Small Bowel, Leiomyosarcoma [LMP66090]

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Diagnostic Modality: 
Whole Slide Image
Disease Category: 
Neoplasia
Diagnosis: 
Leiomyosarcoma
Species: 
Human
Organ System: 
Gastrointestinal Tract
Gender: 
Female
Age: 
60 years
Diagnosis Code: 
ICD-10: C17 | ICD-O: 8890/3
Slide Contributor Information
Duan, K., Hojilla, C.

Keywords

leiomyosarcoma, smooth muscle tumour, spindle cell neoplasm

Clinical History

60 year old female with a 5.0 cm small bowel mass, biopsy.

Clinical Discussion

Microscopic assessment shows fragments of neoplastic spindle cells with fascicular growth pattern and marked cytologic atypia and pleomorphism. The morphologic features are consistent with a smooth muscle tumour with atypia, favouring leiomyosarcoma.

Leiomyosarcomas (LMS) are malignant smooth muscle tumours that infrequently arise in the gastrointestinal tract. Primary small intestinal LMS show variable behavior and may metastasize into the abdomen and distant sites. The main differential diagnosis includes a GIST, which is more common at this location. Although distinction between these two entities is often straightforward on H&E, a panel of immunohistochemical stains (i.e. smooth muscle markers, CD117 and/or DOG1) may be helpful in problematic cases.

See related content for references:

1) Miettinen M., et al. Am J Surg Pathol. 2009;33(3):430-436

Related Content

Related External Links: 
Miettinen M., et al. True smooth muscle tumors of the small intestine: a clinicopathologic, immunohistochemical, and molecula...