FINAL DIAGNOSIS

Your Value:
Surgical Pathology Consult & Slide Review Report Case: Your case number
Authorizing Provider: Your MD
Collected: Date of collection
Ordering Location: Pathology HOV
Receive: Date specimen received
Pathologist: Your assigned pathologist
Specimen: Uterus, cervix and bilateral fallopian tubes, hysterectomy

Uterus including cervix and bilateral fallopian tube, hysterectomy with bilateral salpingectomy (A):
- Myometrium with low-grade smooth muscle neoplasm with epithelioid and clear cell features (8.1 cm) and vascular invasion ; see Comment.
- Cervix, negative for neoplasm.
- inactive endometrium with exogenous hormone effect , negative for neoplasm.
- Bilateral fallopian tubes, negative for neoplasm.

COMMENT:
The myometrium is involved by an epithelioid neoplasm with a trabeculated architecture with uniform cytoplasmic clearing . There are multiple foci of extension into vascular spaces . By provided outside immunohistochemistry, the neoplastic cells are diffusely positive for desmin and SMMHC , supporting smooth muscle differentiation, and negative for Melan-A , calretinin, and Pankeratin. No foci of necrosis are identified and there is no significant cytologic atypia . There are rare, if any, definite mitoses identified.    

By immunohistochemistry performed at XMC, the neoplastic cells have focal nonspecific reactivity for HMB45, making PEComa

COMPONENT

Your Value: 
The overall features are that of a low-grade smooth muscle neoplasm that although it appears innocuous given lack of mitosis, significant atypia or necrosis, given the multifocal presence of extension into vascular spaces, it is worrisome for sarcoma, or at a minimum intravascular leiomyomatosis. Dr. and Dr. have reviewed this case and concur.

Note: Some tests cited above may have been developed and their performance characteristics determined by the X Medicine Pathology Laboratories. They have not been cleared or approved by the U.S. Food and Drug Administration (FDA). However, the FDA has determined that such clearance or approval is not necessary. These tests are used for clinical purposes and should not be regarded as investigational or for research. The performing laboratories at X, Y or Z are certified under the Clinical Laboratory Improvement Amendments of 1988 (CLIA '88) as qualified to perform high complexity laboratory testing.