Smooth Muscle Tumors Of Uterus Research Articles

Frequency and Histopathological variants of Leiomyoma in Uterine Specimens in a Tertiary Care Hospital.

Background: Leiomyoma is the commonest benign smooth muscle tumor of uterus. It also occur in other organs like gall bladder,skin, gasterointestinal tract etc. Leiomyosarcoma is a rare malignant counter part of leiomyoma.Objective: To see the frequency of histopathological variants of leiomyomas in uterine specimens in Southern District ofKhyber Pakhtunkhwa Pakistan.Material and Methods: This descriptive study was conducted in Department of Pathology, Bannu Medical College Bannu incollaboration with Government and Private Hospitals of the Southern District of KPK. The duration of study was seven years fromJanuary 2011 to December 2017. A total of 210 specimen of leiomyoma were included in this study. Inclusion criteria was allbiopsies of uterine leiomyomas of any age. Exclusion criteria wa autolysed and insufficient biopsy specimen. All biopsies werefixed over night in 10% buffered formalin, processed for histopathological slides preparation. Finally slides were prepared, labeledand reported by Histopathologist. . All the data was analysed in Statistical Package for Social Sciences (SPSS) version 20 forfrequency with percentages and mean with standard deviation.Results: In this study of 210 leiomyoma cases, the age range was from 25- 65 years. The commonest age group was 36-45 yearsfollowed by 25-35 years. The frequency of leiomyoma was 21.5% amongst the total uterine biopsy specimen. Histologically theusual leiomyoma was comprising of 176(83.80%) followed by hyalinised leiomyoma 11 (5.23%), myxoid leiomyoma 09(4.28%),lipoleiomyoma 05 (2.38%), cellular leiomyoma 04 (1.90%), shwannian leiomyoma 03 (1.42%) and one each of symplastic andangioleiomyoma 01(0.47%).Conclusin: Leiomyoma which is the commonest benign smooth muscle tumor of uterus have a number of histological variants. Inthis study usuall leiomyoma was the commonest variant followed by hyalinized leiomyoma, myxoid leiomyoma and lipoleiomyoma.It is important to separate various types of leiomyoma on histology to avoid confusion of misdiagnosis.Key WordsS: Histopathology. Fibroids. Leiomyoma variants. Hysterectomy. Myomectomy.

Progesterone receptor antagonist provides palliative effects for uterine leiomyoma through a Bcl-2/Beclin1-dependent mechanism.

Uterine leiomyoma is the most common benign smooth muscle tumor of uterus in women of reproductive age, with a high lifetime incidence. Nowadays, the exploration on the pharmacotherapies, such as progesterone receptor antagonist (PRA) requires more attention. Hence, the current study aimed to examine whether mifepristone, a PRA, influences the autophagy and apoptosis of uterine leiomyoma cells. Primary uterine leiomyoma cells were collected from 36 patients diagnosed with uterine leiomyoma to establish PR-M-positive (PR-M[+]) cells. The lentiviral vector overexpressing or silencing PR-M was subsequently delivered into one part of PR-M(+) cells in order to evaluate the role of PR-M in PR-M(+) cells. The results obtained revealed that cell viability was increased, while cell autophagy and apoptosis were diminished in the PR-M(+) cells treated with overexpressed PR-M, whereby the Bcl-2 level was elevated and the level of Beclin1 was reduced. An opposite trends were identified following treatment with knockdown of PR-M. Mifepristone at different concentrations (low, moderate, or high) was then applied to treat another part of the PR-M(+) cells. Mifepristone was identified to promote cell autophagy and apoptosis, decrease Bcl-2 level and increase Beclin1 level, accompanied by weakened interaction between Bcl-2 and Beclin1. Moreover, these effects of mifepristone on PR-M(+) cells were enhanced with increasing of the concentration. Taken together, the present study present evidence indicates the ability of PRA to regulate the Bcl-2/Beclin1 axis, ultimately promoting the autophagy and apoptosis of uterine leiomyoma cells, highlighting that PRA serves as a promising therapeutic target for the treatment of uterine leiomyoma.

Cotyledonoid leiomyoma of uterus: a case report

The diagnosis of uterine smooth muscle tumors is usually not difficult. Occasionally, benign tumors with an unusual growth pattern may cause some diagnostic confusion for pathologists who had not experienced such a tumor before. A fifty-one year old female patient had admitted to our gynecology outpatient clinics with abnormal uterine bleeding (menorrhagia) and undergone a surgery with a diagnosis of pelvic mass. A neoplasm consisting of spindle cell nodules with prominent hydropic degeneration was observed at pathological examination. Tumor cells were positive for vimentin, desmin and smooth muscle actin at immunohistochemical evaluation. Cotyledonoid leiomyomas are rare benign smooth muscle tumors of uterus which are recently defined in the literature. In this article we report a case of cotyledonoid leiomyoma of uterus with an exophytic growth pattern in the serosa and did not contain an intramural dissecting component.

Relationship of adrenomedullin expression and microvessel density and prognosis in smooth muscle tumor of uterus

The aim of this paper was to investigate the relationship between the expression of adrenomedullin (ADM) and microvessel density (MVD) and prognosis in smooth muscle tumor of uterus. The expression of ADM was detected using immunohistochemical staining in specimens from 15 normal controls, 28 cases of uterine leiomyoma (LE) and 19 cases of uterine leiomyosarcoma (LES). The MVD was assayed by immunostainting with CD34. There was a positive correlation between the ADM expression and MVD in LE and LES respectively (r s = 0.823, P < 0.01; r s = 0.793, P < 0.01). The expression of ADM in LE was statistically lower than that in LES (P < 0.05). There was a positive correlation between the ADM expression and mitotic figures in LES (P < 0.05): the more mitotic figures, the higher levels of the ADM expression and poor prognosis. The ADM is an important angiogenic factor in smooth muscle tumor of uterus. The ADM can be used as an accessory marker in estimating the malignant potency of LE and judging the prognosis of LES, and as a novel molecular target of anti-angiogenic and anticarcinogenic strategies.

Expression of chemokines CCL5 and CCL11 by smooth muscle tumor cells of the uterus and its possible role in the recruitment of mast cells

Objective. Smooth muscle tumors of uterus have been reported to contain considerable number of mast cells, especially cellular leiomyoma. However, to our knowledge the mechanism by which mast cells increased in them is not known. The purpose of this study was to reveal the different mast cell subsets in smooth muscle tumors of uterus and to investigate the mechanism of local increase of mast cells. Methods. Tissue sections from 85 uterine smooth muscle tumors were studied using immunohistochemical double labeling techniques, including 40 cases of ordinary leiomyomas, 30 cases of cellular leiomyomas and 15 cases of leiomyosarcomas. The sections were double immunostained for mast cell tryptase and chymase, mast cell tryptase and ki-67, mast cell tryptase and chemokines (i.e., CCL2, CCL5, CCL11, TGFβ), as well as tryptase and CCR3. Results. MC TC-type of mast cells was the predominant type in ordinary leiomyoma and cellular leiomyoma, whereas MC T-type was seldom found in them. There was no MC C in smooth muscle tumors. The total intratumoral number of mast cells in cellular leiomyoma group was significantly higher than that in both leiomyosarcoma and ordinary leiomyoma ( P < 0.01). Mast cells proliferation was rarely detected in smooth muscle tumors, as revealed by constant negative labeling of the proliferation marker Ki-67 in mast cells. Almost all mast cells (tryptase positive) in smooth muscle tumors were also CCL2, CCL5, CCL11 and TGFβ positive. Expressions of CCL5 and CCL11 in tumor cells in cellular leiomyoma were all significantly higher than that in both ordinary leiomyoma and leiomyosarcoma ( P < 0.01). While the expression of TGFβ in tumor cells in cellular leiomyoma was not significantly different from that in ordinary leiomyoma, expression of CCL2 was not observed in smooth muscle tumor cells. There were positive correlations between CCL5 and the number of mast cells ( r s = 0.801, P < 0.01) and between CCL11 and the number of mast cells ( r s = 0.744, P < 0.01) in smooth muscle tumors as well. The vast majority of the mast cells in cellular leiomyoma were CCR3 positive. Conclusions. Using the monoclonal anti-mast cell tryptase antibody could detect all mast cells in smooth muscle tumor. The increased intratumoral mast cell counts in cellular leiomyoma might be the result of mast cells recruitment from the peripheral blood rather than local mast cells proliferation. CCL5 and CCL11, which are expressed by smooth muscle tumor cells, are possibly responsible for the recruitment of mast cells in uterine cellular leiomyoma. Whether they combine to CCR3 expressed by mast cells need further study.