子宫肌瘤(uterine myoma)双语教学张喜优秀培训书.pptVIP

Uterine Myoma  Women’s Hospital, School of Medicine Zhejiang University   Prof. Lin Jun Introduction Most common benign tumor of female reproductive system Benign neoplasm composed primarily of smooth muscle Common in women 30-50y Usually asymptomatic Etiology Not detectable before puberty and after menopause Probably relates to female hormones Estrogen and ER ↑ Progestin may promote mitosis（有丝分裂） of myoma Classification According to the location： Uterine body myoma 90% Cervical myoma 10% Classification According to the relationship between myoma and uterine myometrium ： intramural myoma 60%-70%? subserous myoma 20% submucous myoma 10%-15% Classification Classification Pathology Gross Appearance： round, smooth, and usually firm false capsular covering ——pseudocapsule can be clearly demarcated from the surrounding myometrium Pathology Gross Appearance： Transverse section : light gray a whorl-like arrangement or an intertwining pattern Pathology Microscopic examination： composed of smooth muscle cells and varying amounts of connectives tissue Individual cells are quite uniform in size, spindle shaped, have elongated nuclei. Nonstriated muscle fibers（平滑肌纤维） are arranged in interlacing bundles of varying size running in different directions. Degeneration Hyaline degeneration Cystic degeneration Red degeneration Sarcomatous change Degeneration with calcification Degeneration Red degeneration most common during pregnancy and puerperium venous thrombosis and congestion with interstitial hemorrhage Degeneration Degeneration Sarcomatous change malignant rare, 0.4-0.8% old women enlarge rapidly with irregular vaginal bleeding Degeneration Sarcomatous change Symptoms Usually no symptoms Associate with location, and degenerations Not associate with the size and the number Symptoms 1. menorrhagia and prolonged menses large intramural myoma submucous myoma 2. abdominal mass 3. leukorr