FH and leiomyosarcoma: FH-deficient leiomyomas demonstrate more cellularity, nuclear atypia, and increased mitotic index, making them prone to being misdiagnosed as smooth muscle tumors of uncertain malignant potential and uterine leiomyosarcoma [3]. Key histological features include staghorn vessels, stromal edema creating an appearance similar to that of lung alveoli, large nucleoli with perinucleolar clearing, and hyaline globules in the cytoplasm [2].