Gynaecology for students and practitioners . enerai-ioncysts Large cystic cavitybeneath capsule Fig. 224. Large Retroperitoneal Fibroid Tumour. A large subcapsularcystic space has been formed in the lower part of the Figure, and manysmaller spaces in other parts. The large cystic space has smooth walls, cf. Fig. 225. in the direction of the muscular bundles. The macroscopic appearanceof fat in a myoma is variable, being influenced by associated conditionsdue to changes in the blood. The cut surface of a fatty myoma maybe pale yellowish in colour, but it is often tinted by soluble blood-pigment
Gynaecology for students and practitioners . enerai-ioncysts Large cystic cavitybeneath capsule Fig. 224. Large Retroperitoneal Fibroid Tumour. A large subcapsularcystic space has been formed in the lower part of the Figure, and manysmaller spaces in other parts. The large cystic space has smooth walls, cf. Fig. 225. in the direction of the muscular bundles. The macroscopic appearanceof fat in a myoma is variable, being influenced by associated conditionsdue to changes in the blood. The cut surface of a fatty myoma maybe pale yellowish in colour, but it is often tinted by soluble blood-pigment. The normal whorled appearance is obscured, and thesurface is homogeneous. Microscopically, the changes are those of hyaline degeneration towhich the deposition of fat-globules is added. Thus there are seen(1) irregular and scanty nuclear staining ; (2) granular and hyalinechange ; (3) fat-globules running in the original direction of the SECONDARY CHANGES IN FIBROIDS 449 muscle-fibres ; (4) fat within wandering phagocytes, both inside and. Fig. 225. Large SuBSEROtis Fibroid attached to the Uterus by a broad Base. The upper half of the tumoiix is cystic. The cyst shows a convoluted , false membrane. The contents were viscid blood-stained fluid and the original change was hyaline degeneration probably followed by red necrosis. U, Uterus. outside lymphatics ; (5) signs of vascular degeneration, engorgement,thrombosis, and fibrin-deposits in the vessels. The above description applies to a true degenerative process, which 29 450 GYNECOLOGY is, as already stated, a precursor of calcareous degeneration. Italso invariably precedes necrosis, a point to which further referencewill be made. The presence of fat in a myoma appears in some rare instancesto be due to a vital but depraved activity, which is akin to lipoma-formation elsewhere in the body. Such terms therefore as lipomyoma,fibro-lipomyoma, and lipomatosis have been used to describe this pseudo-growth. Microscopically, the fat-
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Keywords: ., bookcentury1900, bookdecade1910, booksubjectgynecology, bookyear1
