Morphometric and electron microscopic analyses of the effect of gonadotropin-releasing hormone agonist treatment on arteriole size in uterine leiomyomas.
BACKGROUND
Few studies have been performed on the vascular changes in leiomyomas from patients treated with gonadotropin-releasing hormone agonists (GnRHAs).


OBJECTIVE
To measure luminal diameter and wall thickness of arterioles in uterine leiomyomas using a quantitative stereologic method of analysis.


METHODS
Thirty leiomyomas from 3 study groups were used: (1) patients treated with GnRHAs (10 patient samples), (2) age-matched controls (10 patient samples), and (3) postmenopausal women (10 patient samples). Measurements of arteriolar luminal diameter and wall thickness were made using a video-based, computerized system attached to the microscope, for which a morphometric ad hoc program was written. Electron micrographs were made of random arterioles from the first 2 groups (GnRHA-treated patients and age-matched controls).


METHODS
Department of Pathology, Mount Sinai School of Medicine, New York, NY.


METHODS
A total of 30 patient samples were studied, with 3 groups comprising 10 samples each, including patients treated with GnRHAs, age-matched control patients, and postmenopausal women.


RESULTS
Arterioles in myomas from patients treated with GnRHAs had slightly larger luminal diameters and significantly thicker walls than age-matched controls and resembled arterioles from postmenopausal women. The thickening was due to smooth muscle cell hyperplasia in the muscularis media.


CONCLUSIONS
Treatment with GnRHAs causes a thickening of the walls of intramyomatous arterioles, which resemble those of postmenopausal women. This thickening may play a role in the decreased flow of blood reported in GnRHA treatment.
Kalir
T
T
Department of Pathology, Mount Sinai School of Medicine, New York, NY 10029, USA. Tamara.Kalir@smtplink.mssm.edu
Wu
H
H
Gordon
R E
RE
Gil
J
J
D000328:Adult; D001160:Arterioles / Q000473:pathology*; D005260:Female; D006801:Humans; D006965:Hyperplasia; D007889:Leiomyoma / Q000098:blood supply* / Q000473:pathology; D016729:Leuprolide / Q000008:administration & dosage / Q000627:therapeutic use; D008854:Microscopy, Electron; D008875:Middle Aged; D009131:Muscle, Smooth, Vascular / Q000473:pathology; D017274:Nafarelin / Q000008:administration & dosage / Q000627:therapeutic use*; D017698:Postmenopause; D014594:Uterine Neoplasms / Q000098:blood supply* / Q000473:pathology
D017274:Nafarelin; D016729:Leuprolide