leiomyosarcoma

Digital cases

 JRC:110 : Leiomyosarcoma of the skin.
 JRC:11650 : Leiomyosarcoma of soft tissue.
 JRC:6405 : Pulmonary leiomyosarcoma.

Images

 leiomyosarcoma

• https://twitter.com/histiocytosisX/status/744961403526709249
• https://twitter.com/SamKhader/status/1324431040488841216

 pleomorphic leiomyosarcoma - stromal eosinophilic hyalinization

• https://twitter.com/Konzult_/status/781310175584092160

 Mitosis collections of leiomyosarcoma / atypical mitosis / atypical mitoses

• https://twitter.com/Patholwalker/status/1325546596906364929

Subtypes

 pleomorphic leiomyosarcoma

Immunochemistry

 smooth muscle actin+ (SMA+)
 BCL2+
 cyclin D1+/-
 CD44 (50 to 80%)
 GLUT+ (25-50%)

• Glut1 positivity closely correlated with aggressive biologic behavior reflected by distant metastatic spread.

Localization

 cutaneous leiomyosarcoma
 subcutaneous leiomyosarcoma
 deep leiomyosarcoma (soft tissues leiomyosarcoma)

 retroperitoneal leiomyosarcoma
 vascular leiomyosarcoma

 digestive leiomyosarcoma

 genital leiomyosarcoma

• uterine leiomyosarcoma
• leiomyosarcoma of external genitalia (vulva, penis) (14707873)

Cytogenetics

 Most karyotypes are complex and no consistent aberrations.

CGH (12920222)

losses	10q	13q14-q21	17p	19p
gains	1q	5p14-pter	17p

LOH

 3p LOH (12839673)
 9p LOH (9p21 LOH) (15731925)
 Chr.10 LOH (10079273)

Differential diagnosis

 fusiform cell tumors

• smooth muscle cell tumors
• myofibroblastic tumors

 EBV-associated smooth muscle tumors

• EBV-associated leiomyoma
• EBV-associated leiomyosarcoma

See also

 smooth muscle cell tumors

• EBV-associated smooth muscle tumors
  • EBV-associated leiomyoma
  • EBV-associated leiomyosarcoma

 muscle cell tumors
 soft tissue tumors

References

 Discovery of molecular subtypes in leiomyosarcoma through integrative molecular profiling. Beck AH, Lee CH, Witten DM, Gleason BC, Edris B, Espinosa I, Zhu S, Li R, Montgomery KD, Marinelli RJ, Tibshirani R, Hastie T, Jablons DM, Rubin BP, Fletcher CD, West RB, van de Rijn M. Oncogene. 2009 Nov 9. [Epub ahead of print] PMID: 19901961

 Comparative immunohistochemical and molecular analysis of uterine and extrauterine leiomyosarcomas. Rao UN, Finkelstein SD, Jones MW. Mod Pathol. 1999 Nov;12(11):1001-9. PMID: 10574596