title: Pathological findings of uterine tumors preoperatively diagnosed as red degeneration of leiomyoma by MRI.
abstract: Venous infarction of a leiomyoma is known as red degeneration of leiomyoma (RDL) and can be a cause of acute abdomen. Although magnetic resonance imaging (MRI) is the only modality that can depict the inner condition of a leiomyoma, the typical MR findings of RDL are sometimes identified incidentally even in asymptomatic patients. The purpose of this study is to clarify common pathological findings of uterine tumors preoperatively diagnosed as RDL by MRI.
  
  
  
  We diagnosed 28 cases of RDL by MRI from March 2007 to April 2015. The ten lesions subjected to pathological analysis after resection were included in the study and reviewed by a gynecological pathologist. The average time from MRI to operation was 4.7 months.
  
  
  
  The typical beefy-red color was not observed on the cut surface of the tumor except in one tumor resected during the acute phase. All lesions diagnosed as RDL by MRI had common pathological findings consistent with red degeneration of leiomyoma, including coagulative necrosis. Other common pathological features of RDL besides extensive coagulative necrosis appear to be a lack of inflammatory cell infiltrate or hemorrhage in the entire lesion.
  
  
  
  Although RDL is known to cause acute abdomen, its typical MR findings can be observed even in asymptomatic patients in a condition that manifests long after red degeneration. The characteristic pathological findings in both the acute phase and the chronic phase that we found in this study, along with radiology reports, will be helpful references for gynecologists and pathologists in suspecting a history of red degeneration and confirming the diagnosis.
authors.affiliation: Department of Radiology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan. rad091@osaka-med.ac.jp.
authors.forename: Go
authors.initials: G
authors.lastname: Nakai
authors.affiliation: The Department of Pathology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan.
authors.forename: Takashi
authors.initials: T
authors.lastname: Yamada
authors.affiliation: Department of Radiology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan.
authors.forename: Takamitsu
authors.initials: T
authors.lastname: Hamada
authors.affiliation: Department of Radiology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan.
authors.forename: Natsuko
authors.initials: N
authors.lastname: Atsukawa
authors.affiliation: Department of Radiology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan.
authors.forename: Yoshikazu
authors.initials: Y
authors.lastname: Tanaka
authors.affiliation: Department of Radiology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan.
authors.forename: Kiyohito
authors.initials: K
authors.lastname: Yamamoto
authors.affiliation: Department of Radiology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan.
authors.forename: Akira
authors.initials: A
authors.lastname: Higashiyama
authors.affiliation: Department of Radiology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan.
authors.forename: Hiroshi
authors.initials: H
authors.lastname: Juri
authors.affiliation: Department of Radiology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan.
authors.forename: Atsushi
authors.initials: A
authors.lastname: Nakamoto
authors.affiliation: Department of Radiology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan.
authors.forename: Kazuhiro
authors.initials: K
authors.lastname: Yamamoto
authors.affiliation: The Department of Pathology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan.
authors.forename: Yoshinobu
authors.initials: Y
authors.lastname: Hirose
authors.affiliation: Department of Obstetrics and Gynecology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan.
authors.forename: Masahide
authors.initials: M
authors.lastname: Ohmichi
authors.affiliation: Department of Radiology, Osaka Medical College, 2-7 Daigaku-machi, Takatsuki, Osaka, 569-8686, Japan.
authors.forename: Yoshifumi
authors.initials: Y
authors.lastname: Narumi
mesh_terms: D000328:Adult; D003937:Diagnosis, Differential; D005260:Female; D006801:Humans; D007238:Infarction / Q000000981:diagnostic imaging* / Q000473:pathology*; D007889:Leiomyoma / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008875:Middle Aged; D009336:Necrosis; D014594:Uterine Neoplasms / Q000098:blood supply / Q000000981:diagnostic imaging* / Q000473:pathology*
keywords: Imaging; Leiomyoma; MRI; Pathological finding; Red degeneration