子宫内膜增生和子宫内膜癌田允中ppt课件.pptVIP

子宫内膜增生子宫内膜癌;;This is an area where the distinction between a hyperplasia and a carcinoma can be difficult;The distinction between a case of severe hyperplasia and a well-differentiated adenocarcinoma can be very difficult, largely because of the fact that endometrial hyperplasia and carcinoma represent different points in a disease continuum…;The Hallmark of Hyperplasia is an increase of the gland to stroma ratio than 1:1 (even to at least 3:1 ), with concomitant architectural and sometimes cytological changes;An increase of gland to stroma ratio than 1:1 (even to at least 3:1);When assessing the gland to stroma ratio, the combined area of the gland epithelium and its included luminal space should be taken into account.;The International Society of Gynecological Pathologists (ISGP) and the World Health Organization (WHO) recently proposed a classification scheme, in which architectural and cytological features are independently evaluation ;子宫内膜增生WHO分类;Cytological changes;Architectural changes;The glands of simple hyperplasias are straight and nonbranching, but are variable dilated to produce an irregular pattern of lumens. Occasional luminal protrusions or outpouchings are acceptable in simple hyperplasias 腺体直而没有分支, 但有不同程度的扩张,形成不规则的结构. 偶尔, 出现外突和内陷 ;子宫内膜单纯性增生;A complex architecture is present either when the glands arranged in close proximity (“back to back”), or are individually characterized by prominent branching or epithelial infoldings 腺体或排列紧密 (“背靠背”) 或单个腺体分支明显或有上皮内折;The most striking feature of complex hyperplasia is that the glands are markedly crowded and in areas may have a ‘back to back’ appearance;The glands of complex hyperplasia, by definition, show an increased architectural complexity, with an irregular glandular pattern characterized by ;;单纯性;These lesions represent a morphologic continuum, and their separation depends on subjective weighing of various inexact criteriaScully RE. 1992, Boston;Only a minority of patients with hyperplasia develop ca