The Natural History of Uterine Leiomyomas: Light and Electron Microscopic Studies of Fibroid Phases, Interstitial Ischemia, Inanosis, and Reclamation
We propose, and offer evidence to support, the concept that many uterine leiomyomas pursue a self-limited life cycle. This cycle can be arbitrarily divided on the basis of morphologic assessment of the collagen content into 4 phases: (1) proliferation, (2) proliferation and synthesis of collagen, (3...
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| Format: | Article |
| Language: | English |
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Wiley
2013-01-01
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| Series: | Obstetrics and Gynecology International |
| Online Access: | http://dx.doi.org/10.1155/2013/528376 |
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| author | Gordon P. Flake Alicia B. Moore Deloris Sutton Grace E. Kissling John Horton Benita Wicker David Walmer Stanley J. Robboy Darlene Dixon |
| author_facet | Gordon P. Flake Alicia B. Moore Deloris Sutton Grace E. Kissling John Horton Benita Wicker David Walmer Stanley J. Robboy Darlene Dixon |
| author_sort | Gordon P. Flake |
| collection | DOAJ |
| description | We propose, and offer evidence to support, the concept that many uterine leiomyomas pursue a self-limited life cycle. This cycle can be arbitrarily divided on the basis of morphologic assessment of the collagen content into 4 phases: (1) proliferation, (2) proliferation and synthesis of collagen, (3) proliferation, synthesis of collagen, and early senescence, and (4) involution. Involution occurs as a result of both vascular and interstitial ischemia. Interstitial ischemia is the consequence of the excessive elaboration of collagen, resulting in reduced microvascular density, increased distance between myocytes and capillaries, nutritional deprivation, and myocyte atrophy. The end stage of this process is an involuted tumor with a predominance of collagen, little to no proliferative activity, myocyte atrophy, and myocyte cell death. Since many of the dying cells exhibit light microscopic and ultrastructural features that appear distinct from either necrosis or apoptosis, we refer to this process as inanosis, because it appears that nutritional deprivation, or inanition, is the underlying cause of cell death. The disposal of myocytes dying by inanosis also differs in that there is no phagocytic reaction, but rather an apparent dissolution of the cell, which might be viewed as a process of reclamation as the molecular contents are reclaimed and recycled. |
| format | Article |
| id | doaj-art-4b81a157f4184b4cbfdf9c12113ddbb3 |
| institution | Kabale University |
| issn | 1687-9589 1687-9597 |
| language | English |
| publishDate | 2013-01-01 |
| publisher | Wiley |
| record_format | Article |
| series | Obstetrics and Gynecology International |
| spelling | doaj-art-4b81a157f4184b4cbfdf9c12113ddbb32025-02-03T07:26:10ZengWileyObstetrics and Gynecology International1687-95891687-95972013-01-01201310.1155/2013/528376528376The Natural History of Uterine Leiomyomas: Light and Electron Microscopic Studies of Fibroid Phases, Interstitial Ischemia, Inanosis, and ReclamationGordon P. Flake0Alicia B. Moore1Deloris Sutton2Grace E. Kissling3John Horton4Benita Wicker5David Walmer6Stanley J. Robboy7Darlene Dixon8Cellular 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, USAMolecular 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, USACellular 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, USABiostatistics Branch, National Toxicology Program (NTP), Division of Intramural Research, National Institute of Environmental Health Sciences (NIEHS), National Institutes of Health (NIH), Department of Health and Human Services, Research Triangle Park, NC 27709, USACellular 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, USACellular 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, USADuke University Medical Center, Durham, NC 27710, USADuke University Medical Center, Durham, NC 27710, USAMolecular 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, USAWe propose, and offer evidence to support, the concept that many uterine leiomyomas pursue a self-limited life cycle. This cycle can be arbitrarily divided on the basis of morphologic assessment of the collagen content into 4 phases: (1) proliferation, (2) proliferation and synthesis of collagen, (3) proliferation, synthesis of collagen, and early senescence, and (4) involution. Involution occurs as a result of both vascular and interstitial ischemia. Interstitial ischemia is the consequence of the excessive elaboration of collagen, resulting in reduced microvascular density, increased distance between myocytes and capillaries, nutritional deprivation, and myocyte atrophy. The end stage of this process is an involuted tumor with a predominance of collagen, little to no proliferative activity, myocyte atrophy, and myocyte cell death. Since many of the dying cells exhibit light microscopic and ultrastructural features that appear distinct from either necrosis or apoptosis, we refer to this process as inanosis, because it appears that nutritional deprivation, or inanition, is the underlying cause of cell death. The disposal of myocytes dying by inanosis also differs in that there is no phagocytic reaction, but rather an apparent dissolution of the cell, which might be viewed as a process of reclamation as the molecular contents are reclaimed and recycled.http://dx.doi.org/10.1155/2013/528376 |
| spellingShingle | Gordon P. Flake Alicia B. Moore Deloris Sutton Grace E. Kissling John Horton Benita Wicker David Walmer Stanley J. Robboy Darlene Dixon The Natural History of Uterine Leiomyomas: Light and Electron Microscopic Studies of Fibroid Phases, Interstitial Ischemia, Inanosis, and Reclamation Obstetrics and Gynecology International |
| title | The Natural History of Uterine Leiomyomas: Light and Electron Microscopic Studies of Fibroid Phases, Interstitial Ischemia, Inanosis, and Reclamation |
| title_full | The Natural History of Uterine Leiomyomas: Light and Electron Microscopic Studies of Fibroid Phases, Interstitial Ischemia, Inanosis, and Reclamation |
| title_fullStr | The Natural History of Uterine Leiomyomas: Light and Electron Microscopic Studies of Fibroid Phases, Interstitial Ischemia, Inanosis, and Reclamation |
| title_full_unstemmed | The Natural History of Uterine Leiomyomas: Light and Electron Microscopic Studies of Fibroid Phases, Interstitial Ischemia, Inanosis, and Reclamation |
| title_short | The Natural History of Uterine Leiomyomas: Light and Electron Microscopic Studies of Fibroid Phases, Interstitial Ischemia, Inanosis, and Reclamation |
| title_sort | natural history of uterine leiomyomas light and electron microscopic studies of fibroid phases interstitial ischemia inanosis and reclamation |
| url | http://dx.doi.org/10.1155/2013/528376 |
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