This is a gross pathology photograph of a uterine specimen demonstrating a leiomyoma (fibroid) arising within the uterine corpus, with the cervix oriented to indicate the uncommon cervical location. The image shows a pale, ivory-white to tan, firm nodular mass with a smooth, whorled cut surface embedded in myometrium and extending toward the left uterine body. The lesion appears well circumscribed, encapsulated by native myometrium, and measures on the order of several centimeters in greatest dimension as suggested by the included metric scale. The gross morphology is characteristic of benign smooth muscle neoplasia: firm consistency, whorled fascicles, and uniform pale coloration, with minimal surface necrosis or hemorrhage. The cervical portion remains recognizable; the corpus is to the left, consistent with the note that the corpus is the primary site in this specimen. The image lacks invasion into surrounding structures on gross inspection. This specimen supports a diagnosis of uterine leiomyoma (fibroid), a common benign tumor in women. Cervical involvement or atypical presentation must be considered. Clinically, fibroids cause menorrhagia, pelvic pressure, and reproductive dysfunction; management ranges from observation to myomectomy or hysterectomy depending on symptoms and fertility considerations. Correlation with histology confirms benign smooth muscle tumor.

Gross macroscopic image of a giant subserosal uterine leiomyoma resected from a 42-year-old female. Modality: Gross pathology photography; specimen oriented with cut surface exposed for architectural assessment. The mass is large, firm, pale white to tan, with a lobulated contour and a lightly nodular surface. On cut, the lesion shows a homogeneous, whorled pattern of intersecting smooth muscle bundles with intervening fibrous stroma; margins are well defined, consistent with a benign neoplasm. No obvious hemorrhage or necrosis is evident on the exposed surface. Subserosal location implies growth toward the serosal surface with outward protrusion from the uterine wall. The uterus shows a single, predominant fibroid; the appearance is typical for leiomyoma, though giant size may cause bulk symptoms. Histology (to be confirmed) would demonstrate spindle-shaped myocytes in sweeping fascicles, with minimal atypia and low mitotic activity; hyaline degeneration may be present in larger lesions. Clinically, fibroids are estrogen-responsive and common in women of reproductive age; differential diagnoses include cellular leiomyoma and leiomyosarcoma, with clinical correlation and imaging guiding management. This specimen supports a benign diagnosis and is valuable for education, pathology atlases, and gynecologic oncology teaching.

Imaging modality: gross pathology photograph of a hysterectomy specimen, sagittal cross-section through the uterus, highlighting a large cervical fibroid with degenerative changes. The cervix is enlarged by a well-circumscribed, firm mass measuring approximately 14 cm in maximum dimension. On the cut surface, cystic degeneration is evident, with multiple large, rounded cystic spaces filled by seromucinous fluid, imparting a yellow-orange gelatinous appearance. Intervening solid areas show dense, whorled fascicles of smooth muscle arranged in a classic 'whorled' or 'raw silk' pattern. The capsule is a fibrous envelope; the tumor coexists with adjacent myometrium and cervix, with no gross invasion into surrounding structures described. The external surface is pale white with occasional surface friability. The presence of cystic degeneration reflects long-standing growth and secondary ischemic changes commonly seen in large fibroids. These features help distinguish benign leiomyoma from malignant muscle tumors when evaluated grossly, though confirmation requires histology demonstrating benign smooth muscle cells with minimal mitotic activity. Clinically, a large cervical leiomyoma can cause mass effect and pelvic pain; surgical treatment—hysterectomy or myomectomy—may be indicated based on symptoms and patient fertility considerations. This specimen emphasizes classic gross hallmarks: mature smooth muscle whorling, degenerative changes, and seromucinous content within cystic spaces consistent with uterine fibroid pathology.

This gross pathology image shows a hysterectomy specimen from a 42-year-old female with a large intramural leiomyoma arising within the myometrium, the most frequent fibroid location. The tumor is centered in the uterine wall with a well-circumscribed, rounded appearance and an organized gray-pink to pink-tan cut surface. The surface exhibits a classic whorled pattern consistent with smooth muscle cell bundles and fibrous stroma, while the surrounding myometrium appears otherwise unremarkable macroscopically. External contour of the uterus is mildly enlarged by the intramural mass, with no obvious hemorrhage or necrosis identified on this gross examination. Ultrasound had detected a mass within the uterine wall correlating with the pathologic finding. Clinically, the patient presented with menorrhagia and back pain—typical symptoms of uterine fibroids. Histologically, intramural leiomyomas are benign neoplasms composed of uniform spindle-shaped smooth muscle cells arranged in interlacing fascicles; however a microscopic diagnosis is not shown here. The significance lies in distinguishing benign leiomyoma from malignant sarcoma, and in guiding treatment choices such as hysterectomy or myomectomy based on reproductive goals. This image provides educational demonstration of gross morphology, localization within the myometrium, and the characteristic cut-surface texture of intramural fibroids.

Imaging modality: Light microscopy of a hematoxylin and eosin stained uterine tissue section. Anatomical context: female reproductive system; uterus (myometrium); tissue type smooth muscle; region myometrial wall. Visual features: densely packed spindle to polygonal cells arranged in interlacing fascicles; marked cellular pleomorphism with bizarre, hyperchromatic nuclei; multinucleated smooth muscle cells; abundant eosinophilic cytoplasm; low to absent mitotic activity; no coagulative necrosis; scattered fibrous stroma and thick wavy collagen bands; occasional hyalinization. Interpretation: Symplastic (bizarre) leiomyoma, a histologic variant of benign uterine leiomyoma; despite alarming cellular atypia, lack of mitotic activity and necrosis supports benign behavior. Clinical significance: differentiate from leiomyosarcoma; crucial to avoid overtreatment; in premenopausal patients, often associated with progestin exposure; diagnosis guides conservative surgical management if fertility preservation is desired. Related terms: pleomorphic, symplastic, bizarre leiomyoma; also called unusual cell-variants of fibroid. Potential clinical use cases: educational histology demonstration; diagnostic training; differential diagnosis teaching; pathology review conferences; research on hormonal associations in leiomyoma variants. This image is helpful for learners to recognize that marked cellular atypia alone does not imply malignancy in smooth muscle tumors, provided mitotic activity and necrosis are absent.

This histopathology image depicts a cutaneous smooth muscle tumor (leiomyoma) on light microscopy. The tissue shows interlacing fascicles of spindle-shaped smooth muscle cells with eosinophilic cytoplasm and elongated, blunt-ended nuclei. Cellular atypia is absent or minimal; occasional degenerative nuclear atypia may be present, but mitotic activity is not evident. The tumor is well circumscribed within dermal/subcutaneous tissue, and nerves are evident within or adjacent to the lesion, accounting for pain and sensitivity to manipulation described clinically. There is no overt necrosis or high-grade pleomorphism, supporting a benign behavior. The morphological features—uniform spindle cells, organized architecture, and lack of mitotic figures—are characteristic of leiomyoma and help distinguish it from malignant smooth muscle neoplasms such as leiomyosarcoma. Clinically, cutaneous leiomyomas present as firm, painful nodules and are typically cured by simple surgical excision with excellent prognosis; recurrence is uncommon when completely excised. Immunohistochemistry (not shown) would typically reveal smooth muscle actin (SMA) positivity. This image provides educational value for medical students and clinicians in recognizing benign smooth muscle tumors, differentiating from neural or fibrous lesions, and correlating histology with pain syndromes that drive therapeutic management. This correlation supports clinical decision-making and reinforces the benign, curable nature of cutaneous leiomyoma through complete excision.

Histopathology: A formalin-fixed, paraffin-embedded tissue section stained with Hematoxylin and Eosin (H&E) shows interlacing fascicles of spindle-shaped smooth muscle cells with elongated, blunt-ended or cigar-shaped nuclei and abundant eosinophilic cytoplasm. The cells are uniform in size, with minimal nuclear atypia and rare mitotic figures; there is no evident necrosis. The architectural pattern is consistent with a benign leiomyoma arising from the smooth muscle layer, such as the muscularis propria of the gastrointestinal tract or uterine myometrium, depending on anatomic origin. Immunohistochemistry demonstrates tumor cells that are strongly positive for desmin and smooth muscle actin (SMA), confirming smooth muscle differentiation. The neoplastic cells are negative for gastrointestinal stromal tumor markers CD34, CD117 (c-KIT), and DOG1, effectively excluding GIST. Diagnostic significance: the combination of characteristic spindle cell morphology and desmin/SMA positivity with CD34/CD117/DOG1 negativity supports a diagnosis of leiomyoma over GIST or leiomyosarcoma. Clinical correlation: these lesions are typically benign with favorable prognosis following complete excision; differential diagnoses include leiomyosarcoma (increased mitotic activity, atypia, necrosis) and GIST (c-KIT or DOG1 positivity). This image exemplifies classical smooth muscle tumor histology and IHC profile, and is useful for educational purposes in surgical pathology, GI/hepatic pathology, and mesenchymal tumor differential diagnosis. Educational diagnostic utility.