Leiomyosarcoma of Bone

Fig. 40.1

Leiomyosarcoma of the metaphysis and diaphysis of a femur. Specimen photography and radiography. The lesion involved metallic implants from a previous surgical procedure. (a) Whitish-pink firm and elastic lesion occupying the marrow space in a mostly longitudinal fashion, permeating the cortex and involving adjacent soft tissue. (b) Absence of mineral deposits in tumor tissue

Fig. 40.2

Low-power microscopic view. Long and interwoven bundles of spindle cells

Fig. 40.3

High-power microscopic view. Spindle cells with hyperchromatic nuclei, sometimes showing blunt ends. Atypical mitoses are frequent

Fig. 40.4

Medium-power microscopic view of a leiomyosarcoma of a higher grade than the previous figure. Immunohistochemistry may be needed to properly identify the neoplasia