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Leiomyoma
Etiology

unknown
Pathogenesis

unknown
clonal, estrogen sensitive,
Epidemiology

extremely common neoplasm affecting 25% of reproductive age women
vast majority are asymptomatic
General Gross Description

solitary or multiple well circumscribed neoplasms
may be submucosal, intramural or subserosal with pedunculation
whorled, bulging, rubbery, white cut surface
variety of degenerative changes including hemorrhagic, cystic, mucinous, fatty, myxoid, or fibrotic may be found
•Examples:
Uterine Leiomyomoma (external view) Uterine Leiomyoma with Degeneration Uterine Leiomyoma (cut surface) Uterine Leiomyoma Uterine Leiomyoma (close up cut surface)
General Microscopic Description

composed of spindle cells with blunt ended elongate bland nuclei and thin elongated cytoplasm
cells arranged in interlacing bundles
may see cytological atypia which is acceptable in the absence of mitoses
may see necrosis or hemorrhage
•Examples:
Leiomyoma (Low Power) Leiomyoma (Medium Power) Leiomyoma with Degeneration (Low Power) Leiomyoma with Degeneration (Medium Power) Leiomyoma with Degeneration (High Power)
Clinical Correlation

most patients are completely asymptomatic
symptoms, if present, include heavy, painful menses, pelvic fullness, infertility, spontaneous miscarriage and urinary symptoms due to pressure on bladder
estrogen sensitive with occasional rapid growth during pregnancy; atrophy after menopause
References

Cotran RS, Kumar V, Robbins SL: Robbins Pathologic Basis of Disease. 5th ed. Philadelphia, W.B. Saunders, 1994, pp. 1059-60

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Leiomyoma
Synopsis by: Melinda Sanders M.D. (T85000M88900)[24]
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