While HLRCC-related leiomyomas and sporadic leiomyomas share some common histopathological features, HLRCC-related leiomyomas can also exhibit specific features such as nuclear atypia, the presence of eosinophilic nucleoli and globules, absence of hyalinization, higher microvessel density, and distinct Bcl-2 staining pattern, similar to what we observed in leiomyomatosis with bizarre nuclei [5,20]. Here, BCL2 is linked to hereditary leiomyomatosis and renal cell cancer.