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Gynecologic Pathology
Sunday, March 2, 2008, 7:30 PM
CC Korbel Ballroom 2/3
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Moderator:
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ROBERT KURMAN
Johns Hopkins Hospital
Baltimore, MD
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Disclosure:
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The speakers have indicated they have nothing to disclose.
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Clinical histories are displayed below.
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for Text and References
Submitted by: Marisa R. Nucci - Brigham and Women’s Hospital, Boston, MA
Myomectomy specimen from a 37 year old woman with menorrhagia and fibroids.
Case 1 - Slide 1
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Case 1 - Figure 1
Intramyometrial mass with predominantly rounded, pushing borders.
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Case 1 - Figure 2
In one area there is a slightly irregular interface with the myometrium. Note the prominent chronic inflammatory infiltrate.
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Case 1 - Figure 3
The tumor is composed of fascicular spindle cells set within a myxoid matrix.
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Case 1 - Figure 4
The spindle cells have palely eosinophilic cytoplasm and elongated nuclei with dispersed chromatin and occasional nucleoli.
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Case 1 - Figure 5
Chronic inflammatory cells, particularly plasma cells, are scattered throughout the tumor.
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Case 1 - Figure 6
Mitotic activity was scarce, but focally numbered up to 2 per 10 high power fields (arrows indicate mitotic figures).
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for Text and References
Submitted by: Esther Oliva - Massachusetts General Hospital
A 26-year-old female with no relevant past medical history presented with uterine bleeding of 3 weeks duration. An endometrial curettage was interpreted as a malignant neoplasm most consistent with sarcoma.
The patient underwent radical hysterectomy with extensive lymph node sampling. The tumor measured 5 x 4 x 3 cm. Sectioning revealed a heterogeneous cut surface with fleshy white to gray areas alternating with areas of necrosis.
Case 2 - Slide 1
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Case 2 - Figure 1A
At low power magnification, the infiltrating border of the tumor is lobulated in some areas (A) while has an irregular destructive growth in other areas (B).
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Case 2 - Figure 1B
At low power magnification, the infiltrating border of the tumor is lobulated in some areas (A) while has an irregular destructive growth in other areas (B).
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Case 2 - Figure 2A
At higher magnification, the tumor is hypercellular showing a diffuse growth of small "blue" cells which focally seem to arrange around acellular pink areas
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Case 2 - Figure 2B
At higher magnification, the tumor is hypercellular showing a diffuse growth of small "blue" cells which focally seem to arrange around acellular pink areas
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Case 2 - Figure 3A
The vasculature associated with the tumor is not striking with scattered medium-sized vessels present throughout.
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Case 2 - Figure 3B
The tumor cells do not show prominent degree of pleomorphism.
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for Text and References
Submitted by: Teri A. Longacre - Stanford University, Stanford, CA
- 38-year-old woman with lower abdominal pain and uterine mass
- Representative images of the myomectomy tissue are provided
Case 3 - Slide 1
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