Iranian Journal of Pathology

A Case of Premenopausal Uterine Leiomyoma, Non-cirrhotic Portal Fibrosis, Hepatic Koch's, a PET Gone Astray-Morphology Antidotes a Confounding Concoction

Document Type : Case Reports

Authors

Kavita Gaur 1
Shailaja Shukla 1
Shinjini Choudhury 1
Pankaj Raj 1
Sharda Patra 2

1 Department of Pathology, Lady Hardinge Medical College, Shaheed Bhagat Singh Marg, New Delhi, India

2 Department of Obstetrics and Gynaecology Lady Hardinge Medical College, Shaheed Bhagat Singh Marg, New Delhi, India

https://doi.org/10.30699/ijp.2022.540258.2743
Abstract
Uterine leiomyoma with hepatic vasculopathy, specifically non-cirrhotic portal fibrosis (NCPF), has hitherto been undescribed. NCPF is characterized by elevated portal pressure sans cirrhosis and has previously not been described in association with a gynecological pathology. We report the case of a female under evaluation for a heterogeneously enhancing intrauterine mass with multiple hepatic lesions with increased uptake of fluorodeoxyglucose on positron emission analysis. Fibroscan values were increased. Histopathologic evaluations revealed a leiomyoma with liver tissue showing tubercular granulomas, thin wispy fibrotic strands, and rounded portal tracts pointed to NCPF. No evidence of malignancy was seen. Metabolic imaging may be unreliable to distinguish between benign and malignant uterine pathology and granulomatous and malignant hepatic lesions. Elastography may also be ineffective in diagnosing the etiology of liver fibrosis. Histopathological analysis hence remains essential despite noninvasive tests. Further research is required on females afflicted with NCPF to exclude a hormonal link.

Highlights

  • Possibility of a hormonal link between uterine leiomyoma and non-cirrhotic portal fibrosis
  • Fluorodeoxyglucose Positron emission analysis may be falsely positive in benign conditions
  • Histopathological analysis remains paramount despite the dawn of a noninvasive and serological era

Keywords

Fibrosis
Leiomyoma
Liver
Positron emission tomography
Uterus

Subjects

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Iranian Journal of Pathology
Volume 17, Issue 2
Spring 2022
Pages 229-233

  • Receive Date 03 October 2021
  • Revise Date 21 December 2021
  • Accept Date 21 December 2021

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