Corpora amylacea in a leiomyoma of soft tissue

Incidental deep soft tissue leiomyoma of the groin - a case report and comprehensive review of literature

Leiomyomas are rare, benign tumors arising from smooth muscle cells. Due to the heterogeneous anatomical locations, as well as clinical and radiological findings, early and correct diagnosis is usually tricky. The clinical symptoms depend on the anatomical structure the tumors are compromising by their growth. We present a case of a 53-year-old male patient who suffered from swelling of the right foot and ankle. Initially, arthritis and deep vein thrombosis were ruled out. As the swelling progressed to the entire leg, CT scan was performed showing a tumor compressing the right femoral vein. However, a magnetic resonance imaging (MRI) and a biopsy did not show any conclusive findings. Tumor excision was planned and immunohistochemical staining confirmed leiomyoma. The authors conclude that unspecific, progressive symptoms should prompt further investigation and whenever planning a biopsy, a possible malignant finding should be considered and excision of the biopsy canal together with the tumor must be assured.

Corpora amylacea in pleural effusion

Corpora amylacea are predominantly found in the brain, prostate, and lung. Recent characterizations of their components suggest an important role in protection and clearing. We report the presence of corpora amylacea in pleural effusion in a patient with lupus. The differential diagnoses and potential significance are discussed.

Cerebral Corpora amylacea are dense membranous labyrinths containing structurally preserved cell organelles

Corpora amylacea are cell-derived structures that appear physiologically in the aged human brain. While their histological identification is straightforward, their ultrastructural composition and microenvironment at the nanoscale have remained unclear so far, as has their relevance to aging and certain disease states that involve the sequestration of toxic cellular metabolites. Here, we apply correlative serial block-face scanning electron microscopy and transmission electron tomography to gain three-dimensional insight into the ultrastructure and surrounding microenvironment of cerebral Corpora amylacea in the human brainstem and hippocampal region. We find that cerebral Corpora amylacea are composed of dense labyrinth-like sheets of lipid membranes, contain vesicles as well as morphologically preserved mitochondria, and are in close proximity to blood vessels and the glymphatic system, primarily within the cytoplasm of perivascular glial cells. Our results clarify the nature of cerebral Corpora amylacea and provide first hints on how they may arise and develop in the aging brain.

Leiomyoma of deep soft tissue mimicking calcific myonecrosis

Leiomyoma of deep soft tissue is an unusual entity reported in less than 60 cases in the English literature. The lesion is now accepted as a rare neoplasm. Leiomyomata of deep soft tissue have been divided into 2 groups, those occurring primarily in women in the retroperitoneum, histologically similar to leiomyomata of the uterus, and those occurring equally in both sexes in the somatic deep soft tissues. Irrespective of location, these lesions can demonstrate calcification, and even less commonly ossification. We report a unique case of a leiomyoma of deep soft tissue that mimicked the clinical and radiographic features of calcific myonecrosis, also a rare mass forming soft-tissue lesion. Clinical and radiographic information are often critical in the diagnosis of soft-tissue lesions; however, this case demonstrates that a lesion can deviate from the standard clinical and radiographic interpretations most commonly attributed to it.

Corpora amylacea in gastrointestinal leiomyomas: a clinical, light microscopic, ultrastructural and immunohistochemical study with comparison to hyaline globules

CONTEXT

Corpora amylacea (CA) are inclusions with starch-like composition that occur in various conditions. We have observed CA in gastrointestinal leiomyomas (GILM) and hypothesised that they differ from intracytoplasmic hyaline globules (HG) of GILM. We aimed to investigate the anatomical distribution, prevalence, staining characteristics and ultrastructural features of CA and compare them with HG of GILM.

DESIGN

Slides from a consecutive series of resected GILM and bland spindle cell tumours were examined for CA and HG. Special stains, electron microscopy and elemental analysis were performed on select leiomyomas.

RESULTS

CA occurred in 13/35 GILM (37%) from the following sites: oesophagus (4/8), stomach (5/7) including one frozen section, small intestine (1/2) and large intestine (3/18), but were not identified in 19 gastrointestinal stromal tumours (12 gastric, 7 small intestinal; p=0.0019), five schwannomas (three gastric, two small intestinal; p=0.154) and 35 non-GILM (p=0.0001). The densities of CA ranged from one per 4-200 mm(2). CA stained intensely with periodic acid Schiff after diastase predigestion (PASD), Alcian blue and ubiquitin, and faintly in peripheral zones for desmin and smooth muscle actin. Ultrastructurally, CA consisted of an electron-dense outer layer and a fibrillar core with scattered particle matter. HG were present in all leiomyomas, but showed variable staining for PASD, negative staining for Alcian blue and ubiquitin, and positive staining for smooth muscle markers.

CONCLUSIONS

CA are a distinctive histological feature of approximately one third of GILM with different composition to HG. These differences may represent divergent degenerative processes or different stages of a single degenerative process over time.