Cases reported "Leiomyoma"

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1/50. leiomyoma of the thyroid gland.

    Primary smooth muscle tumors of the thyroid gland are very rare neoplasms, leiomyosarcomas comprising the majority of these. Only three cases of primary leiomyoma have been reported to date, all of which have occurred in females of varying ages. We present the morphological, immunohistochemical and ultrastructural features of a fourth case of leiomyoma of the thyroid gland, occurring in a post-menopausal woman with a history of uterine leiomyomas.
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2/50. Exfoliative cytology of atypical polypoid adenomyoma. A case report.

    BACKGROUND: An atypical polypoid adenomyoma (APA) is a well-defined entity. It occurs in the endometrium, lower uterine segment and endocervix. It is usually composed of atypical complex glands with squamous metaplasia admixed with myofibromatous stroma. CASE: A 35-year-old female presented with one-year history of irregular menstrual periods. A diagnosis of adenocarcinoma in situ was rendered on her cervicovaginal smear. Pelvic examination revealed an enlarged uterus due to a leiomyoma. Colposcopic examination revealed a 0.6-cm, sessile, polypoid mass at the junction of the endocervix and ectocervix. A cone biopsy of the lesion showed irregular, endometrial-type glands embedded in a prominent myofibromatous stroma. The atypical glandular component of the mass demonstrated varying degrees of architectural complexity, ranging from simple to complex hyperplasia. In tissue sections the lesion was diagnosed as APA of the cervix. The patient underwent a hysterectomy for the leiomyoma. The hysterectomy specimen showed an 8.5-cm leiomyoma. The cervix and uterine corpus revealed no residual APA. CONCLUSION: APA of the cervix should be considered among the differential diagnoses of atypical glandular cells of undetermined significance. The diagnosis of APA cannot be made on cytology; the final diagnosis requires histologic confirmation.
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3/50. multiple endocrine neoplasia type 1: atypical presentation, clinical course, and genetic analysis of multiple tumors.

    multiple endocrine neoplasia type 1 (MEN1) is characterized by the development of endocrine tumors of the parathyroid and pituitary glands, pancreas, and duodenum. Less frequently occurring tumors associated with MEN1 include non-endocrine tumors such as lipomas and angiofibromas. An increased incidence of thyroid neoplasms, leiomyomas, adrenal cortical hyperplasia, hepatic focal nodular hyperplasia, and renal angiomyolipoma has been noted in the MEN1 population. The pathogenesis of non-neuroendocrine tumors in MEN1 is unknown. We report a complex clinical course and a detailed morphologic and genetic analysis of a series of tumors that developed in a patient with MEN1. All tumors were microdissected and analyzed for loss of heterozygosity of the MEN1 gene. A germline mutation of the MEN1 gene was detected, and deletions of the MEN1 gene were consistently detected in multiple neuroendocrine tumors involving the parathyroid glands and the pancreas and a hepatic neuroendocrine tumor metastasis, as predicted by Knudson's "two hit" hypothesis. Two hits of the MEN1 gene were also detected in esophageal leiomyoma tissue, suggesting that tumorigenesis was directly related to the patient's underlying MEN1. In contrast, follicular thyroid adenoma, papillary thyroid carcinoma, hepatic focal nodular hyperplasia, and adrenal cortical hyperplasia consistently showed retained heterozygosity of the MEN1 gene with flanking markers and an intragenic marker. Therefore, these tumors appear to develop along pathogenetic pathways that are different from classical MEN1-associated tumors.
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4/50. Benign periurethral masses in women.

    Benign periurethral masses were encountered in 4 women. The masses included 2 vaginal leiomyomas, 1 of which was found simultaneously with a urethral diverticulum, a fibrocystic urethral mass and hyperplastic glandular tissue obstructing the bladder outlet and resembling male prostate. The physical and endoscopic features were helpful in establishing the benign nature and extent of the lesions. Although the bladder base was deformed on an excretory urographic cystogram in each case the radiographic features were non-specific except as they applied to a urethral diverticulum. Transvaginal needle biopsy is recommended in contemplation of open surgical excision. Leiomyomas are best approached transvaginally and anterior urethral masses can be reached suprapubically.
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5/50. Fine-needle aspiration cytology of primary granulosa cell tumor of the adrenal gland: a case report.

    Extraovarian granulosa cell tumors are extremely rare. We report on a primary granulosa cell tumor of the adrenal gland. A 69-yr-old African-American female presented with a 1-yr history of irregular uterine bleeding and a palpable right abdominal mass. CT scan showed a 9.0-cm suprarenal mass as well as an enlarged uterus. CT-guided fine-needle aspiration (FNA) cytology of the adrenal mass was interpreted as a malignant neoplasm. She underwent exploratory laparotomy, right nephrectomy, and hysterectomy with bilateral salpingo-oophorectomy. The gross, histologic, and immunohistochemical findings of the adrenal mass were characteristic of a granulosa cell tumor. The uterus contained multiple leiomyomas. The endometrium showed simple hyperplasia. Both fallopian tubes and ovaries showed no pathologic abnormality. There was no evidence of tumor elsewhere. Although rare, extraovarian granulosa cell tumor should be considered in the differential diagnosis of adrenal tumors in women showing the FNA features described herein, especially when there is evidence of excessive estrogen production. Diagn. Cytopathol. 2000;22:107-109.
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6/50. Uterine adenolipoleiomyoma: a rare hamartomatous lesion.

    An apparently unique intramural uterine lesion is described for which we propose the name adenolipoleiomyoma. On gross examination, a well-circumscribed white intramural mass contained focal fatty areas. histology showed the mass to be composed of smooth muscle, adipose tissue, and endometrial, endocervical, and tubal type glands. The endometrial glands were surrounded by typical endometrial stroma. There was no evidence of adenomyosis in the uterus outside the lesion. This is only the second report of such a lesion within the uterus and the first with an intramural location. We believe it to be a benign hamartomatous lesion.
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7/50. Adenomyofibroma of the endometrium with skeletal muscle differentiation.

    A case of adenomyofibroma with skeletal muscle differentiation is described. A 55-year-old asymptomatic woman had atypical glandular cells of undetermined significance on a routine Papanicolaou smear. The endometrial biopsy revealed fragments composed of benign endometrial glands and myofibromatous stroma with foci of skeletal muscle differentiation. The stroma exhibited focal mild cytologic atypia and hypercellularity without periglandular cuffing or mitoses. Electron microscopy and immunohistochemical staining for myoglobin confirmed the skeletal muscle differentiation. A diagnosis of low-grade adenosarcoma with heterologous differentiation was made in the biopsy specimen based on the atypical stroma, the skeletal muscle differentiation, and previous observations that adenosarcomas may contain bland areas indistinguishable from an adenofibroma. The patient underwent hysterectomy, bilateral salpingo-oophorectomy, and pelvic lymphadenectomy. The hysterectomy specimen revealed small foci of residual tumor. In light of these findings the diagnosis was revised to adenomyofibroma with skeletal muscle differentiation. Uterine adenomyofibroma with skeletal muscle differentiation should be distinguished from a low-grade adenosarcoma in an endometrial biopsy.
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8/50. Mullerianosis of inguinal lymph nodes: report of a case.

    We report a case of florid mullerianosis involving inguinal lymph nodes, a simulator of metastatic adenocarcinoma. The patient was a 48-year-old woman with symptomatic leiomyomas and enlarged right inguinal lymph nodes. Microscopically two lymph nodes were partially or completely replaced by cystically dilated and small glands, many of which contained mucin. The larger of the two lymph nodes was completely replaced by cystically dilated structures and long branching tubular glands that focally displayed well-defined lobular and papillary patterns. The glands were lined predominantly by a single layer of columnar cells similar to those of the endocervical epithelium. The columnar cells had bland basal nuclei and abundant mucin-containing cytoplasm. Admixed with these cells were others similar to those of tubal epithelium. Some of the glands were partially surrounded by a cellular ovarian-like stroma. There was focal cytologic atypia but no mitotic figures were seen. There was also focal oxyphil cell metaplasia with atypical hobnail cells. Some cystically dilated glands that contained abundant mucin were lined by flat epithelial cells. Because of gland rupture, mucin extravasated into the stroma but did not elicit a desmoplastic response. Surgical pathologists should be aware of mullerianosis in lymph nodes to avoid confusing it with metastatic adenocarcinoma.
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9/50. leiomyoma of the corona glans penis.

    A 42-year-old man presented with an 8-mm elliptical indolent solid mass on the superior surface of the corona glandis at our institution 3 months after its appearance. The lesion was excised by using a wedge resection performed by a cool blade knife. The subsequent pathologic evaluation defined the lesion as a leiomyoma. Immunohistochemical analysis using the streptavidin-biotin peroxidase technique and immunoreactivity for cytokeratin, S100 protein, and the proliferative marker MIB1 was performed, confirming the pathologic diagnosis. Early local excision of these tumors is indicated because of the trend toward their dimensions increasing quickly, with subsequent difficulties for cosmetic glandis reconstruction.
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10/50. leiomyoma of the prostate: CT and MR findings.

    Pure prostatic leiomyoma is very rare. We report a case of magnetic resonance imaging findings of prostatic leiomyoma. The mass was expansile and had a slightly higher signal intensity than skeletal muscle on T2-weighted images. Normal prostatic glandular tissue could be clearly distinguished from the tumor.
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