HISTOPATHOLOGIC FINDINGS IN 107 UTERINE LEIOMYOMAS TREATED WITH LEUPROLIDE ACETATE COMPARED WITH 126 CONTROLS

The reported histopathologic findings in leiomyomas treated with leupr olide acetate (LA) differ. We examined 233 myomectomy specimens, inclu ding 107 myomas from 30 patients (mean age, 34.7 +/- 4.6 years) treate d with LA. Their histopathologic findings were compared with those fro m a control group of 126 myomas from 30 untreated patients (mean age, 32.7 +/- 5.3 years). The LA-treated leiomyomas had myxoid change (n = 2; 1.9%), total necrosis (n = 4; 3.7%), focal necrosis (n = 5; 4.7%), calcifications (n = 5; 4.7%), hemorrhage (n = 8; 7.5%), vascular chang es (n = 12; 11.2%), hydropic degeneration (n = 22; 20.5%), and hyalini zation (n = 61;57.0%). None of these changes differed significantly fr om the untreated controls. None of the LA-treated leiomyomas had nucle ar atypia, whereas nuclear atypia occurred in four (3.2%) of the untre ated leiomyomas; this difference was also not significant. Mitotic fig ures were present in 8.4% of the LA-treated myomas and 8.5% of untreat ed controls. The number of mitotic figures per 10 high-power fields wa s slightly higher in the untreated myomas, but the difference was not statistically significant (range, 0-3 for treated, 0-5 for controls). The degree of cellularity did not differ between the two groups. In co nclusion, (a) LA-treated myomas do not significantly differ from untre ated myomas with respect to nuclear atypia, calcification, total coagu lative necrosis, focal coagulative necrosis, hemorrhage, vascular chan ges, myxoid change, hydropic degeneration, hyalinization, mitotic acti vity, or cellularity; and (b) the mechanism leading to a reduction in the size of myomas treated with LA is not apparent from routine histol ogic examination.