title: Uterine leiomyoma with indolent B-lymphoblastic proliferation.
abstract: Uterine leiomyoma with TdT positive B lymphocytes infiltrating is very rare and may simulate precursor B-cell lymphoblastic lymphoma (B-LBL). To the best of our knowledge, this is the first description of such a lesion in English literature. A 51-year-old Chinese woman was noted a mass in her uterus in a routine physical examination. The myomectomy specimen was identified as a well-defined 8.0x6.8 cm tumor and the cut surface was fresh and yellow-tan. A massive small lymphocytic infiltration accompanied by plasma cells and histiocytes was noted in the leiomyoma but not in the surrounding non-neoplastic myometrial fibers. These cells were small in size without significant nuclear irregularities and mitotic figures can not been seen. Immunohistochemical analysis has shown some small lymphocytes were CD20+, CD79a+, Pax5+B cells and some were CD2+, CD3+, CD5+, CD43+T cells. The small B cells coexpressed TdT and Ki67 and were in patchy dense distribution. The postoperative course was uneventful within a 30-month follow-up period without chemotherapy and radiotherapy. The true nature of these TdT(+) B cells has not been determined.
authors.affiliation: Department of Pathology, First Affiliated Hospital, College of Medicine, Zhejiang University, Hangzhou, Zhejiang Province, PR China.
authors.forename: Zhaoming
authors.initials: Z
authors.lastname: Wang
authors.forename: Ke
authors.initials: K
authors.lastname: Sun
authors.forename: Wenbo
authors.initials: W
authors.lastname: Xiao
mesh_terms: D001402:B-Lymphocytes / Q000276:immunology / Q000473:pathology*; D014408:Biomarkers, Tumor / Q000032:analysis; D049109:Cell Proliferation; D004253:DNA Nucleotidylexotransferase / Q000032:analysis; D005260:Female; D006801:Humans; D007150:Immunohistochemistry; D007889:Leiomyoma / Q000276:immunology / Q000473:pathology* / Q000601:surgery; D016246:Lymphocytes, Tumor-Infiltrating / Q000276:immunology / Q000473:pathology*; D008875:Middle Aged; D011237:Predictive Value of Tests; D016896:Treatment Outcome; D063186:Uterine Myomectomy; D014594:Uterine Neoplasms / Q000276:immunology / Q000473:pathology* / Q000601:surgery
chemical_list: D014408:Biomarkers, Tumor; D004253:DNA Nucleotidylexotransferase
keywords: Leiomyoma; lymphoblastic lymphoma; terminal deoxynucleotidyl transferase (TdT)