凑个热闹

绝经半年  宫颈糜烂

名称：图1
描述：图1

名称：图2
描述：图2

名称：图3
描述：图3

名称：图4
描述：图4

名称：图5
描述：图5

名称：图6
描述：图6

 "细胞学医生一定要学会“夹着尾巴做人”谦逊、谨慎、诊断保守些，千万不要想去表现自己的水平去钻牛角尖，否则害人害己。 "

师傅言之有理，宫颈细胞学只是个筛查方法，我们对自己要求严格是宗旨，但过分较真就过犹不及了。

而且，本例组织学我有疑问，首先从大体所见显示病变集中于鳞柱交界便内处，整个宫颈呈桶状，这样的大体提示病变应该以内生性为主。从楼主上传的照片来看，倾向是低分化非角化性鳞癌，部分呈基底细胞样部分呈腺样，但不完全除外高度病变累及腺体，有些蜡块需要深切，还需仔细观察全部切片才好定夺。

 刚看到一篇文献，楼主的这个病例也许可以归为“腺样基底细胞癌”。全子：你对照看看是否符合呢？我来不及翻译。或者你个人想法？？？

Adenoid basal lesions of the uterine cervix: evolving terminology
and clinicopathological concepts
Michael J Russell1,2 and Oluwole Fadare*1,3

The epithelial proliferations that are designated adenoid basal carcinoma (ABC) in the current
classification from the World Health Organization represent <1% of all cervical malignancies. These
lesions may be associated, and occasionally show morphologic transitions with, conventional
cervical malignancies. The determination of the precise frequency with which these so-called ABCs
show this association is hampered by the inherent selection bias in the reported cases. However,
this frequency appears to be substantial (>15%). The biologic course of ABCs that are associated
with separate malignancies is largely dependent on the clinicopathologic parameters of the
associated malignancies. Morphologically pure lesions, in contrast, have largely been associated with
favorable patient outcomes, as none of the 66 reported patients have experienced tumor
recurrence, metastases or tumor-associated death, irrespective of the modality of treatment.
Although the finding of genome integrated high-risk human papillomavirus (HPV) types and p53
alterations in adenoid basal lesions (ABL) argue in support of their neoplastic nature, we identified
no lines evidence that suggest an inherent malignancy for morphologically pure lesions. The finding
of morphologic transitions between ABLs and conventional malignancies and shared HPV types in
these areas, suggest that ABLs have some malignant potential. However, the precise magnitude of
this potential is not readily quantifiable and should not dictate the management of morphologically
pure lesions that are entirely evaluable. ABLs continue to occupy a unique position in human
oncology in which the term carcinoma (without an in-situ suffix) is applied to a tumor that has not
been shown to recur, metastasize or cause death. We concur with a previous proposal that the
term ABC should be discarded and replaced with Adenoid Basal Epithelioma (ABE). In our opinion,
there is insufficient evidence at present time to expose patients with morphologically pure lesions
to the ominous implications – social, psychological, medical, financial – of a "carcinoma" diagnosis.
Morphologically impure lesions should not be designated ABC or ABE. Furthermore, given the
uncertainties regarding the frequency with which ABE are associated with separate malignancies,
we suggest that the ABE designation only be applied when the tumor in question is entirely
evaluable e.g in a hysterectomy specimen or in an excisional biopsy with negative margins.
Otherwise, the generic designation Adenoid Basal Tumor is preferable. This approach strikes an
appropriate balance between the need to prevent over-treatment of pure lesions on one hand, and the need to ensure that the lesions are indeed pure on the other.

马老师：您不要太谦虚，我们都认为您是看细胞的实干家，那是没的说，您的学生也是遍布大江南北。我那两手都是从您那里学来的呢。当然还要不断学习才行，否则出去还真不敢自称是您的学生，呵呵！

您要不认我和掌心啊，我就

刚刚才得意没几天呢。。。

以后您就领着我们一道进步吧