The Natural History of Uterine Leiomyomas: Morphometric Concordance with Concepts of Interstitial Ischemia and Inanosis

Figure 6

Phase 4 fibroid. Note that the only remaining viable cells in this field of a phase 4 fibroid are clustered around and between the two vessels. Most of these cells lie within 50–75 μm of the 2 capillaries. The cell at 2 o’clock (short arrow) is located almost 100 μm from the capillary in the center, and there are no viable cells beyond this point. The cell marked by an arrowhead is 50 μm from the central vessel, and the apparent nuclear ghost (long arrow) is 70 μm from the vessel. This suggests that in the setting of hyalinized fibroid stroma the maximum cell to vascular distance that is compatible with cell survival is in the range of 70–100 μm, and that other factors such as the local density of the stroma may also play a role. 20x, anti-Factor 8 immunostain.