인체 자궁근종(子宮筋腫)의 병리조직학적 및 조직화학적 연구

Abstract

[한글]

[영문]

A myoma of the uterus is one of the most common of human tumors and much the most frequent of uterine neoplasms (novak and Woodruff, 1967), and composed mainly of muscle but with some fibrous connective tissue elements and well circumscribed but

not encapsulated benign tumor. The macroscopic and microscopic features, however, may be greatly altered by certain secondary degenerative processes such as hyaline degeneration, cystic degeneration, calcification, infection and suppuration, necrosis, fatty change and sarcomatous degenerations.

Until now, little or nothing is known as to the underlying causes for the development of myoma, but the possible roles of hereditary factor, sterility and ovarian hormonal disturbances have been discussed.

And it is now quite generally accepted thea the source of uterine myoma is muscle tissue such as genitoblast introduced by DeSnoo (1934). Miller and Ludovici (1950) also considered the persistence of such cells as almost a necessity. But the

variation of secondary degeneration and the pattern of other connective tissue elements according to the type of myoma, to the age of patients and to the size of tumors are not well known.

The present study is an attempt to investigate this variation of the patterns of secondary degeneration, collagen fiber, elastic fiber and acid micopolysaccharide according to age of patients, size and type of the myomas.

Materials and method.

Materials consist of 44 myoma masses removed surgically from the patients and confirmed as having myoma in the body of the uterus. The cases were randomly collected from each age groups such as second, third , forth, fifth and sixth decades and there were 5 cases in 2nd, 12 cases in 3rd, 12 cases in 4th 12 cases in

5 th and 3 cases in 6th decade.

The sections were removed from the myoma masses and fixed in 10% formalin at least 24 hours. The sections were embedded in paraffin and sections were made 6μ in thickness and stained by hematoxylin-eosin method, routinely. For histochemical examinations, Van Gieson's stain, Verhoeff's elastic stain, and alcien blue stain were used.

Results and Summary

Among 44 myoma masses, 36cases showed some degree of hyaline degeneration, revealing the rate over 70 per cent in very age group, and were followed by cystic degeneration, necrosis and calcification in order of frequency. But no sarcomatous change was noted. The degree of hyaline degeneration was related to neither the age of patients, nor type of the myoma, but to the size of the tumor. The bigger one is more degenerative.

The collagen fibers were frankly identified in 42 cases and questionablly in 2 cases. ut the amount was variable and not related to age of patient, type and size of the tumors.

The elastic fibers were found within any myoma masses. The acid

micopolysaccharide was found but variable in amount and not related to any examined item.