Smooth muscle tumors of soft tissue and non-uterine viscera: biology and prognosis

Smooth muscle tumors are here considered an essentially dichotomous group composed of benign leiomyomas and malignant leiomyosarcomas. Soft tissue smooth muscle tumors with both atypia and mitotic activity are generally diagnosed leiomyosarcomas acknowledging potential for metastasis. However, lesio...

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Vydané v:Modern pathology Ročník 27; číslo Suppl 1; s. S17 - S29
Hlavný autor: Miettinen, Markku
Médium: Journal Article
Jazyk:English
Vydavateľské údaje: New York Elsevier Inc 01.01.2014
Nature Publishing Group US
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ISSN:0893-3952, 1530-0285, 1530-0285
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Abstract Smooth muscle tumors are here considered an essentially dichotomous group composed of benign leiomyomas and malignant leiomyosarcomas. Soft tissue smooth muscle tumors with both atypia and mitotic activity are generally diagnosed leiomyosarcomas acknowledging potential for metastasis. However, lesions exist that cannot be comfortably placed in either category, and in such cases the designation ‘smooth muscle tumor of uncertain biologic potential' is appropriate. The use of this category is often necessary with limited sampling, such as needle core biopsies. Benign smooth muscle tumors include smooth muscle hamartoma and angioleiomyoma. A specific category of leiomyomas are estrogen-receptor positive ones in women. These are similar to uterine leiomyomas and can occur anywhere in the abdomen and abdominal wall. Leiomyosarcomas can occur at any site, although are more frequent in the retroperitoneum and proximal extremities. They are recognized by likeness to smooth muscle cells but can undergo pleomorphic evolution (‘dedifferentiation'). Presence of smooth muscle actin is nearly uniform and desmin-positivity usual. This and the lack of KIT expression separate leiomyosarcoma from GIST, an important problem in abdominal soft tissues. EBV-associated smooth muscle tumors are a specific subcategory occurring in AIDS or post-transplant patients. These tumors can have incomplete smooth muscle differentiation but show nuclear EBER as a diagnostic feature. In contrast to many other soft tissue tumors, genetics of smooth muscle tumors are poorly understood and such diagnostic testing is not yet generally applicable in this histogenetic group. Leiomyosarcomas are known to be genetically complex, often showing ‘chaotic' karyotypes including aneuploidy or polyploidy, and no recurrent tumor-specific translocations have been detected.
AbstractList Smooth muscle tumors are here considered an essentially dichotomous group composed of benign leiomyomas and malignant leiomyosarcomas. Soft tissue smooth muscle tumors with both atypia and mitotic activity are generally diagnosed leiomyosarcomas acknowledging potential for metastasis. However, lesions exist that cannot be comfortably placed in either category, and in such cases the designation ‘smooth muscle tumor of uncertain biologic potential’ is appropriate. The use of this category is often necessary with limited sampling, such as needle core biopsies. Benign smooth muscle tumors include smooth muscle hamartoma and angioleiomyoma. A specific category of leiomyomas are estrogen-receptor positive ones in women. These are similar to uterine leiomyomas and can occur anywhere in the abdomen and abdominal wall. Leiomyosarcomas can occur at any site, although are more frequent in the retroperitoneum and proximal extremities. They are recognized by likeness to smooth muscle cells but can undergo pleomorphic evolution (‘dedifferentiation’). Presence of smooth muscle actin is nearly uniform and desmin-positivity usual. This and the lack of KIT expression separate leiomyosarcoma from GIST, an important problem in abdominal soft tissues. EBV-associated smooth muscle tumors are a specific subcategory occurring in AIDS or post-transplant patients. These tumors can have incomplete smooth muscle differentiation but show nuclear EBER as a diagnostic feature. In contrast to many other soft tissue tumors, genetics of smooth muscle tumors are poorly understood and such diagnostic testing is not yet generally applicable in this histogenetic group. Leiomyosarcomas are known to be genetically complex, often showing ‘chaotic’ karyotypes including aneuploidy or polyploidy, and no recurrent tumor-specific translocations have been detected.
Smooth muscle tumors are here considered an essentially dichotomous group composed of benign leiomyomas and malignant leiomyosarcomas. Soft tissue smooth muscle tumors with both atypia and mitotic activity are generally diagnosed leiomyosarcomas acknowledging potential for metastasis. However, lesions exist that cannot be comfortably placed in either category, and in such cases the designation 'smooth muscle tumor of uncertain biologic potential' is appropriate. The use of this category is often necessary with limited sampling, such as needle core biopsies. Benign smooth muscle tumors include smooth muscle hamartoma and angioleiomyoma. A specific category of leiomyomas are estrogen-receptor positive ones in women. These are similar to uterine leiomyomas and can occur anywhere in the abdomen and abdominal wall. Leiomyosarcomas can occur at any site, although are more frequent in the retroperitoneum and proximal extremities. They are recognized by likeness to smooth muscle cells but can undergo pleomorphic evolution ('dedifferentiation'). Presence of smooth muscle actin is nearly uniform and desmin-positivity usual. This and the lack of KIT expression separate leiomyosarcoma from GIST, an important problem in abdominal soft tissues. EBV-associated smooth muscle tumors are a specific subcategory occurring in AIDS or post-transplant patients. These tumors can have incomplete smooth muscle differentiation but show nuclear EBER as a diagnostic feature. In contrast to many other soft tissue tumors, genetics of smooth muscle tumors are poorly understood and such diagnostic testing is not yet generally applicable in this histogenetic group. Leiomyosarcomas are known to be genetically complex, often showing 'chaotic' karyotypes including aneuploidy or polyploidy, and no recurrent tumor-specific translocations have been detected.Smooth muscle tumors are here considered an essentially dichotomous group composed of benign leiomyomas and malignant leiomyosarcomas. Soft tissue smooth muscle tumors with both atypia and mitotic activity are generally diagnosed leiomyosarcomas acknowledging potential for metastasis. However, lesions exist that cannot be comfortably placed in either category, and in such cases the designation 'smooth muscle tumor of uncertain biologic potential' is appropriate. The use of this category is often necessary with limited sampling, such as needle core biopsies. Benign smooth muscle tumors include smooth muscle hamartoma and angioleiomyoma. A specific category of leiomyomas are estrogen-receptor positive ones in women. These are similar to uterine leiomyomas and can occur anywhere in the abdomen and abdominal wall. Leiomyosarcomas can occur at any site, although are more frequent in the retroperitoneum and proximal extremities. They are recognized by likeness to smooth muscle cells but can undergo pleomorphic evolution ('dedifferentiation'). Presence of smooth muscle actin is nearly uniform and desmin-positivity usual. This and the lack of KIT expression separate leiomyosarcoma from GIST, an important problem in abdominal soft tissues. EBV-associated smooth muscle tumors are a specific subcategory occurring in AIDS or post-transplant patients. These tumors can have incomplete smooth muscle differentiation but show nuclear EBER as a diagnostic feature. In contrast to many other soft tissue tumors, genetics of smooth muscle tumors are poorly understood and such diagnostic testing is not yet generally applicable in this histogenetic group. Leiomyosarcomas are known to be genetically complex, often showing 'chaotic' karyotypes including aneuploidy or polyploidy, and no recurrent tumor-specific translocations have been detected.
Author Miettinen, Markku
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United States & Canadian Academy of Pathology 2014
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Keywords leiomyosarcoma
bone and soft tissue
leiomyoma
Language English
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PublicationDate January 2014
20140100
2014-01-00
2014-Jan
20140101
PublicationDateYYYYMMDD 2014-01-01
PublicationDate_xml – month: 01
  year: 2014
  text: January 2014
PublicationDecade 2010
PublicationPlace New York
PublicationPlace_xml – name: New York
– name: United States
– name: Kidlington
PublicationSubtitle Publishing innovative clinical and translational research in the pathology of human disease
PublicationTitle Modern pathology
PublicationTitleAbbrev Mod Pathol
PublicationTitleAlternate Mod Pathol
PublicationYear 2014
Publisher Elsevier Inc
Nature Publishing Group US
Elsevier Limited
Publisher_xml – name: Elsevier Inc
– name: Nature Publishing Group US
– name: Elsevier Limited
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Johnson (10.1038/modpathol.2013.178_bib4) 1989; 125
Jang (10.1038/modpathol.2013.178_bib8) 2000; 142
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Snippet Smooth muscle tumors are here considered an essentially dichotomous group composed of benign leiomyomas and malignant leiomyosarcomas. Soft tissue smooth...
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SubjectTerms 692/699/67/1798
692/700/1750
Abdomen
Angiomyoma - classification
Biomarkers, Tumor - analysis
Biomarkers, Tumor - genetics
Biopsy
bone and soft tissue
Cancer
Cell Differentiation
Fibroids
Hamartoma - classification
Herpesvirus 4, Human - isolation & purification
Humans
Laboratory Medicine
leiomyoma
Leiomyoma - classification
leiomyosarcoma
Leiomyosarcoma - classification
long-course-article
Lymphatic system
Medicine
Medicine & Public Health
Metastasis
Neoplasms, Muscle Tissue - chemistry
Neoplasms, Muscle Tissue - classification
Neoplasms, Muscle Tissue - genetics
Neoplasms, Muscle Tissue - pathology
Neoplasms, Muscle Tissue - virology
Pathology
Prognosis
Smooth muscle
Soft Tissue Neoplasms - chemistry
Soft Tissue Neoplasms - classification
Soft Tissue Neoplasms - genetics
Soft Tissue Neoplasms - pathology
Soft Tissue Neoplasms - virology
Terminology as Topic
Tumors
Title Smooth muscle tumors of soft tissue and non-uterine viscera: biology and prognosis
URI https://dx.doi.org/10.1038/modpathol.2013.178
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