title: Combined clear and granular cell leiomyoma of soft tissue: evidence of transformation to a histiocytic phenotype.
abstract: OBJECTIVE
  We present an unusual case of leiomyoma with a clear and granular cell pattern in which there was immunohistochemical evidence of transformation to a histiocytic phenotype.
  
  
  RESULTS
  A 64-year-old man presented with mild scrotal swelling and pain. A local excision was performed after the clinical diagnosis of epidermal inclusion cyst. In the pathological specimen, another tumour nodule was identified which was composed predominantly of clear cells, with an occasional mixture of granular cells. Immunohistochemical analysis demonstrated positive staining for vimentin, lysozyme, CD68 and HAM56, but complete negativity for desmin, alpha-smooth muscle actin, HHF35, S100 protein, neurone-specific enolase and CD34. Ultrastructural study revealed dilated rough endoplasmic reticulum, glycogen granules, abundant vacuolar structures and also thin microfilaments with subplasmalemmal dense bodies.
  
  
  CONCLUSIONS
  Based on these findings, we have interpreted it to be a rare case of leiomyoma with extensive clear cell and granular cell degeneration (combined clear and granular cell leiomyoma). This complete transformation of the immunohistochemical profile into the histiocytic phenotype has not been previously described in the literature.
authors.affiliation: Department of Pathology, Kitasato University School of Medicine, Kanagawa, Japan. ydobashi@med.kitasato-u.ac.jp
authors.forename: Y
authors.initials: Y
authors.lastname: Dobashi
authors.forename: K
authors.initials: K
authors.lastname: Iwabuchi
authors.forename: J
authors.initials: J
authors.lastname: Nakahata
authors.forename: K
authors.initials: K
authors.lastname: Yanagimoto
authors.forename: T
authors.initials: T
authors.lastname: Kameya
mesh_terms: D000199:Actins / Q000276:immunology; D015703:Antigens, CD / Q000276:immunology; D015214:Antigens, Differentiation, Myelomonocytic / Q000276:immunology; D002454:Cell Differentiation; D003893:Desmin / Q000276:immunology; D006644:Histiocytes / Q000473:pathology*; D006801:Humans; D007150:Immunohistochemistry; D007889:Leiomyoma / Q000276:immunology / Q000473:pathology* / Q000503:physiopathology; D008297:Male; D008875:Middle Aged; D012983:Soft Tissue Neoplasms / Q000276:immunology / Q000473:pathology* / Q000503:physiopathology; D000097382:CD68 Molecule
chemical_list: D000199:Actins; D015703:Antigens, CD; D015214:Antigens, Differentiation, Myelomonocytic; D003893:Desmin; C067980:CD68 antigen, human; D000097382:CD68 Molecule