Siatecka Hanna, Masand Ramya P
Department of Pathology & Immunology, Baylor College of Medicine Houston, TX, USA.
Int J Clin Exp Pathol. 2022 May 15;15(5):238-240. eCollection 2022.
Intravascular leiomyomatosis is a rare disease characterized by extension of benign smooth muscle proliferation into uterine and pelvic vessels. The involved vessels are almost always veins and rarely lymphatics. Intraarterial growth has not been described. Intravascular leiomyomatosis can show different morphologic features that are commonly described in leiomyomas. The differential diagnosis includes endometrial stromal sarcoma, lymphangioleiomyomatosis and leiomyosarcoma. Immunohistochemistry is helpful to establish a correct diagnosis. The condition is histologically benign; however, these lesions can spread by the venous system into the inferior vena cava, heart, and lungs. Treatment of this condition is surgical. The spread of intravenous leiomyomatosis exclusively by uterine lymphatics to the pelvic lymph nodes has not been previously reported.
血管内平滑肌瘤病是一种罕见疾病，其特征为良性平滑肌增生延伸至子宫和盆腔血管。受累血管几乎均为静脉，很少为淋巴管。尚未见动脉内生长的描述。血管内平滑肌瘤病可呈现平滑肌瘤中常见的不同形态学特征。鉴别诊断包括子宫内膜间质肉瘤、淋巴管平滑肌瘤病和平滑肌肉瘤。免疫组化有助于做出正确诊断。该疾病在组织学上为良性；然而，这些病变可通过静脉系统扩散至下腔静脉、心脏和肺部。本病的治疗方法为手术。静脉内平滑肌瘤病仅通过子宫淋巴管扩散至盆腔淋巴结的情况此前尚未见报道。
