen ; analysis ; Receptors, Estrogen ; analysis ; Sarcoma, Endometrial Stromal ; chemistry ; pathology ; Uterine Neoplasms ; chemistry ; pathology

OBJECTIVETo study the histogenesis and pathological characteristics of gastrointestinal stromal tumors (GIST) and GIST type stromal tumor (ST) beyond the gastrointestinal tract.

METHODSA retrospective study was carried out on leiomyoma, leiomyosarcoma and neurilemoma (46 cases in gastrointestinal tract and l3 cases in urinary tract and perineal area). 4 antibodies (CD117, CD34, SMA, S-100) were used for immunohistochemical staining.

RESULTSAmong 45 cases of GIST, the positive rate of CD117 and CD34 was 93.3% and 88.9% respectively. Among 12 cases of GIST type ST beyond the gastrointestinal tract, the positive rate of CD117 and CD34 was 83.3% and 75.0% respectively. In 2 cases (1 in gastrointestinal tract) of leiomyomas, both CD117 and CD 34 were negative in tumor cells, while SMA was extensively positive.

CONCLUSIONSCD117 and CD34 positivity are the most valuable factors in diagnosing ST. Both GIST and GIST type ST beyond the gastrointestinal tract are considered originating from a proto-interstitial stem cell with disoriented differentiation.

Actins ; analysis ; Adult ; Aged ; Aged, 80 and over ; Antigens, CD34 ; analysis ; Biomarkers, Tumor ; analysis ; Female ; Gastrointestinal Stromal Tumors ; chemistry ; pathology ; Humans ; Immunohistochemistry ; Leiomyoma ; chemistry ; pathology ; Leiomyosarcoma ; chemistry ; pathology ; Male ; Middle Aged ; Neurilemmoma ; chemistry ; pathology ; Pelvic Neoplasms ; chemistry ; pathology ; Perineum ; Proto-Oncogene Proteins c-kit ; analysis ; Retrospective Studies ; S100 Proteins ; analysis ; Urologic Neoplasms ; chemistry ; pathology

OBJECTIVETo explore the clinicopathological, immunohistochemical and molecular genetic features of intra-abdomen extra-gastrointestinal stromal tumors (EGISTs) and their differential diagnosis.

METHODSNine cases of EGISTs from the abdominal cavity or retroperitoneum which were previously diagnosed as leiomyoma, leiomyoblastoma, or leiomyosarcoma etc. by a panel of antibodies such as CD117, CD34, alpha-SMA, MSA, desmin, S-100, and PGP9.5 from which five cases were detected for c-kit gene mutation.

RESULTSThe tumors occurred in 5 men and 4 women, the age ranged from 38 to 72 years (mean 61.7 years). Four cases arose from the mesentery, two from omentum, two from retroperitoneum and one located at the hilus of the spleen. The size of tumors ranged from 5 cm to 23 cm (mean 12.9 cm) in diameter and the tumor cell components varied: mainly spindle cells (seven cases), epithelioid cells (one case), mixed cells (one case). Tumors expressed CD117 (8/9), CD34 (5/9), alpha-SMA (3/9), MSA (4/9), desmin (0), S-100 protein (1/9) and PGP9.5 (1/9). Of the five cases examined for heterozygous deletion mutation of 11 exon of the c-kit gene two were found positive. Two borderline cases showed long-term survival of 8 years and 11 years, respectively. In seven malignant cases, two showed adverse outcome, one survived 4 years without recurrence, two were lost in follow up and two new cases were still being in followed.

CONCLUSIONSGIST-type stromal tumors can also occur in the abdomen, most cases were borderline or malignant, tumor coagulative necrosis, mitoses >or= 5 per 50 high-power fields and obvious nuclear atypia indicating malignancy. Differential diagnosis of EGIST including benign or malignant smooth muscle tumors, benign or malignant nerve sheath tumors etc.

Adult ; Aged ; Diagnosis, Differential ; Female ; Humans ; Immunohistochemistry ; Leiomyoma ; pathology ; Leiomyosarcoma ; pathology ; Male ; Middle Aged ; Peritoneal Neoplasms ; chemistry ; genetics ; pathology ; Proto-Oncogene Proteins c-kit ; genetics ; Retroperitoneal Neoplasms ; chemistry ; genetics ; pathology

A 48-year-old woman presented with a 50-day history of irregular vaginal bleeding and lower abdominal pain. Ultrasound indicated an extremely large occupying lesion in the pelvic cavity that was highly suggestive of malignancy. Fluorodeoxyglucose (FDG) positron emission tomography/computed tomography (PET/CT) was performed to further assess the nature of pelvic abnormality. PET/CT images demonstrated a diffusely lobulated mass ranging from cervix up to the inferior pole of kidneys with mild FDG uptake. Simultaneously, multiple nodules in bilateral lungs and a hypodense lesion in the right ventricle were shown without FDG-avidity. Based on the imaging results, the presumptive diagnosis was uterine intravenous leiomyomatosis with intracardiac extension and pulmonary benign metastases, which was subsequently confirmed by MRI and the lesion biopsy.
Female ; Fluorodeoxyglucose F18/chemistry ; Humans ; Leiomyoma/pathology/radiography ; Leiomyomatosis/pathology/*radiography ; Lung Neoplasms/radiography/*secondary ; Magnetic Resonance Imaging ; Middle Aged ; Positron-Emission Tomography ; Tomography, X-Ray Computed ; Uterine Neoplasms/pathology/radiography ; Vena Cava, Inferior/pathology

OBJECTIVETo investigate the improvement effects of Jincao tablet on immune function of the model of hysteromyoma in rat and the relationship between the model and pathogenesis.

METHODRats were randomly divided into 6 groups: normal group, model group, treatment groups including low,middle and high dosage groups of Jincao tablet and Guizhi Fuling pill. Rats were injected respectively with diethyl stilbestrol and progesterone. The immune apparatus of rats were measured. The levels of CD3, CD4 and CD4/ CD8 in serum were determined by flow cytometer. The estrogen and receptor were measured by radioligand binding assay and pathologic changes of womb tissue were observed microscopically.

RESULTCompared with normal group, the weight of thymus, the levels of CD3, CD4 and CD4/CD8 of model group were significantly decreased, and the levels of estrogen, estrogen receptor and CD8 were obviously increased. Jincao tablet groups were significant difference compared with model group and could alleviate the pathological changes of womb tissue.

CONCLUSIONJincao tablet could improve the levels of immune function of the model of hysteromyoma in rat, and it might play a role in the pathogenesis of leiomyoma.

Ajuga ; chemistry ; Animals ; CD3 Complex ; blood ; CD4 Antigens ; blood ; CD4-CD8 Ratio ; CD8 Antigens ; blood ; Drug Therapy, Combination ; Drugs, Chinese Herbal ; administration & dosage ; isolation & purification ; pharmacology ; Estradiol ; blood ; Female ; Flow Cytometry ; Leiomyoma ; blood ; immunology ; pathology ; Phytotherapy ; Plants, Medicinal ; chemistry ; Random Allocation ; Rats ; Rats, Sprague-Dawley ; Receptors, Estrogen ; blood ; Tablets ; Uterine Neoplasms ; blood ; immunology ; pathology