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Uterine Mesenchymal Neoplasia

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Practical Gynecologic Pathology

Part of the book series: Practical Anatomic Pathology ((PAP))

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Abstract

Uterine mesenchymal neoplasms consist of a group of benign and malignant tumors including smooth muscle, endometrial stromal cells, and other rare cell types. Benign uterine smooth muscle tumors are the most common gynecologic mesenchymal tumors, and they are major tumor types encountered in daily pathology practice. Importantly, uterine smooth muscle and endometrial stromal tumors are histologically heterogeneous and consist of many variants which can be a diagnostic challenge. Many tumor types require careful clinical and histologic evaluation, and some may rely on immunohistochemistry and even molecular analysis before rendering a definite diagnosis. Recent progress and published data provide some useful tools in aid of accurate diagnosis and tumor classification. We intend to bring in those new findings in this chapter. Some biphasic tumors originating from endometrial epithelial and stroma cells are also discussed in this chapter. The format of this chapter designs the questions to address the specific and common encountered issues related to tumor types, specific cytohistology, biomarkers or target genes, as well as diagnostic pitfalls. The purpose of this chapter is to provide trainees and early career pathologists a platform with brief and highly relevant descriptions and images for the most updated information regarding uterine mesenchymal neoplasia.

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Abbreviations

APA:

Atypical polypoid adenoma

ER:

Estrogen receptor

ESN:

Endometrial stromal nodule

ESTECLE:

Endometrial stromal tumors with sex cord-like elements

FIGO:

International Federation of Gynecology and Obstetrics

FISH:

Fluorescence in-situ hybridization

GnRH:

Gonadotropin-releasing hormone

HG-ESS:

High-grade endometrial stromal sarcoma

HLRCC:

Hereditary leiomyomatosis and renal cell cancer

HPF:

High-power fields

IHC:

Immunohistochemistry

IMFT:

Inflammatory myofibroblastic tumor

LG-ESS:

Low-grade endometrial stromal sarcoma

LM-BN:

Leiomyoma with bizarre nuclei

LMS:

Leiomyosarcoma

PR:

Progesterone receptor

SEIC:

Serous intraepithelial carcinoma

SMA:

Smooth muscle actin

SMT-FH:

Smooth muscle tumor with fumarate hydratase alteration

SO:

Sarcomatous overgrowth

SPRM:

Selective progesterone receptor modulators

STUMP:

Smooth muscle tumor of uncertain malignant potential

UAE:

Uterine artery embolization

ULM:

Usual-type leiomyoma

USMT:

Uterine smooth muscle tumor

UTROSCT:

Uterine tumors resembling ovarian sex cord tumors

UUS:

Undifferentiated uterine sarcoma

WHO:

World Health Organization

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  1. Department of Pathology, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

    Jian-Jun Wei

  2. Department of Pathology, Cincinnati University, Cincinnati, OH, USA

    Jenna Purdy

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  1. Department of Pathology, Northwestern University, Feinberg School of Medicine, Chicago, IL, USA

    Jian-Jun Wei

  2. Department of Pathology, Yale School of Medicine, New Haven, CT, USA

    Pei Hui

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Wei, JJ., Purdy, J. (2021). Uterine Mesenchymal Neoplasia. In: Wei, JJ., Hui, P. (eds) Practical Gynecologic Pathology. Practical Anatomic Pathology. Springer, Cham. https://doi.org/10.1007/978-3-030-68608-6_6

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