We report 3 cases of a distinctive uterine leiomyoma containing numerous thick-walled vascular channels, which we term angioleiomyoma. The leiomyomas occurred in women aged 33, 44, and 49 and ranged from 1.5 to 6.0 cm. They were composed of bland, spindle-shaped cells with numerous evenly distributed, arteriole-like vessels with thick muscular walls throughout. The spindle cells often swirled around the vessels. In 1 case, fibrin was present within vessel walls. The spindle cells were positive with smooth-muscle markers and negative with HMB45. We believe angioleiomyoma should be recognized as a distinct entity and included in the World Health Organization classification of tumors of the female genital tract as a benign leiomyoma variant, similar to cellular and atypical leiomyoma. Uterine angioleiomyoma has a close morphological resemblance to the similarly named skin tumor. We review uterine smooth-muscle and other mesenchymal neoplasms in which prominent vascular channels are a feature.

Mounting evidence supports incorporation of HPV testing into cervical screening; however, the optimal test format and target population have yet to be confirmed. Assessment of the potential benefits of type-specific testing requires estimation of the risk associated with infection with individual HPV types. However, the risk posed by individual HPV types may be population specific and influenced by cervical screening practice. The existing data on HPV type-specific risk is derived largely from unscreened populations. Our study addressed the lack of data on HPV type-specific risk in cytologically screened populations using a casecontrol study of 262 invasive cervical cancers diagnosed in Wales between 2000 and 2006, and 8,428 controls who attended for cytological screening in 2004. The analysis showed that the odds ratios (ORs) for infection with HPV 16 and 18 are considerable; 2770 (95% CI 1050-7320) and 950 (95% CI 330-2740), respectively, and that the OR for other oncogenic types are in general considerably less (ranging, where quantified, from 20.2 to 386 in the same population). The effect of age on OR associated with particular HPV types was also assessed; this indicated that infection with a high-risk HPV in women older than 40 years was associated with an approximately 30-fold increased risk of invasive cervical cancer relative to women younger than 40 years. These results indicate that there is significant prognostic information associated with knowledge of HPV type.Human papillomavirus (HPV) is present in the vast majority of invasive cervical cancers and is considered the primary cause of this disease.1 In the United Kingdom, vaccination to prevent infection with two oncogenic types of HPV (16 and 18) commenced in September 2008, with vaccine being given to 12-to 13-year-old girls born between September 1995 and August 1996. A 2-year catch up program for women aged up to 18 years is also underway. In clinical trials, this vaccine has shown 100% efficacy for prevention of both persistent infection and high-grade cervical intraepithelial neoplasia associated with HPV 16 and 18 in HPV naïve women. 2 It is likely that cervical screening in the United Kingdom will change substantially in the near future, with two main factors driving this change. The first is the growing body of evidence showing that HPV testing has greater sensitivity than cytological screening for cervical cancer and precancer.3-5 The second is the expected reduction in the positive predictive value of cytological screening after introduction of vaccination; this is inevitable as the number of false positives will remain the same while the number of true positives will decline. However, there remain many questions regarding how best to use HPV testing. These include whether genotyping for specific HPV types is worthwhile, and what is the significance of a positive HPV test result in different age groups.The objectives of our study were to investigate the potential benefit of HPV genotyping by assessing the risk of cervical cancer associa...

The pathogenesis of these microscopic extraovarian sex cord proliferations is unknown, but they may represent non-neoplastic proliferations of embryonic remnants.

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