Red degeneration of a leiomyoma
Updates to Article Attributes
Body
was changed:
Red or carneous degeneration is one of a five main types degeneration that can involve a uterine leiomyoma. While it is an uncommon type degeneration it is thought to be the most common form of degeneration of a leiomyoma during pregnancy 3.
Clinical presentation
Patients with a leiomyoma undergoing red degeneration may present with abdominal pain (particularly during pregnancy). It may also give systemic symptoms such as fever and leucocytosis.
Pathology
Carneous degeneration is a subtype of haemorrhagic infarction of leiomyomas that often occurs during pregnancy. On gross pathology, it is characterized by a red (haemorrhagic) appearance of the leiomyoma. Red degeneration primarily occurs secondary to venous thrombosis within the periphery of the tumor or rupture of intratumoral arteries 4.
Radiographic features
MRI
Unusual signal intensity patterns have described on MR imaging 1,4:
-
T1
:- can have peripheral (rim) or diffuse high signal intensity
- the high signal intensity on T1-weighted images is likely secondary to the proteinaceous content of the blood or the T1-shortening effects of methemoglobin
-
T2
:- variable signal intensity with or without a low-signal-intensity rim.
- when high signal intensity is isolated to the rim of the leiomyoma, it has been hypothesized that the blood products are confined to thrombosed vessels that surround the tumor
- when it shows rim - perihperalchanges these findings were thought to correspond to numerous dilated vessels filled with red blood cells at the periphery of the lesion.
- the signal characteristics of the rim are best explained as an effect of abundant intracellular methemoglobin in these vessels 1.
-<p><strong>Red or carneous degeneration</strong> is one of a five main types degeneration that can involve a <a href="/articles/uterine-leiomyoma">uterine leiomyoma</a>. While it is an uncommon type degeneration it is thought to be the most common form of degeneration of a leiomyoma during pregnancy <sup>3</sup>.</p><h4>Clinical presentation</h4><p>Patients with a leiomyoma undergoing red degeneration may present with abdominal pain (particularly during pregnancy). It may also give systemic symptoms such as fever and leucocytosis. </p><h4>Pathology</h4><p>Carneous degeneration is a subtype of haemorrhagic infarction of leiomyomas that often occurs during pregnancy. On gross pathology, it is characterized by a red (haemorrhagic) appearance of the leiomyoma. Red degeneration primarily occurs secondary to venous thrombosis within the periphery of the tumor or rupture of intratumoral arteries <sup>4</sup>.</p><h4>Radiographic features</h4><h5>MRI</h5><p>Unusual signal intensity patterns have described on MR imaging <sup>1,4</sup> :</p><ul>- +<p><strong>Red or carneous degeneration</strong> is one of a five main types degeneration that can involve a <a href="/articles/uterine-leiomyoma">uterine leiomyoma</a>. While it is an uncommon type degeneration it is thought to be the most common form of degeneration of a leiomyoma during pregnancy <sup>3</sup>.</p><h4>Clinical presentation</h4><p>Patients with a leiomyoma undergoing red degeneration may present with abdominal pain (particularly during pregnancy). It may also give systemic symptoms such as fever and leucocytosis. </p><h4>Pathology</h4><p>Carneous degeneration is a subtype of haemorrhagic infarction of leiomyomas that often occurs during pregnancy. On gross pathology, it is characterized by a red (haemorrhagic) appearance of the leiomyoma. Red degeneration primarily occurs secondary to venous thrombosis within the periphery of the tumor or rupture of intratumoral arteries <sup>4</sup>.</p><h4>Radiographic features</h4><h5>MRI</h5><p>Unusual signal intensity patterns have described on MR imaging <sup>1,4</sup>:</p><ul>
-<strong>T1</strong> :<ul>- +<strong>T1</strong><ul>
-<strong>T2</strong> : <ul>- +<strong>T2</strong> <ul>
-<li>when it shows rim - perihperal changes these findings were thought to correspond to numerous dilated vessels filled with red blood cells at the periphery of the lesion.</li>- +<li>when it shows rim - perihperal changes these findings were thought to correspond to numerous dilated vessels filled with red blood cells at the periphery of the lesion.</li>