Norris H J, Hilliard G D, Irey N S
Department of Gynecologic and Breast Pathology, Armed Forces Institute of Pathology, Washington, D.C. 20306-6000.
Int J Gynecol Pathol. 1988;7(3):212-24. doi: 10.1097/00004347-198809000-00002.
The clinical and pathological findings in 22 women with a distinctive hemorrhagic cellular (HC) leiomyoma of the uterus are described. Characterized by a dense cellularity accompanied by hemorrhage and edema, 17 occurred in women taking oral contraceptives, three occurred in pregnant women, and one was found in a woman 3 days postpartum. One woman, not pregnant or taking steroids, was using hydrochlorothiazide. Recognition of this special form of leiomyoma associated with the use of reproductive steroids is needed to avoid confusing it with leiomyosarcoma. The major differences with leiomyosarcoma are that HC leiomyomas are generally small, often multiple, and have discrete areas of hemorrhage and tearing artifact, but little or no atypia. Also, their mitotic activity is confined to a narrow zone adjacent to the hemorrhage.
本文描述了22例患有独特的出血性细胞（HC）子宫平滑肌瘤的女性的临床和病理表现。其特征为细胞密集，并伴有出血和水肿，其中17例发生在服用口服避孕药的女性中，3例发生在孕妇中，1例在产后3天的女性中发现。有1名未怀孕或未服用类固醇的女性正在使用氢氯噻嗪。需要认识到这种与生殖类固醇使用相关的特殊形式的平滑肌瘤，以避免将其与平滑肌肉瘤混淆。与平滑肌肉瘤的主要区别在于，HC平滑肌瘤通常较小，常为多发，有离散的出血区域和撕裂伪像，但很少或没有异型性。此外，它们的有丝分裂活性局限于与出血相邻的狭窄区域。
