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- an easy case for you-Pap test (cqz 3)
It is not uncommon to see the normal endometrial cells in women age >45 even the LMP more than 12 days.
We should report the presence of endometrial cells if women 40 y or above. Then we need to mention the EM cells are consistent with LMP, or > 12 days after LMP or do not know the LMP of the patient.
Normal EM cells in women <40, do not need to report regardless of LMP
Normal EM cells in women 40 or above: Clinical correlation.
Atypical EM cells: should have endometrial and endocervical sampling for all ages. If no endometrial pathology identified, colposcopy should be performed. So atypical EM cells are critical report.
My discussion is no relation to the interpretation of my above case (I do not mean which of your answers is right or wrong). So continue to guess.
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本帖最后由 于 2008-12-16 13:30:00 编辑
译上楼cqzhao ：.45岁以上的妇女，在末次月经12天后的宫颈涂片中发现正常的子宫内膜腺上皮细胞并不罕见，但是如果看见了40岁以上女士宫颈涂片中有子宫内膜细胞应该报告出。 然后需要再去了解与患者的末次月经关系，是否月经12天以后，或者根本不知道与患者月经情况， 40岁以下的女士，宫颈涂片中查见正常的子宫内膜细胞根本不用管。大于40岁以上的人宫颈涂片中出现正常的子宫内膜细胞与临床有关。 无论什么年龄段出现了非典型的的子宫内膜腺上皮细胞都应该做活检，.如果刮宫标本正常还应该再做阴道镜，所以非典型的子宫内膜细胞是一定要报出来。 .我的问题了本例的正确答案无关，只是讲一下子宫内膜腺上皮细胞的问题，请大家继续猜。
Thank 月新 for your good translation
Normal EM cells in women 40 or above: Clinical correlation. 大于40岁以上的人宫颈涂片中出现正常的子宫内膜细胞. In this situation we can write the comment: Clinical correlation is suggested. It means that clinical physicians should consider patient's clinical stituation to decide how to handle the case. Basically I give the ball to the patient's physicians.
i did not say above answers are right or wrong. Just give a resonable interpretation based on your knowledge.
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本帖最后由 于 2008-12-13 22:01:00 编辑
| 以下是引用cqzhao在2008-12-13 0:57:00的发言：
My discussion is no relation to the interpretation of my above case (I do not mean which of your answers is right or wrong). So continue to guess. |
我猜了半天，不明白赵老师的心思。
我就描述一下细胞特点吧：三维立体细胞团，略成乳头状，粘附紧密，细胞单一，浆少，可见核仁。（宫内膜细胞的特点）
宫颈细胞：多平铺，可见成排、刷状，核多偏位。
此例考虑AGC。
不知当否？请赵老师指导！谢谢！呵呵
- 广州金域病理
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本帖最后由 于 2008-12-14 20:18:00 编辑
| 以下是引用cqzhao在2008-12-14 3:11:00的发言： If it were your case above and you know there was some residual fluid left in the lab (10 ml fluid totally), what would you like to do? |
回复赵老师：
1、在做TCT时，我喜欢每次将剩余的液体，再离心沉淀备用，如果液基图片有可疑细胞，或制片欠佳，再将备用液制片或做细胞块，再染色观察或做免疫组化等。
2、常与临床沟通，只要有异常细胞，都要和临床联系，询问病史和其它相关检查，并建议做相关的检查,如宫颈外观情况、B超示内膜情况、既往史等。可建议分段清宫、宫颈活检、查HPV、查内分泌激素等。
- 广州金域病理
| 以下是引用天山望月在2008-12-14 20:15:00的发言：
回复赵老师： 1、在做TCT时，我喜欢每次将剩余的液体，再离心沉淀备用，如果液基图片有可疑细胞，或制片欠佳，再将备用液制片或做细胞块，再染色观察或做免疫组化等。 2、常与临床沟通，只要有异常细胞，都要和临床联系，询问病史和其它相关检查，并建议做相关的检查,如宫颈外观情况、B超示内膜情况、既往史等。可建议分段清宫、宫颈活检、查HPV、查内分泌激素等。
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