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Gross: Spherical and firm

  • Cut surface: White to tan with a whorled trabecular pattern

  • Leiomyomas can be located anywhere in the myometrium: Submucosal, intramural and subserosal.

  • Degenerative changes in the form of hemorrhage, necrosis, ulcerations and cystic change.

Leiomyoma

Microscopy: Composed of whorled, interlacing bundles and fascicles with uniform, fusiform smooth muscle cells. The spindle shaped cells have indistinct borders and abundant fibrillar, eosinophilic cytoplasm. Nuclei are elongated with blunt or tapered ends with finely dispersed chromatin and small nucleoli. Degenerative changes such as hyaline fibrosis is present in more than 60% of the cases.

Histological variants: Cellular, mitotically active, epithelioid, atypical, myxoid leiomyoma

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