The Natural History of Uterine Leiomyomas: Light and Electron Microscopic Studies of Fibroid Phases, Interstitial Ischemia, Inanosis, and Reclamation
Figure 16
Reclamation. Cytologic and histologic changes are sometimes noted in involuting fibroids that are suggestive of cell resorption, a process that we refer to as reclamation. Angulated nuclear shapes, such as the triangular shaped nucleus in (a) (arrow) and the burr-shaped nuclei (acanthanuclear alteration) in (b) (arrows), are aberrant shapes that would not be expected in viable cells and may be related to loss of nuclear membrane integrity. Structures that appear to be hollow or empty nuclei, with only a shell of surrounding cytoplasm, are noted in (c) (arrows), and these structures often lie within clear spaces in the stroma that may represent resorption pits (arrowheads). Small fragments of probable cytoplasmic material are sometimes noted within clearings in the stroma, as seen in (d) (arrow); whether these are discarded lateral buds or decapitated particles of cell cytoplasm is uncertain. Finally, clear, circular spaces are sometimes noted within hyalinized areas of Phase 4 tumors, as seen in (e) and (f) (arrows) that are believed to be the end stage of the reclamation process. In (e), inanotic dead cells are also noted (arrowheads). In (f), the clear spaces are numerous, resulting in a spongiform appearance. Original magnification of (a): 330x, (b): 330x, (c): 330x, (d): 198x, (e): 132x, and (f): 40x.
