从图片看，刮宫标本：符合“息肉、复杂性不典型增生，局部癌变”，或者按照另一分类系统报：“息肉内EIN，局部癌变”。（EIN与复杂性增生是两个分类系统，国内有这样的诊断：“复杂性不典型增生，局部呈EIN”，把EIN理解为重度不典型增生或原位腺癌。似乎不妥，不知其他专家什么意见？）

切除标本没有残存癌，不影响刮宫标本的诊断。

 内膜内癌.

 学些了

 高分化子宫内膜样腺癌

Although EIN is not perfectly equivalent to CAH (Complext atypical hyperplasia), up to 80% of EIN will be diagnosed by traditional system as CAH. So it share many morphologic features. That is probably one of the reasons most people are still using simple/complext hyperplasia with or without atypia diagnostic system. As mentioned by Dr. Zhao in other case discussion, both their hospital and ours still use old diagnostic system because we do not confuse our clinicians with totally brand new terminology. So it is very very important to know if your clinicans are on the same page with you when you are applying a new terminology in your diagnosis, since we are in the same team with clinicians and the patient care is the center of our mission and our collective efforts.

 复杂性子宫增生过长伴非典型增生，局部癌变。17楼不是浸润

 真是好病例，讨论的也热烈，有看头有学头

 

虽然视野有限，前面4张为良性病变，后面几张不能见到明显的间质浸润，但：（1）间质比例显著减少，某些视野下几乎非常少间质；（2）腺壁复层，结构异型；（3）腺壁内细胞灶性凋亡或小灶坏死；（4）核分裂像是可以看到的。

 粘膜内癌

 子宫内膜样癌

 够癌，17楼图不是浸润。

 诊刮子宫内膜样癌

 活检：子宫内膜息肉并复杂性非典型性增生，部分区癌变。

子宫切除标本：未见浸润。

 子宫内膜样癌

  子宫内膜样癌

 癌

 学习