Uterine fibroids - Classification, Types of uterine fibroids
Uterine fibroids - are benign neoplasm that develops as a result of hypertrophy and proliferation of muscle and connective tissue elements. With the predominance of the structure of a tumor of smooth muscle fibers occurs leiomyoma. In the case of the prevalence of striated muscle tissue it comes to rhabdomyomas. In the formation of connective tissue tumors mostly develop fibroids if the addition is determined by the atrophy of muscle fibers, a fibroma. Having a well-developed network of blood vessels of myoma node is classified as angiomyoma.
Classification of uterine fibroids
World Health Organization proposed a classification of leiomyomas of the uterus, depending on their degree of differentiation:
The usual leiomyoma (a benign tumor of mature).
Leiomyoblastoma (epithelioid leiomyoma).
Intravascular leyomiomatoz ("metastatic" leiomyoma, which has all the features of benign tumors, but is able to recur and metastasize in the vascular gap).
Proliferating leiomyoma (which has a slow growth).
Leiomyoma with symptoms predsarkomy (maligniziruyuschayasya).
Uterine fibroids may be solitary (rarely) or multiple (often), it depends on the number of nodes. Depending on their location deep in the body secrete intermuscular or intramural, or submucosal submucous and subserous or subperitoneal leiomyomas types.
Submucous leiomyoma according to the classification of the European Association of Endoscopic Gynecology divided into types depending on the degree of deformation of the uterus:
0 type. Fully submucosal site, do not germinate in the myometrium.
The I type. Less than 50% of the node enters the myometrium.
Type II. Over 50% of penetrating into the host myometrium.
Type III. Between the tumor and host tissues of the endometrium is no layer of myometrium (according to MRI).
Among the subserous myomas release:
0 type. A node on the stem, located entirely in the abdominal cavity.
I type. Less than 50% of the site grow into the myometrium, while it is predominantly in the abdominal cavity.
Type II. Over 50% of the site is intramural.
With respect to the axis of the uterine fibroids may be corporal, is the most common location, with the tumor is determined by the body of the uterus, cervical, which grows in the vagina and contributes to the emergence of infectious complications; peresheechnaya, often provoking the development of pain and violation of urination.
There are atypical forms of fibroids: predsheechnaya, pozadisheechnaya, nadbryushinnaya, retroperitoneal, paracervical, mezhsvyazochnaya (intraligamentarnaya).
Given the size of myoma knots, talking about small tumors smaller than 1.5-2 cm, medium - 4-6 cm, and large - more than 6 cm
Depending on the presence or absence of specific complaints distinguish symptomatic and asymptomatic uterine fibroids. If there is necrosis of the site, sarcomatous degeneration, remalyatsionnaya cyst, hyaline degeneration of neoplasms, talk about complicated form of the disease, in their absence - the uncomplicated.
Taking into account the diversity of uterine fibroids, which are dependent on the size, cellular composition, location and number of myoma nodes, a survey of patients should include a series of laboratory and instrumental investigations. This will help establish the correct diagnosis and select appropriate counseling and treatment.