RESUMEN
Intravascular leiomyomatosis (IVL) is characterized by the presence of smooth muscle in venous and lymphatic spaces within the myometrium. Although the intravascular component usually consists solely of typical smooth muscle or variants of smooth muscle differentiation, we report 5 cases in which the intravascular component also included endometrioid glandular and stromal elements. We propose the term "intravenous adenomyomatosis" to describe this unusual variant of IVL. The mean age of the patients in this series was 50.2 years, slightly older than that of patients with conventional IVL. In addition to intravenous adenomyomatosis, both adenomyosis and leiomyomas were identified in all of our cases, supporting the hypothesis that the intravascular smooth muscle component in IVL is derived from associated myometrial pathology rather than from vessel walls. In our series, intravenous adenomyomatosis had a similar benign clinical behavior to most cases of IVL with no metastatic or recurrent disease identified at follow-up in 4 cases for which follow-up information was available. The main differential diagnoses are adenomyosis with vascular involvement, low-grade endometrial stromal sarcoma (ESS), including ESS with smooth muscle and glandular differentiation, and adenosarcoma with lymphovascular invasion. The possibility of intravenous adenomyomatosis should be borne in mind when considering these diagnoses, particularly ESS and adenosarcoma, which have different implications for patient management and prognosis.
Asunto(s)
Adenomiosis/patología , Adenosarcoma/patología , Leiomiomatosis/patología , Miometrio/patología , Sarcoma Estromático Endometrial/patología , Neoplasias Uterinas/patología , Venas/patología , Adenomiosis/clasificación , Adenomiosis/metabolismo , Adenomiosis/cirugía , Adenosarcoma/química , Adenosarcoma/clasificación , Adenosarcoma/cirugía , Adulto , Anciano , Biomarcadores de Tumor/análisis , Biopsia , Diagnóstico Diferencial , Femenino , Humanos , Inmunohistoquímica , Leiomiomatosis/química , Leiomiomatosis/clasificación , Leiomiomatosis/cirugía , Persona de Mediana Edad , Miometrio/química , Clasificación del Tumor , Invasividad Neoplásica , Valor Predictivo de las Pruebas , Pronóstico , Sarcoma Estromático Endometrial/química , Sarcoma Estromático Endometrial/clasificación , Sarcoma Estromático Endometrial/cirugía , Terminología como Asunto , Neoplasias Uterinas/química , Neoplasias Uterinas/clasificación , Neoplasias Uterinas/cirugía , Venas/químicaRESUMEN
This report describes a simple method of preparing cell blocks from fluids submitted for cytology, using croutons of gelatin foam surgical dressing material.