子宮內(nèi)膜增生55

1、this is the microscopic appearance of normal proliferative endometrium in the menstrual cycle. the proliferative phase is the variable part of the cycle. in this phase, tubular glands with columnar cells and surrounding dense stroma are proliferating to build up the endometrium following shedding wi

2、th previous menstruation.here is early secretory endometrium. the appearance with prominent subnuclear vacuoles in cells forming the glands is consistent with post-ovulatory day 2. the histologic changes following ovulation are quite constant over the 14 days to menstruation and can be utilized to d

3、ate the endometrium. 正常子宮內(nèi)膜正常子宮內(nèi)膜 增生期增生期 早期分泌期早期分泌期(proliferative endometrium) (early secretory endometrium)this is normal secretory phase endometrium. note the larger tortuous glands with secretions. the secretory phase follows a set 14 day course leading to either implantation of a fertilized ovum

4、 or menstruation.晚期分泌期（月經(jīng)前期）晚期分泌期（月經(jīng)前期）(secretory phase endometrium)this is endometrial cystic hyperplasia in which the amount of endometrium is abnormally increased and not cycling as it should. the glands are enlarged and irregular with columnar cells that have some atypia. simple endometrial hype

5、rplasias can cause bleeding, but are not thought to be premalignant. however, adenomatous hyperplasia is premalignant.子宮內(nèi)膜非典型增生子宮內(nèi)膜非典型增生this adenocarcinoma of the endometrium is more obvious. irregular masses of white tumor are seen over the surface of this uterus that has been opened anteriorly. th

6、e cervix is at the bottom of the picture. this enlarged uterus was no doubt palpable on physical examination. such a neoplasm often present with abnormal bleeding.the endometrial adenocarcinoma is present on the lumenal surface of this cross section of uterus. note that the neoplasm is superficially

7、 invasive. the cervix is at the right. 子宮內(nèi)膜癌子宮內(nèi)膜癌 iii 期期 侵肌全層、宮頸、附件侵肌全層、宮頸、附件 侵肌侵肌 this is endometrial adenocarcinoma which can be seen invading into the smooth muscle bundles of the myometrial wall of the uterus. this neoplasm has a higher stage than a neoplasm that is just confined to the endometr

8、ium or is superficially invasive.子宮內(nèi)膜癌侵肌子宮內(nèi)膜癌侵肌the endometrial adenocarcinoma in the polyp at the left is moderately differentiated, as a glandular structure can still be discerned. note the hyperchromatism and pleomorphism of the cells, compared to the underlying endometrium with cystic atrophy at the right. 子宮內(nèi)膜增生子宮內(nèi)膜增生子宮內(nèi)膜子宮內(nèi)膜 癌（息肉樣）癌（息肉樣） 子宮內(nèi)膜增生子宮內(nèi)膜增生normal cavityhysteroscopypolyp 陰道流血、排液或?qū)m腔積膿、積液者陰道流血、排液或?qū)m腔積膿、積液者 婦科檢查婦科檢查 細(xì)胞學(xué)檢查細(xì)胞學(xué)檢查