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Image Description

Intravascular leiomyomatosis is an exceedingly rare condition consisting of growth of mature smooth muscle within the lumens of uterine and pelvic veins. It frequently coexists with uterine leiomyomas. The gross appearance is that of intravascular worm-like projections from the sectioned surface of the uterus as shown here. It may mimic endometrial stromal sarcoma grossly.

However, the lesion is composed of bundles of elongated mature smooth muscle cells, where as the endometrial stromal sarcomas contain round or oval endometrial stromal cells. There is no atypia and mitotic activity is not increased. The growth of smooth muscle may involve inferior vena cava and even extend into the right atrium in rare cases. Image courtesy of Ed Uthman, MD, Houston, Texas. Used with permission

Image 14 of 51