case_images: PMC11251876_01
case_images: A 40-year-old patient with diffuse uterine leiomyomatosis. (A-C) Diffuse thickening of the myometrium with multiple masses showing a low signal in sagittal T2WI, mild enhancement in sagittal T1-enhanced image, and a slightly greater signal in DWI. T2WI, T2-weighted imaging; DWI, diffusion-weighted imaging.
case_images: fonc-14-1430531-g001.jpg
case_images: PMC11251876_01_fonc-14-1430531-g001.jpg
case_images: f1
case_images: The enhancement of the lesions was slightly lower than that of the uterine body ( Figure 1 ). The diagnosis was multiple uterine leiomyomas. The right ovary showed a long cystic T1 and long T2 signal, measuring approximately 27 mm x 22 mm, with no obvious appearance on the enhanced scan.
case_images: The same patient shown in 
  Figure 1
  . (A) The tumor cells of the patient with diffuse uterine leiomyomatosis were long and fusiform. The cytoplasm was rich in red dye and was arranged in bundles or interleaved shapes according to H&E staining. (B) The SMA (+) is shown by immunohistochemical staining.
case_images: fonc-14-1430531-g002.jpg
case_images: PMC11251876_01_fonc-14-1430531-g002.jpg
case_images: f2
case_images: The immunostaining results were as follows: P53 (some positive), progesterone receptor (PR) (+), smooth muscle actin (SMA) (+), CD10 (-), Ki-67 (approximately 5%-10%+), and P16 (some +) ( Figure 2 ).
case_images: PMC11251876_02
case_images: A 46-year-old patient with diffuse uterine leiomyomatosis (DUL) with peritoneal disseminated leiomyoma (DPL). (A-D) A large mass was observed in the anterior wall of the uterus. In addition, multiple masses were also observed in the posterior wall of the uterus and the abdominal and pelvic cavities beside the peritoneum (arrow). The masses above the myometrium and beside the peritoneum showed low signal intensity on sagittal T2WI, mild signal intensity on sagittal T1WI, and greater signal intensity on DWI. T2WI, T2-weighted imaging; T1WI, T1-weighted imaging; DWI, diffusion-weighted imaging.
case_images: fonc-14-1430531-g003.jpg
case_images: PMC11251876_02_fonc-14-1430531-g003.jpg
case_images: f3
case_images: T2WI, isointensity on T1WI, and hyperintensity on DWI. The diagnosis indicated a typical uterine leiomyoma, while multiple lesions in the abdomen and pelvis were identified as metastatic tumors ( Figure 3 ).
case_images: The same patient shown in 
  Figure 3
  . (A) The tumor cells of patients with diffuse uterine leiomyomatosis were long and fusiform. The cytoplasm was rich in red dye and was arranged in bundles or interleaved shapes according to H&E staining. (B) Immunohistochemical staining for h-caldesmon (+) is shown.
case_images: fonc-14-1430531-g004.jpg
case_images: PMC11251876_02_fonc-14-1430531-g004.jpg
case_images: f4
case_images: The immunostaining results were as follows: P53 (-), Ki-67 (<1% +), SMA (+), caldesmon (+), and CD117 (a few scattered +) ( Figure 4 ).