title: Cytodiagnostic problems in uterine sarcoma. Analysis according to a novel classification of tumor growth types.
abstract: OBJECTIVE
  To clarify the cytologic diagnostic problems of uterine sarcomas and the differential properties between pure sarcomas and carcinosarcomas.
  
  
  METHODS
  Four leiomyosarcomas and 21 carcinosarcomas (homologous and heterologous) treated at the Saitama Cancer Center from 1991 to 2000 were analyzed macroscopically and microscopically.
  
  
  RESULTS
  Of 4 leiomyosarcomas, 3 were intramuscular, localized type, with a negative diagnosis for sarcoma. Of 21 carcinosarcomas, 7 were exophytic type with little necrosis (B-1), 5 were exophytic type with marked necrosis (B-2), 6 were exophytic type with a small sarcomatous component (B-3), and 3 were endophytic type (B-4). All endometrial smears were positive for sarcoma in B-1, whereas 5 of 14 (36%) were positive in the latter 3 types (B-2, 3 and 4).
  
  
  CONCLUSIONS
  In pure leiomyosarcomas, the sarcomatous portions are usually covered with normal endometrium. In carcinosarcomas, sarcomatous component is relatively limited in some cases and frequently covered with marked necrosis or carcinomatous tissue. These pathologically specific findings should make cytologic diagnosis difficult in uterine sarcomas.
authors.affiliation: Department of Obstetrics and Gynecology, Faculty of Medicine, University of Tokyo, 7-3-1 Hongo, Bunkyo-Ku, Tokyo 113-8655, Japan. katsutoshi-tky@umin.ac.jp
authors.forename: Katsutoshi
authors.initials: K
authors.lastname: Oda
authors.forename: Satoshi
authors.initials: S
authors.lastname: Okada
authors.forename: Tomomi
authors.initials: T
authors.lastname: Nei
authors.forename: Takako
authors.initials: T
authors.lastname: Shirai
authors.forename: Michiko
authors.initials: M
authors.lastname: Takahashi
authors.forename: Yusaku
authors.initials: Y
authors.lastname: Sano
authors.forename: Kenji
authors.initials: K
authors.lastname: Shiromizu
mesh_terms: D000368:Aged; D002296:Carcinosarcoma / Q000473:pathology; D003937:Diagnosis, Differential; D004717:Endometrium / Q000473:pathology; D004847:Epithelial Cells / Q000473:pathology; D005260:Female; D006801:Humans; D007890:Leiomyosarcoma / Q000473:pathology; D008875:Middle Aged; D009130:Muscle, Smooth / Q000473:pathology; D009215:Myometrium / Q000473:pathology; D012509:Sarcoma / Q000145:classification* / Q000473:pathology*; D014594:Uterine Neoplasms / Q000145:classification* / Q000473:pathology*; D014599:Uterus / Q000473:pathology*; D014626:Vaginal Smears