page_title: Uterine fibroid
section_title: Pathophysiology
hierarchical_section_title: Uterine fibroid / Pathophysiology
caption_attribution_description: English: Micrograph of a lipoleiomyoma. H&amp;E stain. Micrograph of a uterine lipoleiomyoma. H&amp;E stain. Lipoleiomyomas are a type of leiomyoma and commonly known as fibroids. Gross appearance: Sharply circumscribed. Gray-white. Whorled appearance. Microscopic appearance: Well-demarcated border. Spindle cells in a whorled arrangement. Few mitoses. See also Low magnification micrograph of a lipoleiomyoma
context_page_description: Uterine fibroids, also known as uterine leiomyomas or fibroids, are benign smooth muscle tumors of the uterus. Most women have no symptoms while others may have painful or heavy periods. If large enough, they may push on the bladder causing a frequent need to urinate. They may also cause pain during sex or lower back pain. A woman can have one uterine fibroid or many. Occasionally, fibroids may make it difficult to become pregnant, although this is uncommon.
  The exact cause of uterine fibroids is unclear. However, fibroids run in families and appear to be partly determined by hormone levels. Risk factors include obesity and eating red meat. Diagnosis can be performed by pelvic examination or medical imaging.
  Treatment is typically not needed if there are no symptoms. NSAIDs, such as ibuprofen, may help with pain and bleeding while paracetamol may help with pain. Iron supplements may be needed in those with heavy periods. Medications of the gonadotropin-releasing hormone agonist class may decrease the size of the fibroids but are expensive and associated with side effects. If greater symptoms are present, surgery to remove the fibroid or uterus may help.
context_section_description: Fibroids are a type of uterine leiomyoma. Fibroids grossly appear as round, well circumscribed (but not encapsulated), solid nodules that are white or tan, and show whorled appearance on histological section. The size varies, from microscopic to lesions of considerable size. Typically lesions the size of a grapefruit or bigger are felt by the patient herself through the abdominal wall.
  Microscopically, tumor cells resemble normal cells (elongated, spindle-shaped, with a cigar-shaped nucleus) and form bundles with different directions (whorled). These cells are uniform in size and shape, with scarce mitoses. There are three benign variants: bizarre (atypical); cellular; and mitotically active.
  The appearance of prominent nucleoli with perinucleolar halos should alert the pathologist to investigate the possibility of the extremely rare hereditary leiomyomatosis and renal cell cancer (Reed) syndrome.
caption: Micrograph of a lipoleiomyoma, a type of leiomyoma. H&E stain.
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