Perinodular hydropic degeneration of a uterine leiomyoma is a rare form of the more common hydropic change observed in leiomyomas. 1. Cotyledonoid leiomyoma apparently results from a combination of several uncommon growth patterns operating together, including subserosal growth, dissecting growth, and perinodular hydropic degeneration. A variety of unusual growth patterns can occur in uterine leiomyomas, such as diffuse uterine leiomyomatosis, disseminated peritoneal leiomyomatosis, benign metastasizing leiomyoma, parasitic leiomyoma, intravascular leiomyomatosis, dissecting leiomyoma, and leiomyoma with perinodular hydropic degeneration.1 In 1996, Roth et al2 reported a series of 4 cases of leiomyoma characterized … This is also referred to as Carneous degeneration. A presumed direct relation between the abundance of intratumoral fluid and presence of ascites seemed justified. The cut surfaces are well circumscribed, with greywhite and whorled cut surface. 1) was described and distinguished from the interstitial hyaline degeneration that is commonly seen in uterine leiomyomata. These are the ones which can manifest with menorrhagia. Red Degeneration: This is due to hemorrhagic infaction of a leiomyoma. pathology examination confirmed that the mass was a leiomyoma with hydropic and cystic degeneration. 1. The common cause is due to obstruction of venous drainage at the periphery of the lesion. Anastomosing thin cord-like arrangements of the leiomyoma cells mimicked the architecture of adenomatoid tumors. This is a complication usually occurs in pregnancy. Cystic change, an extreme form of hydropic degeneration is a rare clinical presentation. Geographic areas of hydropic degeneration were identified (Fig. They can be single or multiple. A leiomyoma is a benign smooth muscle tumor that can develop anywhere in the body Hydropic Leiomyoma of Uterine Corpus is an uncommon morphological variant of Uterine Corpus Leiomyoma. 3. Uncomplicated leiomyomas are of a heterogeneous echo texture and vary from hypoechoic to hyperechoic, sometimes containing calcifications with acoustic shadowing. Ultrasonography (US) showed a heterogeneous abdominopelvic mass. Most important risk factor is exposure to environmental estrogens before puberty. The common cause is due to obstruction of venous drainage at the periphery of the lesion. Address correspondence and reprint requests to Dr. Lawrence M. Roth, Department of Pathology, University Hospital, Room 3465, 550 North University Boulevard, Indianapolis, IN 46202-5280, U.S.A. ... and one was a multinodular leiomyoma with hydropic degeneration. Aims: We present the histopathological findings of a series of six cases of a benign uterine smooth muscle tumour with an unusual growth pattern.. Methods and results: All cases have the appearances of the recently described dissecting (cotyledonoid) leiomyoma.In addition, three of these lesions demonstrate the … Cotyledonoid dissecting leiomyoma is an extremely rare variant of uterine leiomyoma with an unusual growth pattern characterized by an extrauterine mass that resembles a placenta and histologically shows an intramural dissecting pattern in the uterus [2, 3]. No striated muscle tissues were noted between the tumor and resection margin, but a thin smooth muscle layer, positive for hormone receptors, was present at the periphery, suggesting the origin of the tumor. The cytoplasm s abundant and eosinophilic with elongated bipolar processes. Occasionally uterine tumors may detach and results in a rare type called PARASITIC leiomyoma. If the tumor is very large, the degenerative changes can be seen. Gross: Am J Surg Pathol. Based on the location of the tumor they are categorized as Uterine Leiomyoma: These are the benign tumors of smooth muscle of uterus. Magnetic resonance imaging (MRI) was performed to further … Leiomyoma dissects into myometrium (black arrow) at the cornu; hydropic change is present around smooth muscle bundles (perinodular hydropic degeneration) 4. They also showed an intravascular luminal growth pattern. The individual smooth muscle cells are uniform in size and shape and have characteristic oval to elongated with blunt ends ( CIGAR shaped). Leiomyomas can undergo degeneration, which can result in a variety of sonographic appearances. These are usually asymptomatic if small and are often incidental finding. (perinodular hydropic degeneration), 30100 Telegraph Road, Suite 408, Bingham Farms, Michigan 48025 (USA). The patient was admitted in the emergency department because of diffuse abdominal bloating and discomfort. is present around smooth muscle bundles It is critical for ... 1Department of Pathology, KKR Sapporo Medical Center, 6-3–40, Ichijyo, Hiragishi, Toyohira-ku, Sapporo, Hokkaido 062-0931, Japan ... marked hyalinized degeneration and hydropic change (Fig. The mass grossly contained serous and hemorrhagic fluids in the cavities, and pathology examination confirmed that the mass was a leiomyoma with hydropic and cystic degeneration. arrow) at the cornu; hydropic change This website is intended for pathologists and laboratory personnel but not for patients. Hyaline degeneration consisting of nodular confluent acellular areas (Fig. Leiomyomas can occur in any age group but more common in 30 to 50 years. However, we cannot answer medical or research questions or give advice. Microscopy: the pattern is that of interlacing fascicles or whorling of smooth muscle cells. rajuwilk_ngp@sancharnet.in In the growing knowledge of rare interesting tumors, the cotyledonoid leiomyoma is a tumor with an alarming appearance, of … With minimal discussion in the surgical pathology literature, appropriate evaluation may be challenging because the differential diagnosis includes other uncommon uterine disorders such as intravenous leiomyomatosis, diffuse leiomyomatosis, myxoid … There are many microscopic variants which include cellular, Leiomyoma with bizzare nuclei, Mitotically active, hydropic, apopletic, lipomatous, epithelioid, myxoid, dissecting leiomyomas etc. Saeed et al. Polarizing Microscopy Simplified! Pathology When the leiomyomas increase in size, the vascular supply to it becomes inadequate and leads to different types of degeneration which are hyaline, cystic, myxoid, or red degeneration and dystrophic calcification may also occur. But can manifest with abnormal uterine bleeding which is more common in submucosal leiomyomas. Diffuse hydropic degeneration is considered much less common and may result in exceptionally large tumors, depending on the degree of fluid accumulation . It is a close mimicker of malignancy due to rapid growth and atypical imaging appearances. Etiology: Exact etiology is not known, however age of menarche and parity are important risk factors. 21 year old woman with bilateral massive ovarian leiomyomata (Mod Pathol 1992;5:586) 31 year old woman with primary ovarian leiomyoma associated with endometriotic cyst presenting with symptoms of acute appendicitis (Diagn Pathol 2009;4:25) 79 year old woman with leiomyoma of the ovary presenting with Meigs' syndrome (J Obstet Gynaecol Res … Cotyledonoid hydropic intravenous leiomyomatosis: a new variant leiomyoma. Highly cellular variant and lipoleiomyomas will be yellowish in color. Perinodular hydropic degeneration of a uterine leiomyoma is a rare form of the more common hydropic change observed in leiomyomas. Ovary tumor - Leiomyoma. No reported case of pseudo-Meigs syndrome presenting with hydropic degeneration of uterine leiomyoma and an elevated CA 125 level could be found on a MEDLINE search. Leiomyomas with hydropic change do not have thick smooth muscle cells fascicles but a delicate filigree pattern with oedema fluid as extracellular material [1]. We welcome suggestions or questions about using the website. Posted by Dr Vijay Shankar S | Jan 11, 2021 | Female Genital System & Breast |. Reports of leiomyoma with marked cystic degeneration have been relatively uncommon (Aydin et al., 2013). Specifically, a rapidly growing uterine mass is not a reliable predictor of leiomyosarcoma according to Parker et al. Hyalinization is the commonest type of degeneration. leiomyoma might have a unique clinical presentation involving concomitant uterine adenomyosis. 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