A 45-year-old woman undergoes hysterectomy for a rapidly enlarging uterine mass. Histology shows a spindle cell tumor with marked nuclear atypia, coagulative tumor cell necrosis, and 15 mitoses per 10 high-power fields. What is the definitive diagnosis?
- A Cellular leiomyoma
- B Leiomyosarcoma ✓
- C Endometrial stromal sarcoma
- D Intravenous leiomyomatosis
Correct answer: B. Leiomyosarcoma
Explanation
The diagnosis of leiomyosarcoma requires the presence of at least two of the following three criteria: moderate to severe cytologic atypia, mitotic count of 10 or more per 10 HPF, and coagulative tumor cell necrosis. This mass exhibits all three features, confirming leiomyosarcoma. Cellular leiomyoma lacks significant atypia and coagulative necrosis. Endometrial stromal sarcoma shows tongue-like infiltration and lacks the marked atypia and necrosis seen here.
Reference: Robbins and Cotran Pathologic Basis of Disease, 10th ed.
High-yield for: NEET PGINI-CETNExTFMGEUSMLEPLABMRCP
Written and medically reviewed by the StethoPrep medical team.