PMC9240338_01
(a) Gross aspect of ULMS: enlarged and deformed uterus by a nodular lesion with a
maximum diameter of 28 cm. (b) Microscopical features of the cytological exam: round or
fusiform malignant cells, isolated or grouped in clusters; in case: a giant
multinucleated cell (Giemsa stain; Ob x100; in case Ob x200). (c) Microscopical features
of ULMS: hypercellular and fusiform proliferation of highly mitotic, pleomorphic
malignant cells (HE stain, Ob x100).
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The cytological evaluation identified isolated or clustered malignant cells, round or spindle-shaped, highly suggestive for sarcoma (Figure 1b). On cut surface, this was fleshy, fasciculated, with cystic spaces, necrosis and hemorrhage (Figure 1a). Microscopically, the tumor was composed of a dense malignant cell population with fusiform appearance, moderate to severe cytological pleomorphism and an important mitotic activity (12 mitoses/10 high power fields) (Figure 1c).
(a) Ki-67: intense, diffuse nuclear expression in more than 50% of the tumor nuclei
(Immunohistochemical stain, Ob x100). (b) p16: intense, diffuse nuclear expression in
more than 75% of the tumor nuclei (Immunohistochemical stain, Ob x100). (c) p53:
intense, diffuse nuclear expression in more than 80% of the tumor nuclei
(Immunohistochemical stain, Ob x100).
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Negative immunoexpression for Estrogen (ER) and Progesteron receptor (PR) was noticed, as well as weak focal reaction for Smooth Muscle Actin (SMA) and Desmin (Figure 2).