Leiomyosarcoma differential diagnosis: Difference between revisions
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* Association with lymphangiomyomatosis and tuberous sclerosis | * Association with lymphangiomyomatosis and tuberous sclerosis | ||
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| style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Epitheloid [[angiosarcoma]]'''<ref>{{cite journal|doi=10.1043/1543-2165-135.2.268.}}</ref><ref name="HwangLim2013">{{cite journal|last1=Hwang|first1=Jae Pil|last2=Lim|first2=Sang Moo|title=Uterine Epithelioid Angiosarcoma on F-18 FDG PET/CT|journal=Nuclear Medicine and Molecular Imaging|volume=47|issue=2|year=2013|pages=134–137|issn=1869-3474|doi=10.1007/s13139-013-0191-y}}</ref> | | style="background: #DCDCDC; padding: 5px; text-align: center;" |'''Epitheloid [[angiosarcoma]]'''<ref>{{cite journal|doi=10.1043/1543-2165-135.2.268.}}</ref><ref name="HwangLim2013">{{cite journal|last1=Hwang|first1=Jae Pil|last2=Lim|first2=Sang Moo|title=Uterine Epithelioid Angiosarcoma on F-18 FDG PET/CT|journal=Nuclear Medicine and Molecular Imaging|volume=47|issue=2|year=2013|pages=134–137|issn=1869-3474|doi=10.1007/s13139-013-0191-y}}</ref><ref name="ChenFirth2018">{{cite journal|last1=Chen|first1=Innie|last2=Firth|first2=Bianca|last3=Hopkins|first3=Laura|last4=Bougie|first4=Olga|last5=Xie|first5=Ri-hua|last6=Singh|first6=Sukhbir|title=Clinical Characteristics Differentiating Uterine Sarcoma and Fibroids|journal=JSLS : Journal of the Society of Laparoendoscopic Surgeons|volume=22|issue=1|year=2018|pages=e2017.00066|issn=1086-8089|doi=10.4293/JSLS.2017.00066}}</ref> | ||
| style="background: #F5F5F5; padding: 5px;" | | | style="background: #F5F5F5; padding: 5px;" | | ||
* Painful, enlarging soft tissue masses | * Painful, enlarging soft tissue masses |
Revision as of 19:41, 13 March 2019
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]Associate Editor(s)-in-Chief: Nima Nasiri, M.D.[2]
Overview
Leiomyosarcoma must be differentiated from other soft tissue tumors, some variants of leimyoma resembles malignant tumor. Other possible differential diagnosis of leimyosarcoma include, epithelioid endometrial stromal sarcoma, epithelioid angiosarcoma.
Differentiating Leiomyosarcoma from other Diseases
The table below summarizes the findings that differentiate Leiomyosarcoma from other conditions that may cause similar signs and symptoms.[1][2][3]
Diseases | Clinical manifestations | Para-clinical findings | Gold standard | Additional findings | |||||
---|---|---|---|---|---|---|---|---|---|
Symptoms | Physical examination | ||||||||
Lab Findings | Imaging | Histology | |||||||
Ultrasound | CT scan | MRI | |||||||
Uterine Leiomyosarcoma[4][5][6] |
|
|
|
|
|
|
|
Histology and biopsy |
|
Leiomyoma (mitotically active type)[7][8][9][10][11][12] |
|
|
|
|
T2-weighted MRI:
enhancement
|
|
Biopsy and histology | ||
Hemorrhagic cellular leiomyomas (apoplectic leiomyoma)[13][14] |
|
|
|
|
|
T2-weighted MRI:
|
On microscopic analysis:
|
Biopsy specimen and histology | |
PEComa[15][16][17] |
|
|
|
|
|
|
Microscopic analysis:
|
|
|
Epitheloid angiosarcoma[18][19][20] |
|
|
|
|
|
T2-weighted MRI:
|
Microscopic histology:
|
|
|
References
- ↑ Cotton PB, Shorvon PJ (1984) Analysis of endoscopy and radiography in the diagnosis, follow-up and treatment of peptic ulcer disease. Clin Gastroenterol 13 (2):383-403. PMID: 6378443
- ↑ Wanebo HJ, Kennedy BJ, Chmiel J, Steele G, Winchester D, Osteen R (1993) Cancer of the stomach. A patient care study by the American College of Surgeons. Ann Surg 218 (5):583-92. PMID: 8239772
- ↑ Kimura T, Kamiura S, Yamamoto T, Seino-Noda H, Ohira H, Saji F (2004) Abnormal uterine bleeding and prognosis of endometrial cancer. Int J Gynaecol Obstet 85 (2):145-50. DOI:10.1016/j.ijgo.2003.12.001 PMID: 15099776
- ↑ Santos, Pedro; Cunha, Teresa Margarida (2015). "Uterine sarcomas: clinical presentation and MRI features". Diagnostic and Interventional Radiology. 21 (1): 4–9. doi:10.5152/dir.2014.14053. ISSN 1305-3825.
- ↑ Hata, Kohkichi; Hata, Toshiyuki; Makihara, Ken; Aoki, Showa; Takamiya, Osamu; Kitao, Manabu; Harada, Yuji; Nagaoka, Saburo (1990). "Sonographic Findings of Uterine Leiomyosarcoma". Gynecologic and Obstetric Investigation. 30 (4): 242–245. doi:10.1159/000293278. ISSN 1423-002X.
- ↑ Rha, Sung Eun; Byun, Jae Young; Jung, Seung Eun; Lee, Soo Lim; Cho, Song Mee; Hwang, Seong Su; Lee, Hae Giu; Namkoong, Sung-Eun; Lee, Jae Mun (2003). "CT and MRI of Uterine Sarcomas and Their Mimickers". American Journal of Roentgenology. 181 (5): 1369–1374. doi:10.2214/ajr.181.5.1811369. ISSN 0361-803X.
- ↑ Woźniak, Andrzej; Woźniak, Sławomir (2017). "Ultrasonography of uterine leiomyomas". Menopausal Review. 16 (4): 113–117. doi:10.5114/pm.2017.72754. ISSN 1643-8876.
- ↑ Bodner, Klaus; Bodner-Adler, Barbara; Kimberger, Oliver; Czerwenka, Klaus; Mayerhofer, Klaus (2016). "Bcl-2 Receptor Expression in Patients With Uterine Smooth Muscle Tumors: An Immunohistochemical Analysis Comparing Leiomyoma, Uterine Smooth Muscle Tumor of Uncertain Malignant Potential, and Leiomyosarcoma". Journal of the Society for Gynecologic Investigation. 11 (3): 187–191. doi:10.1016/j.jsgi.2003.10.003. ISSN 1071-5576.
- ↑ Adaikkalam J (April 2016). "Lipoleiomyoma of Cervix". J Clin Diagn Res. 10 (4): EJ01–2. doi:10.7860/JCDR/2016/16505.7531. PMID 27190823.
- ↑ Houser, L. Murray; Carrasco, C. H.; Sheehan, C. R. (1979). "Lipomatous tumour of the uterus: radiographic and ultrasonic appearance". The British Journal of Radiology. 52 (624): 992–993. doi:10.1259/0007-1285-52-624-992. ISSN 0007-1285.
- ↑ Keriakos, Remon; Maher, Mark (2013). "Management of Cervical Fibroid during the Reproductive Period". Case Reports in Obstetrics and Gynecology. 2013: 1–3. doi:10.1155/2013/984030. ISSN 2090-6684.
- ↑ Coronado GD, Marshall LM, Schwartz SM (May 2000). "Complications in pregnancy, labor, and delivery with uterine leiomyomas: a population-based study". Obstet Gynecol. 95 (5): 764–9. PMID 10775744.
- ↑ Myles JL, Hart WR (November 1985). "Apoplectic leiomyomas of the uterus. A clinicopathologic study of five distinctive hemorrhagic leiomyomas associated with oral contraceptive usage". Am. J. Surg. Pathol. 9 (11): 798–805. PMID 4073354.
- ↑ . doi:10.1097/PAS.0000000000000569. Check
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(help) - ↑ Tan, Y.; Zhang, H.; Xiao, E.-H. (2013). "Perivascular epithelioid cell tumour: Dynamic CT, MRI and clinicopathological characteristics—Analysis of 32 cases and review of the literature". Clinical Radiology. 68 (6): 555–561. doi:10.1016/j.crad.2012.10.021. ISSN 0009-9260.
- ↑ Kang, Jeong Ba; Seo, Jin Won; Park, Young-Han; Jang, Pong Rheem (2014). "Malignant Perivascular Epithelioid Cell Tumor of the Uterus with Lung Metastasis". The Korean Journal of Pathology. 48 (6): 454–457. doi:10.4132/KoreanJPathol.2014.48.6.454. ISSN 1738-1843.
- ↑ "PEComa of the Uterus: A Rare Mesenchymal Tumor Displaying a ≪Snowstorm≫ Pattern at Magnetic Resonance Imaging". Journal of the Belgian Society of Radiology. 100 (1). 2016. doi:10.5334/jbr-btr.926. ISSN 1780-2393.
- ↑ . doi:10.1043/1543-2165-135.2.268. Check
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(help) - ↑ Hwang, Jae Pil; Lim, Sang Moo (2013). "Uterine Epithelioid Angiosarcoma on F-18 FDG PET/CT". Nuclear Medicine and Molecular Imaging. 47 (2): 134–137. doi:10.1007/s13139-013-0191-y. ISSN 1869-3474.
- ↑ Chen, Innie; Firth, Bianca; Hopkins, Laura; Bougie, Olga; Xie, Ri-hua; Singh, Sukhbir (2018). "Clinical Characteristics Differentiating Uterine Sarcoma and Fibroids". JSLS : Journal of the Society of Laparoendoscopic Surgeons. 22 (1): e2017.00066. doi:10.4293/JSLS.2017.00066. ISSN 1086-8089.