子宫肌瘤Myomaofuterus医学课妇产科教学教程.pptVIP

脂 肪 样 变 第一节 子 宫 肌 瘤 Myoma of uterus 武汉大学第一临床学院 妇产科 Department of Obstetrics and Gynecology 张 蔚 教 授 Zhang Wei Most common benign tumor of female reproductive system. And the most common benign tumor in human body 是女性生殖系统最常见的良性肿瘤, 并且是人体最常见的良性肿瘤 Present in 20-25% of reproductive-age women 发生于20-25%的生育年龄妇女 病 因 Aetiology High concentrations of both estrogen and progesterone receptors 肌瘤组织中含有高浓度的雌、孕激 素受体 分类Classification According to the location,Myoma is divided into: Uterine body myoma (90%) Cervical myoma (10%) 依据肌瘤的位置分类: 子宫体肌瘤(90%) 子宫颈肌瘤(10%) 分 类 Types Myoma of uterus 子宫肌瘤 Intramural myoma 肌壁间肌瘤 Subserous myoma 浆膜下肌瘤 Submucous myoma 粘膜下肌瘤 各型子宫肌瘤示意图 肌 壁 间 肌 瘤(intramural myoma) Within the uterine wall 肌瘤位于子宫肌壁内，周围均被肌层包围。 占60～70％ 阔韧带肌瘤Broad ligament myoma 粘 膜 下 肌 瘤 (submucous myoma) Deforming the uterine cavity 肌瘤向子宫粘膜方向生长,突出于宫腔,仅由粘膜层覆盖,占10-15% 粘 膜 下 肌 瘤 多发性子宫肌瘤 (multiple myomata ) 子宫肌瘤常为多个性,各种类型的肌瘤可发生在同一子宫，称多发性子宫肌瘤 多 发 性 子 宫 肌 瘤 white-colored, round, smooth, and usually firm, pseudocapsule 呈白色的,圆形的,光滑的,并且常是 坚硬的,有假包膜 病 理Pathology 漩涡状 whorled appearance 纤维结缔组织 Fibrous connective tissue sarcomatous change 肉瘤变 Degeneration 肌瘤变性 cystic degeneration 囊性变 red degeneration 红色变 Hyaline degeneration 玻璃样变 with calcification 钙 化 透明样变Hyaline degeneration The most common degeneration 最普遍的变性 Its whorled structure disappears and is replaced by clear substance, white color 螺旋状结构消失,由透明结构代替,呈白色 Under microscope, the cells in the degeneration area disappear 镜下观,变性区域细胞消失 囊性变Cystic degeneration Secondary change following hyaline degeneration 紧随透明样变性的次级变化 Tissue necrosis and liquefaction and forms multiplecysts 有组织坏死、液化和形成多发囊性结构 红色变Red degeneration Whorled structure disappears and has bad smell 螺旋结构消失和有恶臭 Most common during pregnancy and puerperium 最常见于妊娠期和产褥期 It is a special type necrosis which cause is not clear 为一种特殊类型的坏死,原因不明 Accompanied by pain and fever