上海交通大学医学院：《妇产科学》（双语） 13 Myoma of Uterus

Myoma of Uterus Xu ho 2003-11-3

2003-11-3 1 Myoma of Uterus Xu Hong

Synonyms eiomyoma of uterus leiomyomas fibromyoma myofibroma fibroids fibromas myomas 2003-11-3 2

2003-11-3 2 Synonyms leiomyoma of uterus leiomyomas fibromyomas myofibromas fibroids fibromas myomas

Incidence o Most common solid pelvic tumors o Develop in 2025%of women during reproductive years 930-50 years old 2003-11-3

2003-11-3 3 Incidence Most common solid pelvic tumors Develop in 20～25% of women during reproductive years 30～50 years old

Correlative Factors puberty o An estrogenic milieu may be necessary 青春期 o Progesterone function menopause 绝经期 estrogen progesterone 雌激素 孕激素 o Growth factor and their receptor epithelial growth factor (EGF Insulin-like growth factor (IGF) platelet-derived growth factor 2003-11-3 4

2003-11-3 4 Correlative Factors An estrogenic milieu may be necessary Progesterone function Growth factor and their receptor： epithelial growth factor（EGF） Insulin-like growth factor（IGF） platelet-derived growth factor puberty 青春期 menopause 绝经期 estrogen 雌激素 progesterone 孕激素

Pathology 2003-11-3

2003-11-3 5 Pathology

Gross Appearance o Rare only a single, usually many exist o Well-circumscribed, nonencapsulated pseudocapsule pseudocapsule is present 假包膜 o The consistency is usually firm or even hard except when degeneration or hemorrhage has occurred o color: light gray or pinkish white o cut section: an intertwining pattern or a whorl-like arrangement bung. 2003-11-3 6

2003-11-3 6 Gross Appearance Rare only a single，usually many exist Well-circumscribed，nonencapsulated A pseudocapsule is present. The consistency is usually firm or even hard except when degeneration or hemorrhage has occurred. color：light gray or pinkish white cut section：an intertwining pattern or a whorl-like arrangement； bulgy pseudocapsule 假包膜

Smooth muscle tumors of the uterus are often multiple. Seen here are submucosal, intramural and subserosal leiomyomata of the uterus 2003-11-3

2003-11-3 7 Smooth muscle tumors of the uterus are often multiple. Seen here are submucosal, intramural, and subserosal leiomyomata of the uterus

Microscopic Appearance Q Composition: smooth muscle connective tissue o The nonstriated muscle fibers are arranged in bundles of various sizes that run in multiple directions 2003-11-3 8

2003-11-3 8 Microscopic Appearance Composition：smooth muscle connective tissue The nonstriated muscle fibers are arranged in bundles of various sizes that run in multiple directions

Classification(1) According to growth location Myomas on the body of uterus(90%) Myomas on the cervix of uterus (10%) 2003-11-3

2003-11-3 9 Classification（1） According to growth location： • Myomas on the body of uterus（90%） • Myomas on the cervix of uterus（10%）

Classification(2 According to the relation to uterine muscle Submucous (10 15%) Intramural(60%) Subserosal(20%) Few leiomyomas are actually of a single pure type hybrids 2003-11-3

2003-11-3 10 Classification（2） According to the relation to uterine muscle： • Submucous（10 ～ 15%） • Intramural（60 ～ 70%） • Subserosal（20%） Few leiomyomas are actually of a single “pure” type. — hybrids