Diffuse leiomyomatosis of the uterus: A case report with clonality analysis

Diffuse uterine leiomyomatosis is a rare condition distinguished from the c ommon uterine leiomyomata by involvement of the entire myometrium by innume rable, ill-defined, often small and confluent, histologically benign smooth -muscle nodules. Fourteen cases have been previously described in the liter ature. We report a case of diffuse leiomyomatosis in a 39-year-old woman. S everal microscopic foci of the process were microdissected for clonality an alysis. All samples showed a non-random X-chromosome inactivation pattern, and thus were consistent with a monoclonal neoplastic population of cells, However, in different foci of tumor, different X chromosomes were inactivat ed, supporting the independent origin of neoplastic clones and rejecting th e possibility of a single clonal origin of all tumor cells. The results of the molecular analysis suggest that diffuse uterine leiomyomatosis may be a n exuberant example of diffuse and uniform involvement of the entire myomet rium by multiple leiomyomata, HUM PATHOL 31:1429-1432. Copyright (C) 2000 b y W.B. Saunders Company.