主观性太强的诊断其实无所谓谁对谁错. 你说是癌我没意见,说非典我也认同,只要各自能说出各自的理由

最重要的是和临床做好沟通.并且了解你们医院这两种诊断各自临床的处理.

我觉得这个诊断挺好:非典型复杂性子宫内膜增生，不能排除高分化子宫内膜样腺癌。

另几个观点

缺乏肌层浸润不能除外癌的诊断-30% 的癌可能局限于子宫内膜
子宫切除标本子宫内膜内癌和非典型性增生的鉴别是学术性的
在绝经后妇女的刮宫标本中区分两者没有实际意义
注意腺体的复杂性（筛状结构）以及核的多形性和突出的核仁
诊断癌的特征是(Cancer 1982;49:2547):
腺体不规则浸润伴有间质的纤维组织增生性反应
复杂而融合的腺体和筛状结构
广泛的乳头状结构，乳头具有血管轴心

 高分化子宫内膜样腺癌

 高分化子宫内膜样腺癌

 高分化子宫内膜样腺癌

 I basically agree Drs. Zhao and Yu's comments. Based on the photos provided, I have no problem for "Atypical complex endometrial hyperplasia". However, I do not see definitive frankly carcinoma in those photos. The patient's age is relatively young. If she is not postmenopausal, she should have other clinical manifestations which place her in high risk group for endometrial carcinoma, such as severe obese, polycystic ovarian syndrome, ovarian mass (such as granulosa cell tumor) and long time anovulatory cycles due to other ovarian diseases. If clnically this women is free of high risk factors, then you should be very cautious to make diagnosis of "carcinoma" with a borderline morphology like this case. Therefore, with no further clinical information support, I will diagnose this case as:

ATYPICAL COMPLEX ENDOMETRIAL HYPERPLASIA, CANNOT RULE OUT WELL DIFFERENTIATED ENDOMETRIAL ADENOCARCINOMA.

In most clinical situations in our hospital, patients with my above diagnosis will first go through progestin-based hormore therapy. If patient is continous bleeding after hormone treatment, she will have the second endometrial biopsy to reevaluate. Up to 80% of CAH and 50% of well differentiated carcinoma will resolve after hormone treatment. If atypical complex hyperplasia persists, regardless if you see carcinoma or not on second bopsy, GYN oncologists will advise patients for total hysterectomy. However, I do not know if in your hospital, gynecologic oncologists will follow the similar approaches. For the sake of patient's benifit, a little conservative approach with communication with clinicians is my advice for this case.