GPR: 2019 - Week 20

From MGH Learn Pathology

Clinical history

45 yo F presents with abnormal uterine bleeding:

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Leiomyoma with perinodular hydropic change
  • The gross appearance of leiomyomas can have a wide spectrum.
  • Here you can see a well-circumscribed mass with multiple white nodules surrounded by edematous connective tissue.

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Usual hydropic leiomyoma

  • Hydropic change is one of the commonest alterations in leiomyomas and can results in a very soft spongy appearance as one gets an impression on the right compared to the more usual leiomyoma on the left

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Apoplectic leiomyoma

  • Apoplectic leiomyoma typically shows focal hemorrhage on gross inspection and has a variety of distinctive features on microscopic examination recently elaborated upon in a paper from this department.

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Highly cellular leiomyoma

  • Often are yellow and may exhibit cystic degeneration which is striking in this example.
  • Dr. Young
  • Michelle Lee
  • MGH pathology
  • Clement PB, Young RH, Scully RE. Diffuse, perinodular, and other patterns of hydropic degeneration within and adjacent to uterine leiomyomas. Problems in differential diagnosis. Am J Surg Pathol. 1992 Jan;16(1):26-32. PubMed PMID: 1309411.
  • Atlas of Gynecologic Surgical Pathology: Expert Consult

This week's Gross Pathology Roundup was presented by [[| , ]] on Mon, May 13, 2019.