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Objective:
Uterine lipoleiomyoma is a rare benign tumour composed of
variable amounts of smooth muscle, fat cells and fibrous tissue.
Chondroid metaplasia in an uterine lipoleiomyoma is extremely rare with
only a few reports in medical literature.
Method:
We report the case of a 39-year-old patient who presented with
pelvic pain. Ultrasound scan and MRI of the pelvis showed multiple
circumscribed intramural or submucosal tumours of the uterus with max-
imum diameter 5 cm and heterogeneous appearance. She underwent lap-
arotomy with excision of 6 of the tumours.
Results:
Microscopically, the largest tumour revealed an admixture of
smooth muscle fibers with mature fat cells in varying proportions, and
scattered nodular areas of mature cartilage. No cytologic atypia, mitoses
or necrosis were found in each counterpart of the tumour.
Immunohistochemically, the fat and the chondroid cells expressed S100
protein and variably estrogen and progesterone receptors. The patient
1 year later is in good condition, with no evidence of recurrence. The rest
of the tumours represented typical leiomyomas.
Conclusion:
In conclusion, we report an extremely rare case of mature
lipoleiomyoma with chondroid metaplasia of a leiomyomatous uterus. It
is considered a benign tumour and is important to differentiate its different
components from their malignant counterparts.
E-PS-10-019
Uterine malignant perivascular epithelioid cell tumour with late pul-
monary metastasis
G. Narli*, I. Yilmaz
*Yüksekova Public Hospital, Dept. of Pathology, Hakkari, Turkey
Objective:
Perivascular epithelioid cell tumours are rare mesenchy-
mal neoplasms with a distinct perivascular epithelioid cell differ-
entiation. They can arise in a large spectrum of anatomic loca-
tions, and are characterized by their myelomelanocytic phenotype
and unpredictable natural history . A case of malignant
perivascular epithelioid cell tumour (PEComa) of the uterus with
late pulmonary metastasis is presented.
Method:
A 60-year-old female patient admitted by obstetrics and
gynecology department, complaining of lower abdominal pain and
abnormal uterine bleeding. MRI revealed a 13-cm-mass located in
subserozal space of uterine fundus, which is extending to the
cervix uteri. Hysterectomy was performed.
Results:
Histologically, the tumour was composed of round to polygonal
cells with round nuclei and abundant clear to slightly eosinophilic cyto-
plasm. There were scattered foci of necrosis. The tumour cells showed
high atypia and high mitoti c activity (>50MF/10HPF).
Immunohistochemically, the tumour was strong positive for HMB45,
vimentin, B-katenin and p16. Focal positive for CD10 and desmin. The
tumour was negative for S100, SMA, MSA, EMA, myoglobulin, inhibin,
CD117, Melan-A, and CD68 . After surgery, the patient underwent three
sessions of adjuvant chemotherapy. After 2 years, a 5 cm solitary meta-
static mass was detected in right lower lobe of lungs, and lobectomy was
performed. The tumour was arranged in nests or trabeculae of epithelioid
cells with clear cytoplasm and round nuclei with prominent nucleoli and
share same immunohistochemistry with the primary tumour.
Conclusion:
Although PEComas have a wide spectrum of biological
behavior, tumour size (>5 cm), infiltrative growth pattern, high nuclear
grade, necrosis and high mitotic rate > 1/50 HPF are related with aggres-
sive clinical behavior and poor clinical outcomes/prognosis.
E-PS-10-020
Solitary luteinised follicle cyst of pregnancy: Two cases
H. Akkaya*
*Baskent University School of Medicine Antalya; Alanya Hospital,
Turkey
Objective:
Solitary luteinized follicle cyst of pregnancy (SLFCP) is a
benign condition that affects pregnant females or appears during puerpe-
rium. It is self-limited in nature and most often regresses spontaneously in
the puerperium.
Method:
Two cases of SLFCP were described with clinicopathologic
findings.
Results:
The first case occurred in a 35-year old woman who was found to
have a left ovarian mass during the caesarean section. The ovarian mass was
removed by oophorectomy. The specimen has unilocular, thin-walled, clear
fluid filled cyst measuring 13 × 9× 5 cm. Internal surface of cyst was smooth
and solid tissue or papillary tumour was not seen. The ovarian tissue was
measured as 3x2x1 cm adjacent to cyst. Microscopically, cyst was lined by
luteinized cells with focal large nuclei, scattered nests of luteinized cells in the
edematous fibrous wall. Mitotic figures were not seen. The patient has been
healthy without disease after 15 years. The second case was a 26-year old
pregnant woman who was found to have a right ovarian cyst during the
caesarean section. The patient delivered a full term healthy female infant
and the ovarian mass was removed by cystectomy. The specimen showed a
unilocular, thin-walled, clear fluid filled cyst measuring 8 cm in diameter.
Microscopic features were similar to the first case. Nomitoses were identified,
too. The patient has been healthy in 2 months after surgery.
Conclusion:
The differentiation between solitary luteinized follicle cyst and
a cystic ovarian tumour is important. Awareness of this entity will minimize
the risk of a misdiagnosis.
E-PS-11-001
Myeloid sarcoma of the breast: An uncommon presentation
Z. Sagnak Yilmaz*, U. Cobanoglu, S. Mungan
*Karadeniz Technical University, Dept. of Pathology, Trabzon, Turkey
Objective:
Myeloid sarcoma is an extramedullary solid neoplasm of imma-
ture myeloid cells. Affected sites include skin, lymph nodes, bone, small
intestine, and less commonly, the breast. These tumours usually develop
synchronously or following the diagnosis of acute myeloid leukemia (AML).
Method:
Core biopsy of the lesion was performed. The section were
stained with routinary H&E. Immunohistochemistry was performed.
Results:
A 27-year-old female presented with a lump in the left breast to
our hospital. Computed tomography scan showed a mass in the left breast
.Histopathological examination revealed a tumour composed of blasts
with scant cytoplasm and round-oval nuclei. The tumour cells were
immunonegative for cytokeratin, ER, PR, e-cadherin, Her2neu, CD3
and CD20. Malignant cells were immunoreactive for myeloperoxidase
CD34, leukocyte common antigen (LCA) and lysozyme. These results
established a diagnosis of myeloid sarcoma. Following the diagnosis of
myeloid sarcoma bone marrow aspiration & biopsy was performed. The
bone marrowwas hypercellular with extensive blast infiltration consistent
with AML.
Conclusion:
Myeloid sarcoma is an uncommon neoplasm of immature
myeloid cells. The breast is an uncommon site for presentation of this
tumour. It is important to pathologists not to misidentify this tumour as
lymphoma or carcinoma.
E-PS-11-002
Hodgkin lymphoma: A definite diagnosis to an indefinite clinical
setting
R. Luis*, E. Vitorino, L. Ferreira, J. Raposo, C. Ferreira
*Hosp Santa Maria - CHLN, EPE, Serv Anatomia Patologica, Lisbon,
Portugal
E-PS-11 Haematopathology
Virchows Arch
(
2017
)
471
(
Suppl 1
):
S1
–
S352
S330