The Natural History of Uterine Leiomyomas: Morphometric Concordance with Concepts of Interstitial Ischemia and InanosisReport as inadecuate




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Obstetrics and Gynecology InternationalVolume 2013 2013, Article ID 285103, 9 pages

Research Article

Cellular and Molecular Pathology Branch, National Toxicology Program NTP, National Institute of Environmental Health Sciences NIEHS, National Institutes of Health NIH, Department of Health and Human Services, Research Triangle Park, NC 27709, USA

Molecular Pathogenesis Group, National Toxicology Program Laboratory NTPL, National Toxicology Program NTP, National Institute of Environmental Health Sciences NIEHS, National Institutes of Health NIH, Department of Health and Human Services, Research Triangle Park, NC 27709, USA

Biostatistics Branch, Division of Intramural Research, National Toxicology Program NTP, National Institute of Environmental Health Sciences NIEHS, National Institutes of Health NIH, Department of Health and Human Services, Research Triangle Park, NC 27709, USA

Department of Pathology, Duke University Medical Center, Durham, NC 27710, USA

Received 4 March 2013; Accepted 30 July 2013

Academic Editor: Pasquapina Ciarmela

Copyright © 2013 Gordon P. Flake et al. This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Abstract

Based upon our morphologic observations, we hypothesize and also provide morphometric evidence for the occurrence of progressive developmental changes in many uterine fibroids, which can be arbitrarily divided into 4 phases. These developmental phases are related to the ongoing production of extracellular collagenous matrix, which eventually exceeds the degree of angiogenesis, resulting in the progressive separation of myocytes from their blood supply and a condition of interstitial ischemia. The consequence of this process of slow ischemia with nutritional and oxygen deprivation is a progressive myocyte atrophy or inanition, culminating in cell death, a process that we refer to as inanosis. The studies presented here provide quantitative and semiquantitative evidence to support the concept of the declining proliferative activity as the collagenous matrix increases and the microvascular density decreases.





Author: Gordon P. Flake, Alicia B. Moore, Norris Flagler, Benita Wicker, Natasha Clayton, Grace E. Kissling, Stanley J. Robboy, and

Source: https://www.hindawi.com/



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