B. Leiomyoma

B. Leiomyoma:

Also known as fibroids are benign tumors of smooth muscle origin. They could be single or multiple and may arise from smooth muscle in any organ, but the most common sites include the uterus, small bowel, and the esophagus. 

Uterine fibroids are commonly seen in women during reproductive years and are more common in nulliparous, postmenopausal women. Estrogen is likely to play a role as it enlarges during pregnancy and regresses after menopause or castration. They are generally asymptomatic, but may produce abnormal uterine bleeding or lower abdomen pressure related symptoms and interfere with pregnancy. 

Surgery is the mainstay of treatment and includes myomectomy or hysterectomy.

History: 

45 year-old female patient presented with H/O menorrhagia. 

Key Questions & Answers 

1) Describe the gross features of the specimen.

1. Specimen of bulky uterus with cervix 

2. C/S shows multiple well circumscribed grey white masses with whorled appearance

2) Mention the microscopic features of the given slide.

1. Well circumscribed lesion composed of interlacing bundles of smooth muscle cells.

2. Individual cells have plump oval to spindle shaped nuclei with blunt ends (Cigar shaped) and moderate amount of eosinophilic cytoplasm.

3) Diagnose the pathological condition correlating the history, gross and microscopic features.

Leiomyoma of Uterus

4) Mention the different sites of occurrence of the above lesion.

1. Myometrium of Uterus

2. Blood vessels

3. Gastrointestinal tract

4. Erector pili muscle of skin

5) What are the degenerative changes that can be seen in this lesion?

1. Hyaline degeneration

2. Red degeneration

3. Cystic degeneration

4. Calcification