Leiomyosarcoma differential diagnosis: Difference between revisions
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* Coagulative necrosis (red degeneration) | * Coagulative necrosis (red degeneration) | ||
* Mitotic figure not exceeding 2/10 HPF, mostly located in the perihemorrhagic areas | * Mitotic figure not exceeding 2/10 HPF, mostly located in the perihemorrhagic areas | ||
* On gross examination, there are small and frequently multiple hemorrhagic areas that may be accompanied by cystic change | |||
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Revision as of 20:23, 28 February 2019
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Leiomyosarcoma Microchapters |
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Leiomyosarcoma differential diagnosis On the Web |
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American Roentgen Ray Society Images of Leiomyosarcoma differential diagnosis |
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Risk calculators and risk factors for Leiomyosarcoma differential diagnosis |
Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Nima Nasiri, M.D.[2]
Overview
Leiomyosarcoma must be differentiated from other soft tissue tumors, some variants of leimyoma resembles malignant tumor. Other possible differential diagnosis of leimyosarcoma include, epithelioid endometrial stromal sarcoma, alveolar soft part sarcoma, epithelioid angiosarcoma, pleomorphic rhabdomyosarcoma.
Differentiating Leiomyosarcoma from other Diseases
The table below summarizes the findings that differentiate Leiomyosarcoma from other conditions that may cause similar signs and symptoms.[1][2][3]
| Diseases | Clinical manifestations | Para-clinical findings | Gold standard | Additional findings | |||||||||||
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Symptoms | Physical examination | ||||||||||||||
| Lab Findings | Imaging | Histology | |||||||||||||
| Physical exam 1 | Lab 1 | Lab 2 | Lab 3 | Imaging 1 | Imaging 2 | Imaging 3 | |||||||||
| Uterine Leiomyosarcoma | Grossly, most LMSs are large, solitary, poorly circumscribed masses (average 10 cm) or the largest mass in a fibroid uterus that typically display a fleshy variegated cut surface with areas of hemorrhage or necrosis | ||||||||||||||
| Leimyoma (mitotically active type) |
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CBC Suggestive of Anemia |
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Biopsy and histology | - | ||||||||||
| Hemorrhagic cellular leiomyomas (apoplectic leiomyoma)[4] | - | - |
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| Endometrial Cancer | Abnormal Vaginal bleeding or post coital bleeding | Pelvic pain | Dysparunia | Vaginal Bleeding | Enlarged uterus | Lymphadenopathy | CBC and Clotting studies to r/o anemia and coagulopathy | Urine or serum Beta HCG to r/o pregnancy | LFT/ CA-125 can also be done | Thickened endometrial line on ultrasound. | Thickened endometrial line on CT | Thickened endometrial line on MRI | In well-differentiated forms, endometrioid adenocarcinoma produces small, round back-to-back glands without intervening stroma with varying degrees of glandular complexity are demonstrated by luminal infolding, budding, papillae (with or without psammoma bodies), and cribriforming. In grade 1 lesions, nuclei of the lining epithelial cells are uniform and oval to cylindrical, with minimal atypia and small discrete nucleoli. The cellular axes are perpendicular to the basement membrane, and stratification may or may not be present. Typically, high-grade tumors (with significant solid components) display an increased amount of nuclear atypia, as demonstrated by pleomorphism, irregular chromatin clumping, and prominent nucleoli | Biopsy under hysteroscopic guidance | - |
| Symptom 1 | Symptom 2 | Symptom 3 | Physical exam 1 | Physical exam 2 | Physical exam 3 | Lab 1 | Lab 2 | Lab 3 | Imaging 1 | Imaging 2 | Imaging 3 | Histopathology | Gold standard | Additional findings | |
| Differential Diagnosis 5 | |||||||||||||||
| Differential Diagnosis 6 | |||||||||||||||
References
- ↑ Cotton PB, Shorvon PJ (1984) Analysis of endoscopy and radiography in the diagnosis, follow-up and treatment of peptic ulcer disease. Clin Gastroenterol 13 (2):383-403. PMID: 6378443
- ↑ Wanebo HJ, Kennedy BJ, Chmiel J, Steele G, Winchester D, Osteen R (1993) Cancer of the stomach. A patient care study by the American College of Surgeons. Ann Surg 218 (5):583-92. PMID: 8239772
- ↑ Kimura T, Kamiura S, Yamamoto T, Seino-Noda H, Ohira H, Saji F (2004) Abnormal uterine bleeding and prognosis of endometrial cancer. Int J Gynaecol Obstet 85 (2):145-50. DOI:10.1016/j.ijgo.2003.12.001 PMID: 15099776
- ↑ Myles JL, Hart WR (November 1985). "Apoplectic leiomyomas of the uterus. A clinicopathologic study of five distinctive hemorrhagic leiomyomas associated with oral contraceptive usage". Am. J. Surg. Pathol. 9 (11): 798–805. PMID 4073354.