Uterine angioleiomyoma: clinicopathological evaluation of 5 cases

Öz

Aim: Uterine angioleiomyoma (ALM) is a very rare benign perivascular neoplasm. In this study, clinicopathologic and immunohistochemical features and treatment modalities of the cases were evaluated with a comprehensive literature review. Materials and Methods: 5 cases of uterine ALM admitted to the pathology department of our hospital were found in the pathology database. Hematoxylin-Eosin (HE) stained preparations of the cases were removed from the archive and reviewed. Immunohistochemical markers, namely muscle-specific actin, h-caldesmon, desmin, CD10, melan-A, HMB-45 and WT-1, were done. Results: The mean age of the patients was 40 years. Abnormal uterine bleeding and abdominal pain were the cause of admission in all patients. In one case (multiple ALM ), infertility was also present. A single tumour mass was observed in 4 cases, while multiple tumours focus (2 separate tumour focuses) were present in one case. The smallest tumour size was 5.2 cm, and the largest was 10 cm. The tumour was submucosal in one case and intramural in four cases. Macroscopically, all cases were sharp-edged, solid, white-grey, with a vortex nodular appearance. Two cases had solid and venous variants, one had venous and cavernous variants, one had venous variants, and one had all three variants. All cases were stained with desmin, h-caldesmon, smooth muscle actin; Staining with CD10, melan-A, HMB-45 and WT-1 was not observed. Conclusion: Uterine ALM is a rare, benign tumour and preoperative diagnosis is very difficult since there are no specific imaging findings. Therefore, it is crucial for the clinician and pathologist to remember this rare tumour and to distinguish it from similar ones.

Anahtar Kelimeler

• Angioleiomyoma,myomectomy,immunohistochemistry,myopericytoma

Uterin Anjioleiomyom: 5 Olgunun Klinikopatolojik Değerlendirilmesi

Öz

Amaç: Anjioleiomyom (ALM) sıklıkla alt ekstremite, baş ve gövde bölgesini içeren, iyi huylu bir perivasküler neoplazmadır. Uterin ALM oldukça nadir bir tümördür. Bu çalışmada olguların klinikopatolojik ve immünohistokimyasal özellikleri ve tedavi yöntemleri kapsamlı bir literatür taraması ile değerlendirildi. Gereç ve Yöntemler: Hastanemiz patoloji servisine başvuran 5 uterin ALM vakası, patoloji veri tabanından bulundu. Vakaların Hemotoksilen-Eozin (HE) boyalı preparatları arşivden çıkarılarak yeniden gözden geçirildi. Vakalarda immünohistokimyasal olarak düz kas aktin (SMA), h-caldesmon, desmin, CD10, melan-A, HMB-45, ve WT-1 boyaları çalışıldı (Ventana benchmark XT). Bulgular: Hastaların ortalama yaşı 40 idi. Hastaların hepsinde hastaneye başvuru sebebi anormal uterin kanama ve abdominal ağrı idi. 1 vakada (multipl ALM vakası) infertilite şikayeti de mevcuttu. 4 vakada tek bir tümör kitlesi izlenmekteyken, 1 vakada multipl tümör odağı (2 ayrı tümör odağı) mevcuttu. Tümör boyutu en küçük 5.2 cm, en büyük 10 cm olarak saptandı. 1 vakada tümör submukozal yerleşimli olup, diğer 4 vakada intramural yerleşimliydi. Makroskobik olarak tüm vakalar keskin sınırlı, solid, beyaz gri renkte, girdapsı nodüler görünümdeydi.2 vakada solid ve venöz varyant, 1 vakada venöz ve kavernöz varyant, 1 vakada venöz varyant, 1 vakada da her üç varyant izlendi.Vakaların hepsi desmin, h-kaldesmon, düz kas aktin ile boyanırken; CD10, melan-A, HMB-45 ve WT-1 ile boyanma izlenmedi. Sonuç: Uterin ALM oldukça nadir, benign bir tümör olup, spesifik görüntüleme bulguları olmadığından preoperatif tanı son derece zordur. Tanı ancak patolojik çalışma ile mümkündür. Bu nedenle, klinisyen ve patoloğun bu nadir görülen tümörü hatırlaması ve histopatolojik inceleme ve gerektiğinde uygun immünohistokimyasal panel ile benzerlerinden ayırması önemlidir.

Anahtar Kelimeler

• Anjiyoleiomyom,myomektomi,immunohistokimya,myoperisitoma

Kaynakça

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