Uterus, Dystrophic ossification [LMP82607]

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Diagnostic Modality: 
Whole Slide Image
Disease Category: 
Cellular Responses to Stress and Toxic Insults: Adaptation, Injury, and Death
Diagnosis: 
Dystrophic ossification
Species: 
Human
Organ System: 
Female Genital Tract
Gender: 
Female
Diagnosis Code: 
ICD-10: M61 and D25 | ICD-O: 8890/0
Slide Contributor Information
Stevenson, M.

Keywords

leiomyoma, PVA, foreign body reaction, dystrophic osteogenesis, embolization, artifact

Clinical History

Uterine leiomyoma.

Clinical Discussion

Uterine fibroids (leiomyomas) are one of the most common benign tumours, and can be associated with a wide range of unusual findings. For example, a range of treatment-related artifacts can be observed after treatment by uterine artery embolization. In this technique, foreign material such as particles of polyvinyl alcohol (PVA) is injected into the uterine arteries to occlude blood supply to the fibroids.

PVA appears as a non-refractile, pale, grayish-blue lattice within vessels on H&E sections. Following uterine artery embolization, leiomyomas and adjacent tissue can demonstrate foreign body giant cell reaction (present in this case), PCA PVA emboli, and necrosis. In this case, the reactive formation of bone within calcified matrix, or dystrophic ossification, can also be seen. The calcification is thought to result from aggregated particles of PVA in the peripheral arteries supplying the leiomyomas.

See Related Content for reference:
1) Colgan, TJ, et al. Am J Surg Pathol. 2003 Feb;27(2):167-77.

Related Content

Related External Links: 
Colgan, TJ, et al. Pathologic Features of uteri and leiomyomas following uterine artery embolization for leiomyomas...