Clinicopathology of Vaginal Epithelioid Leiomyoma

Objective To explore the clinicopathological features,immnophenotype,differential diagnosis and prognosis of epithelioid leiomyoma of vagina.Methods Immunohistochemical staining and in situ hybrization technique were used to detect the clinicopathological features,human telomerase reverse transcriptase(hTERT) protein expression and EBERs gene expression in vaginal epithelioid leiomyoma tissues.Results The tumor was composed of small,round to oval epithelioid cells arranged in nests and clusters.Cytoplasm was faintly eosinophilic or clear.Nuclei were centrally located and round to oval.Mitotic figures were(2～4)/50 HPF and atypia was not present.Collagenous and myxoid areas were seen in the stroma.Giant rosette-like structures were observed.The centres of these giant rosettes were composed of eosinophilic collagen.Vimentin,Desmin,estrogen receptor,progestogen receptor and hTERT were all positively stained in the tumor in the immunohistochemical examination.EBERs were negatively stained in the tumor during the in situ hybridization.Conclusion Epithelioid leiomyoma of vagina is rare and probably benign,which could be cured by local resection.The tumor is hTERT-postive,indicating a correlation between its development and the activation of telomerase.The tumor is EBERs-negative,indicating that no correlations exist between its development and EBV infection.Estrogen receptor and progestogen receptor were strongly positive in the tumor,indicating that the tumor is highly reactive to estrogen and progestogen.