Case Report
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Uterin Leiomyoma Containing Foci of Extramedullary Hematopoiesis: A Case Report

Year 2020, Volume: 46 Issue: 1, 97 - 99, 01.04.2020
https://doi.org/10.32708/uutfd.638859

Abstract

Extramedullary hematopoiesis is non-neoplastic proliferation of hematopoietic tissue other than bone marrow and peripheral blood. Extramedullary hematopoiesis can be found in many organs and tumors. Myomectomy was applied to the 37-year-old patient who was admitted to our hospital with the complaints of dysmenorrhea and metrorrhagia due to submucosal myoma observed in radiological imaging. In the microscopic examination of the material, it was seen that tumor cells consist of spindle cells arranged as bundles that cross each other. When this tumor, which is morphologically similar to leiomyoma, was examined at high power, cell groups consisting of several different cell types of different sizes, with hyperchromatic nucleus, high nucleus/cytoplasm ratios, sawed in the stroma of leiomyoma. As a result of immunohistochemical studies, some of the cells in the foci showed immunoreactivity with glycophorin A and some with myeloperoxidase. Morphological and immunohistochemical staining revealed that these cell groups were extramedullary hematopoiesis containing erythroid and myeloid serial precursors and the case was reported as leiomyoma containing extramedullary hematopoiesis. Although leiomyoma is a benign smooth muscle tumor that is common in women of reproductive age, it has been observed that the case of leiomyoma involving extramedullary hematopoiesis areas is rare.

References

  • 1. Al-Aabassi A, Murad BA. Presacral extramedullary hematopoiesis: a diagnostic confusion concerning a rare presentation. Med Princ Pract. 2005; 14: 358-62. PMID: 16103704 DOI:10.1159/000086936
  • 2. Humphrey PA, Vollmer RT. Extramedullary hematopoiesis in the prostate. Am J Surg Pathol. 1991;15:486–90.PMID: 2035742
  • 3. O’ Malley DP. Benign extramedullary myeloid proliferation. Modern Pathology. 2007;20: 405–415. PMID: 17334344 DOI: 10.1038/modpathol.3800768
  • 4. Buttram VC Jr, Reiter RC.Uterine leiomyomata: etiology, symptomatology, and management. Fertil Steril. 1981;36:433-45 PMID: 7026295
  • 5.Cramer SF, Patel A. The frequency of uterine leiomyomas. Am J Clin Pathol. 1990;94:435-8 PMID: 2220671 DOI:10.1093/ajcp/94.4.435
  • 6. Downes E, Sikirica V, Gilabert-Estelles J, Bolge SC, Dodd SL, Maroulis C, Subramanian D. The burden of uterine fibroids in five European countries. Eur J Obstet Gynecol Reprod Biol. 2010;152:96-102. PMID: 20598796 DOI: 10.1016/j.ejogrb.2010.05.012.
  • 7. Schmid C, Beham A, Kratochvil P. Hematopoiesis in a degenerating uterine leiomyoma. Arch Gynecol Obstet. 1990;248:81–6. PMID: 2078060
  • 8. Öztürk E, Uğur MG, Balat Ö, Aydın A, Pehlivan M. Extramedullary hematopoiesis in leiomyoma uteri. J Turk Ger Gynecol Assoc. 2012;13:61–3. PMID: 24627677DOI: 10.5152/jtgga.2011.49
  • 9. Cui X, Peker D, Greer HO, Conner MG, Novak L. Extramedullary hematopoiesis in uterine leiomyoma associated with numerous intravascular thrombi. Case Rep Pathol. 2014;2014:957395. PMID: 24711952DOI: 10.1155/2014/957395
  • 10. Gru AA, Hassan A, Pfeifer JD, Huettner PC. Uterine extramedullary hematopoiesis: what is the clinical significance? Int J Gynecol Pathol. 2010;29:366-73. PMID: 20567151 DOI: 10.1097/PGP.0b013e3181cf3830
  • 11.Ward HP, Block MH. The natural history of agnogenic myeloid metaplasia (AMM) and a critical evaluation of its relationship with myeloproliferative syndrome. Medicine. 1971; 50:357-420. PMID: 4940717 DOI:10.1097/00005792-197109000-00001
  • 12.Goldman BI, Wurzel J. Hematopoiesis/erythropoiesis in myocardial infarcts. Mod Pathol. 2001;14:589-94. PMID: 11406661 DOI:10.1038/modpathol.3880356
  • 13.Rowlands CG, Rapson D, Morell T. Extramedullary hematopoiesis in a pyogenic granuloma. Am J Dermatopathol. 2000;22:434–8. PMID: 11048980
  • 14.Jaffe E, Arber DA,Campo E, Harris NL,Quintanilla-FendL. Hematopathology. 2nd ed. Elsevier; 2017

Ekstramedüller Hematopoez Odakları İçeren Uterin Leiomyoma: Olgu Sunumu

Year 2020, Volume: 46 Issue: 1, 97 - 99, 01.04.2020
https://doi.org/10.32708/uutfd.638859

Abstract

Ekstramedüller hematopoez, hematopoetik dokunun kemik iliği ve periferik kan dışındaki neoplastik olmayan proliferasyonudur. Ekstramedüller hematopoeze pek çok organ ve tümör içerisinde rastlanılabilmektedir. Dismenore ve metroraji şikayetleri ile hastanemize başvuran 37 yaşındaki hastaya radyolojik görüntülemelerde izlenen submukozal myom nedeniyle myomektomi uygulanmıştır. Materyalin mikroskobik incelemesinde, tümör hücrelerinin birbirini çaprazlayan demetler şeklinde düzenlenmiş iğsi hücrelerden oluştuğu görülmüştür. Morfolojik olarak leiomyoma benzeyen bu tümör, büyük büyütmede incelendiğinde, stromasında küçük odaklar halinde yerleşim gösteren, hiperkromatik nükleuslu, nükleus /sitoplazma oranları yüksek, değişik büyüklüklerde birkaç farklı hücre grubundan oluşan hücre topluluklarına rastlanmıştır. Uygulanan immünohistokimyasal çalışmalar sonucunda odaklardaki hücrelerden bazılarının glikoforin A, bazılarının ise myeloperoksidaz ile immünreaktivite gösterdiği görülmüştür. Morfolojik ve immünohistokimyasal boyamalar sonucunda bu hücre gruplarının eritroid ve myeloid seri öncülleri içeren ekstramedüller hematopoez alanları olduğu ortaya konmuş, olgu ekstramedüller hematopoez alanları içeren leiomyoma olarak raporlanmıştır. Leiomyoma, üreme çağındaki kadınlarda sık rastlanılan benign düz kas tümörü olmakla birlikte, literatür incelendiğinde, ekstramedüller hematopoez alanları içeren leiomyom olgusunun az sayıda olduğu görülmüştür.

References

  • 1. Al-Aabassi A, Murad BA. Presacral extramedullary hematopoiesis: a diagnostic confusion concerning a rare presentation. Med Princ Pract. 2005; 14: 358-62. PMID: 16103704 DOI:10.1159/000086936
  • 2. Humphrey PA, Vollmer RT. Extramedullary hematopoiesis in the prostate. Am J Surg Pathol. 1991;15:486–90.PMID: 2035742
  • 3. O’ Malley DP. Benign extramedullary myeloid proliferation. Modern Pathology. 2007;20: 405–415. PMID: 17334344 DOI: 10.1038/modpathol.3800768
  • 4. Buttram VC Jr, Reiter RC.Uterine leiomyomata: etiology, symptomatology, and management. Fertil Steril. 1981;36:433-45 PMID: 7026295
  • 5.Cramer SF, Patel A. The frequency of uterine leiomyomas. Am J Clin Pathol. 1990;94:435-8 PMID: 2220671 DOI:10.1093/ajcp/94.4.435
  • 6. Downes E, Sikirica V, Gilabert-Estelles J, Bolge SC, Dodd SL, Maroulis C, Subramanian D. The burden of uterine fibroids in five European countries. Eur J Obstet Gynecol Reprod Biol. 2010;152:96-102. PMID: 20598796 DOI: 10.1016/j.ejogrb.2010.05.012.
  • 7. Schmid C, Beham A, Kratochvil P. Hematopoiesis in a degenerating uterine leiomyoma. Arch Gynecol Obstet. 1990;248:81–6. PMID: 2078060
  • 8. Öztürk E, Uğur MG, Balat Ö, Aydın A, Pehlivan M. Extramedullary hematopoiesis in leiomyoma uteri. J Turk Ger Gynecol Assoc. 2012;13:61–3. PMID: 24627677DOI: 10.5152/jtgga.2011.49
  • 9. Cui X, Peker D, Greer HO, Conner MG, Novak L. Extramedullary hematopoiesis in uterine leiomyoma associated with numerous intravascular thrombi. Case Rep Pathol. 2014;2014:957395. PMID: 24711952DOI: 10.1155/2014/957395
  • 10. Gru AA, Hassan A, Pfeifer JD, Huettner PC. Uterine extramedullary hematopoiesis: what is the clinical significance? Int J Gynecol Pathol. 2010;29:366-73. PMID: 20567151 DOI: 10.1097/PGP.0b013e3181cf3830
  • 11.Ward HP, Block MH. The natural history of agnogenic myeloid metaplasia (AMM) and a critical evaluation of its relationship with myeloproliferative syndrome. Medicine. 1971; 50:357-420. PMID: 4940717 DOI:10.1097/00005792-197109000-00001
  • 12.Goldman BI, Wurzel J. Hematopoiesis/erythropoiesis in myocardial infarcts. Mod Pathol. 2001;14:589-94. PMID: 11406661 DOI:10.1038/modpathol.3880356
  • 13.Rowlands CG, Rapson D, Morell T. Extramedullary hematopoiesis in a pyogenic granuloma. Am J Dermatopathol. 2000;22:434–8. PMID: 11048980
  • 14.Jaffe E, Arber DA,Campo E, Harris NL,Quintanilla-FendL. Hematopathology. 2nd ed. Elsevier; 2017
There are 14 citations in total.

Details

Primary Language Turkish
Subjects Pathology
Journal Section Case Report Articles
Authors

Sevda Akyol This is me 0000-0002-3107-207X

Fatma Öz Atalay This is me 0000-0002-7188-6115

Mehmet Aral Atalay This is me 0000-0002-9685-956X

Publication Date April 1, 2020
Acceptance Date March 10, 2020
Published in Issue Year 2020 Volume: 46 Issue: 1

Cite

APA Akyol, S., Öz Atalay, F., & Atalay, M. A. (2020). Ekstramedüller Hematopoez Odakları İçeren Uterin Leiomyoma: Olgu Sunumu. Uludağ Üniversitesi Tıp Fakültesi Dergisi, 46(1), 97-99. https://doi.org/10.32708/uutfd.638859
AMA Akyol S, Öz Atalay F, Atalay MA. Ekstramedüller Hematopoez Odakları İçeren Uterin Leiomyoma: Olgu Sunumu. Uludağ Tıp Derg. April 2020;46(1):97-99. doi:10.32708/uutfd.638859
Chicago Akyol, Sevda, Fatma Öz Atalay, and Mehmet Aral Atalay. “Ekstramedüller Hematopoez Odakları İçeren Uterin Leiomyoma: Olgu Sunumu”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 46, no. 1 (April 2020): 97-99. https://doi.org/10.32708/uutfd.638859.
EndNote Akyol S, Öz Atalay F, Atalay MA (April 1, 2020) Ekstramedüller Hematopoez Odakları İçeren Uterin Leiomyoma: Olgu Sunumu. Uludağ Üniversitesi Tıp Fakültesi Dergisi 46 1 97–99.
IEEE S. Akyol, F. Öz Atalay, and M. A. Atalay, “Ekstramedüller Hematopoez Odakları İçeren Uterin Leiomyoma: Olgu Sunumu”, Uludağ Tıp Derg, vol. 46, no. 1, pp. 97–99, 2020, doi: 10.32708/uutfd.638859.
ISNAD Akyol, Sevda et al. “Ekstramedüller Hematopoez Odakları İçeren Uterin Leiomyoma: Olgu Sunumu”. Uludağ Üniversitesi Tıp Fakültesi Dergisi 46/1 (April 2020), 97-99. https://doi.org/10.32708/uutfd.638859.
JAMA Akyol S, Öz Atalay F, Atalay MA. Ekstramedüller Hematopoez Odakları İçeren Uterin Leiomyoma: Olgu Sunumu. Uludağ Tıp Derg. 2020;46:97–99.
MLA Akyol, Sevda et al. “Ekstramedüller Hematopoez Odakları İçeren Uterin Leiomyoma: Olgu Sunumu”. Uludağ Üniversitesi Tıp Fakültesi Dergisi, vol. 46, no. 1, 2020, pp. 97-99, doi:10.32708/uutfd.638859.
Vancouver Akyol S, Öz Atalay F, Atalay MA. Ekstramedüller Hematopoez Odakları İçeren Uterin Leiomyoma: Olgu Sunumu. Uludağ Tıp Derg. 2020;46(1):97-9.

ISSN: 1300-414X, e-ISSN: 2645-9027

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