Practical diagnostic aspects of uterine leiomyosarcoma in the context of the 2020 WHO classification].

Lars-Christian Horn, Grit Gesine Ruth Hiller, Doris Mayr, Elisa Schmoeckel, Anne Kathrin Höhn

Der Pathologe 2022 May

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The 2020 WHO Classification defines the spindle cell, epithelioid, and myxoid variants as subtypes of uterine leiomyosarcomas (LMS). Presence of cellular atypia (size variation of polymorphic nuclei > 2-3:1), tumor cell necroses, and mitotic count (usually ≥ 10 MF/10 HPF) are still the key features for diagnostic separation from uterine leiomyomas. Preanalytic variables, staining quality, as well as intralesional geographic distribution may affect the mitotic count. Smooth muscle tumors of uncertain malignant potential (STUMP) still exist as a not yet well-characterized diagnostic entity. Immunohistochemical stains against p16, p53, Ki-67, and WT‑1 may aid differential diagnosis in selected cases. Diagnostic molecular pathology is not yet relevant for diagnosis. © 2022. The Author(s), under exclusive licence to Springer Medizin Verlag GmbH, ein Teil von Springer Nature.

Citation

Lars-Christian Horn, Grit Gesine Ruth Hiller, Doris Mayr, Elisa Schmoeckel, Anne Kathrin Höhn. Practical diagnostic aspects of uterine leiomyosarcoma in the context of the 2020 WHO classification]. Der Pathologe. 2022 May;43(3):196-201