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以下是引用笨笨鱼在2009-2-28 21:34:00的发言: 谢谢 好病例 第三例真不好诊断 做个记号 提醒自己应当结合临床 |
Exactly. I confused me also.
But if you know the clinical information, it will be so easy
第三例:
年龄:24 月经周期:第六天 病史:无
Remember to try to know all information including previous Pap tests before you sign out Pap.
Menstral phase (day 1-4)
Proliferative phase (day 5-14)
Secretory phase (day 15-28).
Endometrial biological chemical changes are due to effect of multple hormons. I cannot remember it exactly now. But you will understand if you read the text books about menstrual cysle.
Exfoliation of normal-appearing endometrial cells during the first part of menstrual cycle (from day 1 tp day 10-14) is normal, called physiologic shedding.
以下是引用小荷在2009-2-9 20:06:00的发言:
好病例!谢谢! 1,颈管内膜细胞 2,腺癌 3,子宫内膜细胞 4,滴虫 |
Now it is easy for the dx with LMP and age. Just remind your guys that you do not need to report the endometrial cells if women is younger than 40. For this case if women is 40 or older your report should be 1). NILM, 2) endometrial cells correlate with the menstrual history provided.
In the US we have taken many times of tests during residency and cytofellow training,for pathology board, cytopathology board. Tell you a secretory. The first impression for the question photos in computer often is right. You are easy to make wrong dx if you think more and more.
I used only two minutes for the above 4 photos when I reviewed them first time during my working time. I got all correctly (floor 6). I saw the four photos more carefully and thought over at night, then made 2 questions wrongly (floor 9). Ha, ha. It is a good example.
Of cause you always need to consider all the conditions to make your diagosis in true clinical practice.
Thank 兰青风采 for the good study cases. cz
Thank for more photos. I change my dx again. Now I agree with all of my times of diagnoses.
1. Bengin reactive endocervical cells, tubal metaplasia
2. Adenocarcinoma
3. benign endometrial cells, exodus. Cohesive clusters, double contour, present in day 6-10 of the cycle.
4 Trich
This is my final and no more change.
More than 100 person reviewing the cases and only few gave the interpretation. I never understand why. Here just is a study place, not true clinical practice. No persons care your performance. No one has any responsibility for the diagnoses, right or wrong. For these cases I changed three times for my interpretation.I do not care if you think I am a changable or bad cytopathologist. I do not need you to get promotion or get monthly pay. Joking