Hysterectomy from a 35-year -old female showed the following gross and histological features. What could be your possible diagnosis?
High-Yield Explanation
Ref. Robbins Pathology. 9th edition. Page. 1019
Leiomyoma is the most common pelvic tumor in women
Symptoms include:
AUB
Pelvic pain and pressure
Infertility or adverse pregnancy
Gross
Sharply circumscribed, round, firm, grayish white, "raw silk" and whorled cut surface
Often shells out
Bulging and trabeculated cut surface
Usually within myometrium (intramural), may be submucosal or subserosal
Microscopy
Whorled (fascicular) pattern of smooth muscle bundles separated by well vascularized connective tissue
Smooth muscle cells are elongated with eosinophilic or occasional fibrillar cytoplasm and distinct cell membranes
May develop areas of degeneration if large including hyaline or mucoid change, calcification, cystic change or fatty metamorphosis