子宫肌瘤myomaofuterus妇产科.pptxVIP

第一节 子 宫 肌 瘤 Myoma of uterusMost 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 AetiologyHigh 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ClassificationAccording 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％浆 膜 下 肌 瘤(subserous myoma)Deforming the external serosa肌瘤向子宫浆膜面生长，突起在子宫表面，约占20%浆 膜 下 肌 瘤阔韧带肌瘤Broad ligament myomaExtend between the 2 peritoneal layers of the broad ligament若肌瘤位于宫体侧壁向宫旁生长，突阔韧带两叶之间称阔韧带肌瘤阔韧带肌瘤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 瘤病 理Pathologywhite-colored, round, smooth, and usually firm, pseudocapsule 呈白色的,圆形的,光滑的,并且常是 坚硬的,有假包膜漩涡状whorled appearance 纤维结缔组织Fibrous connective tissue Hyaline degeneration玻璃样变cystic degeneration囊性变Degeneration肌瘤变性red degeneration红色变sarcomatous change肉瘤变with calcification钙 化透明样变Hyaline degenerationThe most common degeneration最普遍的变性Its whorled structure disappears and is replacedby 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 degenerationSecondary 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 degenerationWhorled 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 and rapidly enlarged myoma伴随有疼痛,发热和肌瘤迅速增大肉瘤变Sarcomatous changeMalignant transformation of leiomyoma子宫肌瘤的恶性转变The frequency is 0.4-0.8%,of