Rucha Kanhe

Abstract

Objectives: To know the incidence of leiomyoma in hysterectomy specimens and study the degenerative changes of leiomyoma and its variants. Materials and Methods: A prospective study of 1000 hysterectomy specimens was done. All the chief complaints, gross features and microscopic findings were recorded. Results: The most common benign lesion found was leiomyoma in 55.4% cases followed by adenomyosis in 32.5% cases. Majority of leiomyoma cases (99.2%) were usual leiomyoma. 2 variants of leiomyoma, 1 case of cellular leiomyoma and other case of mitotically active leiomyoma were found. Conclusion: Leiomyoma was the most common pathology found in hysterectomy specimens in our study which is also true for other countries. Adenomyosis identified on histopathological examination was seen to be an important lesion in cases presenting with DUB. Hence, cases presenting with DUB should be thoroughly evaluated to rule out any underlying pathology. Keywords: Adnexam, Leiomyoma, Adenomyosis, Dysfunctional uterine bleeding.

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Abstract

Introduction: Primitive neuroectodermal tumor (PNET) / Ewing sarcoma of kidney are rare aggressive tumor with poor prognosis. It occurs in young adults generally in 2nd to 3rd decade of life Case Reports: We report three cases of PNET/Ewing sarcoma of kidney in patients of age 25and 35 years with complain of hematuria and abdominal pain .CT scan revealed heterogeneously enhancing lesion in kidney and we received radical nephrectomy specimen with variegated appearance on gross. Microscopic examination showed tumor with malignant cells in sheets and pseudorosettes .The diagnosis was given as PNET/ES and was confirmed with immunohistochemistry. Discussion: Renal PNET/ES is a member of Ewing sarcoma family. They are rare tumor originating from the neural crest and are more aggressive than PNET at any other site. The presence of Homer Wright rosettes is less common in extra-osseous Ewing sarcoma and their presence is a sure diagnosis of PNET/ES. The differential diagnosis for these small round cell tumor of kidney other than PNET include malignant lymphoma, renal neuroblastoma,,embryonalrhanbdomyosarcoma, wilms tumor. The immunohistochemical marker CD99 positivity is diagnostic. Other markers positive are S-100, vimentin and NSE (neuron specific enolase). Conclusion: Histopathology and immunohistochemistry remains gold standard for confirming the diagnosis. Keywords: Ewing sarcoma (ES) / kidney/, Primitive neuroectodermal tumor, (PNET).

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