PMC9764289_01
Gray scale ultrasound aspect of the 10 cm fibroid.
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Upon admission, the ultrasound examination revealed a 10-cm anterior intramural and subserosal uterine leiomyoma without unusual features, but there were other ultrasound findings suggestive of adenomyosis in the posterior uterine wall (Figs. 1 and 2).
Doppler ultrasound evaluation of the 10 cm fibroid.
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Upon admission, the ultrasound examination revealed a 10-cm anterior intramural and subserosal uterine leiomyoma without unusual features, but there were other ultrasound findings suggestive of adenomyosis in the posterior uterine wall (Figs. 1 and 2).
Multiple 2-4 cm leiomioma nodules firm, tan-white, variable in size with foci of hemorrhage (macroscopic aspect).
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Macroscopic aspect of the leiomyoma well circumscribed nodules (2-4 cm) with whorled pattern.
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Interlacing bundles of smooth muscle cells arranged in an anastomosing fascicular pattern (hematoxylin-eosin staining; magnification, x10).
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The tumor with intravascular growth featured uniform spindle-shaped smooth muscle cells (Fig. 5, Fig. 6 and Fig. 7).
Anastomosing fascicular pattern of spindle-shaped smooth muscle cells with oval nuclei and eosinophilic cytoplasm (hematoxylin-eosin staining; magnification, x20).
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The tumor with intravascular growth featured uniform spindle-shaped smooth muscle cells (Fig. 5, Fig. 6 and Fig. 7).
CD34 positive in endothelial vascular walls confirming intravascular origin (anti CD34; magnification, x10).
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The CD34 analysis established its intravascular origin (Fig. 8).
Estrogen receptors highly positive in intravascular leiomyomatous tumor (anti ER; magnification, x10).
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The immunohistochemical evaluation revealed that the area of the tumor that had intravascular development was positive for estrogen receptors (Fig. 9) and for the smooth muscle actin marker (Fig. 10).