Walocha Jerzy A, Litwin Jan A, Miodoński Adam J
Departments of Anatomy, Histology and Laboratory of Scanning Electron Microscopy, Jagiellonian University Medical College, Kopernika 12, 31-034 Kraków, Poland.
Hum Reprod. 2003 May;18(5):1088-93. doi: 10.1093/humrep/deg213.
The vascular system of leiomyomata, the most common benign tumours in women, is an important factor controlling development and growth of the tumour. It has not been, however, investigated morphologically using the best currently available technique, corrosion casting combined with scanning electron microscopy.
Myomatous uteri collected upon autopsy were perfused via afferent vessels with fixative followed by Mercox resin and corroded after polymerization of the resin. The obtained vascular casts visualizing all vessels including capillaries were examined using scanning electron microscopy.
The smallest (1-3 mm) fibroids were avascular, in larger ones (<1 cm) a few small vessels invaded the lesion from the periphery. The largest tumours (>1 cm) contained irregular networks of blood vessels with density similar to or lower than that of normal myometrium. Such tumours were surrounded by an extremely dense vascular layer ('vascular capsule') which was the source of larger vessels supplying and draining the tumour.
During development of leiomyoma, the pre-existing blood vessels undergo regression and new vessels invade the tumour from the periphery, where intense angiogenesis, probably promoted by growth factors secreted by the tumour, leads to the formation of a 'vascular capsule' responsible for supply of blood to the growing tumour.
平滑肌瘤是女性最常见的良性肿瘤，其血管系统是控制肿瘤发生和生长的重要因素。然而，尚未采用目前最先进的技术——铸型腐蚀结合扫描电子显微镜对其进行形态学研究。
对尸检收集的子宫肌瘤标本，经传入血管灌注固定剂，随后灌注Mercox树脂，树脂聚合后进行腐蚀。使用扫描电子显微镜检查获得的显示包括毛细血管在内的所有血管的血管铸型。
最小的（1 - 3毫米）肌瘤无血管，稍大的（<1厘米）肌瘤有少数小血管从周边侵入病变。最大的肿瘤（>1厘米）含有不规则的血管网络，其密度与正常肌层相似或更低。此类肿瘤被一层极其致密的血管层（“血管包膜”）所包围，该血管层是为肿瘤供血和引流的较大血管的来源。
在平滑肌瘤发生过程中，原有血管发生退化，新血管从周边侵入肿瘤，在周边部位，可能由肿瘤分泌的生长因子促进的强烈血管生成导致形成负责为生长中的肿瘤供血的“血管包膜”。
