PMC9647032_01
Imaging and ultrasound findings of the patient. (A-C) Pelvic enhancement MR: an oval equal T1 mixed T2 signal shadow was observed on the anterior wall of the upper segment of the vagina, approximately 1.7 cm x 1.4 cm x 1.9 cm, with obvious ring reinforcement; (D-F) Pelvic ultrasound: a 2.1 cm x 1.5 cm x 1.4 cm mass was observed on the anterior wall of the vagina, with a fuzzy boundary and a hypoechoic inside with multiple strong echoes. CDFI could detect blood flow signals.
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An oval equal T1 mixed T2 signal shadow was observed on the anterior wall of the upper segment of the vagina, approximately 1.7 cm x 1.4 cm x 1.9 cm, with obvious ring reinforcement ( Figures 1A-C ). CDFI could detect blood flow signals ( Figures 1D-F ).
Colposcopy findings of the patient. (A-C) A mass was observed on the right anterior wall of the upper part of the vagina, approximately 3.0 cm x 3.0 cm x 1.0 cm in size, pink, tough in texture, smooth on the surface, small vesicles visible inside the mass, a wide pedicle connected to the vaginal wall, and the shape similar to a mushroom; (D, E) There was no significant change in the tumor epithelium after staining with 5% acetic acid; (F) The tumor epithelium appeared brownish-black after staining with 5% Lugol's solution.
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Under the colposcope, a mass was observed on the right anterior wall of the upper part of the vagina, approximately 3.0 cm x 3.0 cm x 1.0 cm in size, pink, tough in texture, smooth on the surface, small vesicles visible inside the mass, a wide pedicle connected to the vaginal wall, and the shape similar to a mushroom ( Figures 2A-C ). There was no significant change in the tumor epithelium after staining with 5% acetic acid ( Figures 2D, E ), and the tumor epithelium appeared brownish-black after staining with 5% Lugol's solution (an iodine-containing solution) ( Figure 2F ).
Histopathological and immunohistochemical staining findings. (A) The gross pathological examination showed that the size of the tumor was approximately 3.2 cm x 2.8 cm x 0.8 cm, the texture was tough and slightly soft, and the color was pink white; (B) The tumor tissue was located under the squamous epithelium (H&E staining, x40); (C, D) The tumor tissue was composed of spindle and stellate-shaped cells and contained abundant thin-walled blood vessels, with some mast cells scattered in the tissue (H&E staining, C, x100; D, x 200); (E) caldesmon (+), (F) desmin (+), (G) CD34 (+), (H) ER (+), (I) PR (+), (J) alphaSMA (focally +), (K) Ki-67 (approximately 3% +), (L) CK (-), (M) EMA (-), (N) S-100 (-); (O) The scattered mast cells were positive for CD117 (E-O, x100).
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The gross pathological examination showed that the size of the tumor was approximately 3.2 cm x 2.8 cm x 0.8 cm, the texture was tough and slightly soft, and the color was pink white ( Figure 3A ). Microscopic examination revealed that the tumor tissue was located under the squamous epithelium ( Figure 3B ) and was composed of spindle and stellate-shaped cells and contained abundant thin-walled blood vessels, with some mast cells scattered in the tissue ( Figures 3C, D ). Immunohistochemical analysis showed that the tumor was positive for caldesmon, desmin, CD34, estrogen receptor (ER), and progesterone receptor (PR) ( Figures 3E-I ); was focally positive for alpha-smooth muscle actin (SMA) ( Figure 3J ); and was approximately 3% positive for Ki-67 ( Figure 3K ) and negative for cytokeratin (CK), epithelial membrane antigen (EMA), and S-100 ( Figures 3L-N ). The scattered mast cells were positive for CD117 ( Figure 3O ).