妇科12周英文课程.pptxVIP

妇科12周英文课程第1页/共33页 Prevalence/incidence25% - 50% reproductive womenIncreased incidence with age Age incidence 20-30yr 4 % 30-40yr 11-18% 40-50yr 33 % Lurie ?S, Piper ?I, Woliovitch ?I, Glezerman ?M. ?Age-related prevalence of sonographically confirmed uterine myomas. ?J Obstet Gynaecol. ?2005;25:42–4 第2页/共33页 Etiology/EpidemiologyEtiology unknown Increased risk factors 40 years or older Family history of uterine fibroid Nulliparity Obesity Black race第3页/共33页 Associated FactorsFemale Hormones ---Estrogen (雌激素)/ Progestron (孕激素) Clinical evidences: Reproducutive patients No cases before puberty No new cases after menopause(停经) Increased during pregnancy Estrogen receptor (ER-α) high concentration in black women第4页/共33页 Intramural ~(60%--70%) 肌壁间Subserous(20%) 浆膜下Submucous ~(10%) 粘膜下 Cervical ~ -2% Classification I第5页/共33页 ClassificationIISingleMultiple第6页/共33页 Pathology ---gross structureFrequently multipleFirm, vary in size Spherical or irregularly lobulatedFalse capsule (假包膜) Whorled appearance (漩涡状结构) 第7页/共33页 Pathology ---microscopic structure第8页/共33页 Hyaline ? 玻璃样变性yellow, soft gelatinous areas Cystic ?囊性变liquefaction follows extreme hyalinizationRed (carneous) degeneration 红色变性 Edema hypertrophy ?impede blood supply ?aseptic degenration infarction with venous thrombosis hemorrhageOther changes calcification 钙化 hemorrhage 出血 necrosis 坏死 SECONDARY CHANGES/ DEGENERATION第9页/共33页 Hyaline /Cystic Degeneration第10页/共33页 Red (carneous) degenerationUsually occurs during pregnancy第11页/共33页 Malignant Transformation rare 0.1-0.5% leiomyomaleiomyosarcomaIncreased cell number Pathological nuclear fiss