A case of uterine adenomyoma with bizarre smooth muscle cells mimicking leiomyosarcoma.
We report a case of adenomyoma of the uterus that was cytologically difficult to distinguish from leiomyosarcoma. Examination of a uterine cervical smear revealed numerous spindle cells that were present in cell clusters or as isolated cells. These cells contained nuclei that were oval-shaped/elongated with nucleoli and delicate wispy cytoplasm. Large and bizarre nuclei were also identified. Based on these cytological findings leiomyosarcoma was considered: however, this diagnosis remained uncertain because of the absence of mitosis and/or necrotic substance. Histologically, we recognized leiomyomatous smooth muscle cells growing in a solid pattern and intermingled with endometrial-type glands. Moreover, bizarre smooth muscle cells were observed in the surface layer of the tumor. These observations suggest that for a diagnosis of uterine leiomyosarcoma the presence of mitosis and/or necrosis is important in addition to nuclear atypia.
Ohta
Yoshiki
Y
Department of Pathology, Showa University Northern Yokohama Hospital, Kanagawa, Japan. yomareko@cmed.showa-u.ac.jp
Suzuki
Takao
T
Shiokawa
Akira
A
Ota
Hidekazu
H
D018194:Adenomyoma / Q000473:pathology* / Q000601:surgery; D000328:Adult; D002467:Cell Nucleus / Q000473:pathology; D003581:Cytodiagnosis / Q000379:methods*; D003937:Diagnosis, Differential; D004717:Endometrium / Q000473:pathology; D005260:Female; D006801:Humans; D007890:Leiomyosarcoma / Q000473:pathology*; D032389:Myocytes, Smooth Muscle / Q000473:pathology*; D016896:Treatment Outcome; D014594:Uterine Neoplasms / Q000473:pathology* / Q000601:surgery