> 50% are painful

• Treatment: Simple, conservative excision

• Excellent prognosis; very rarely recurs


• Usually < 2 cm


• Sharp circumscription
• 3 types described: Solid (most common), venous, and cavernous

• Well-differentiated smooth muscle component

• Prominent component of medium- to large-sized blood vessels with dilated or compressed lumina

image Smooth muscle cells can show concentric, perivascular accentuation in some cases

• No significant nuclear atypia or mitotic activity

• Mature adipose tissue, stromal hyalinization, myxoid changes, or calcification may be present

Ancillary Tests

• Strong, diffuse SMA(+) and h-caldesmon (+)

• Desmin (+) but varies in extent

Top Differential Diagnoses

• Myopericytoma

• Hemangioma

• PEComa

Angioleiomyoma is a small, sharply circumscribed smooth muscle neoplasm containing a prominent component of stromal blood vessels. These vessels vary in size and may be compressed (solid variant, shown) or markedly dilated/ectatic (venous and cavernous variants).

Perivascular Growth by Smooth Muscle Cells
Perivascular arrangement image of the lesional smooth muscle cells is a common finding in angioleiomyoma and creates morphologic overlap with myopericytoma. This finding, however, may be focal or absent in some cases.

Mature Smooth Muscle Cells
The well-differentiated smooth muscle cells of angioleiomyoma show classic cytologic features including prominent eosinophilic cytoplasm and elongated, blunt, cigar-shaped nuclei. They are also typically arranged in bundles and fascicles, as seen in other smooth muscle neoplasms.

Cavernous Morphology
The cavernous type of angioleiomyoma has thin-walled, dilated vascular channels image arranged in small clusters within a stroma composed of smooth muscle fibers image that form branching fascicles.



• Vascular leiomyoma

• Angiomyoma


• Benign, well-circumscribed neoplasm composed of mature smooth muscle cells arranged around prominent blood vessels
image Now classified as tumor of pericytic (perivascular) origin (2013 WHO classification)

image Considered to exist on morphologic spectrum with myopericytoma



• Age
image Wide range (most common: 40-70 years)

Apr 24, 2017 | Posted by in PATHOLOGY & LABORATORY MEDICINE | Comments Off on Angioleiomyoma

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