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- 子宫内膜够癌吗?
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本帖最后由 于 2010-01-01 23:29:00 编辑
Challenge case. I did not see conflence growth. Most likely it is not an cancer yet.
No double the endometrial glands show complex hyperplasia. Question is atypical complex hyperplasia or without atypia. Seems epithelial cells show tubular metaplasia. No obvious cytologic atypia, epithelial stratification are appreciated based on the photos. Are there foal papillary or cribriform strctures in low power? The cases of complex hyperplasia without atypia is relatively few. You need to have review your slides carefully to make your final dx.
挑战病例。我没有看到融合性生长。很可能还不是癌。
内膜腺体无疑显示复杂性增生。问题是有不典型的复杂性增生还是无不典型增生的复杂性增生。根据这些图片，没有明显的细胞学不典型性，上皮复层化。低倍是否有局灶乳头结构或筛状结构？无不典型增生的复杂性增生相当少见。你要仔细观察切片再作出最终诊断。__abin译
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| 以下是引用cqzhao在2010-1-1 22:10:00的发言：
Challenge case. I did not see conflence growth. Most likely it is not an cancer yet. No double the endometrial glands show complex hyperplasia. Question is atypical complex hyperplasia or without atypia. Seems epithelial cells show tubular metaplasia. No obvious cytologic atypia, epithelial stratification are appreciated based on the photos. Are there foal papillary or cribriform strctures in low power? The cases of complex hyperplasia without atypia is relatively few. You need to have review your slides carefully to make your final dx. 挑战病例。我没有看到融合性生长。很可能还不是癌。 内膜腺体无疑显示复杂性增生。问题是有不典型的复杂性增生还是无不典型增生的复杂性增生。根据这些图片，没有明显的细胞学不典型性，上皮复层化。低倍是否有局灶乳头结构或筛状结构？无不典型增生的复杂性增生相当少见。你要仔细观察切片再作出最终诊断。__abin译 |
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At least atypical complex hyperplasia, suspicious for well differentiated adenocarcinoma. I think if it isn't cancer yet, it is very close to cancer. I wouldn't fight if somebody calls this adenocarcinoma directly. The clinical information is worrisome too.
This is a borderline case, no point to get a concensus. Communication with your physician is very important. If this is endometrial biopsy, a curettage is certainly needed. If this is a curettage, patient needs to be evaluated completely and treated.
| 以下是引用mingfuyu在2010-1-2 23:15:00的发言：
At least atypical complex hyperplasia, suspicious for well differentiated adenocarcinoma. I think if it isn't cancer yet, it is very close to cancer. I wouldn't fight if somebody calls this adenocarcinoma directly. The clinical information is worrisome too. This is a borderline case, no point to get a concensus. Communication with your physician is very important. If this is endometrial biopsy, a curettage is certainly needed. If this is a curettage, patient needs to be evaluated completely and treated. |
朱正龙
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本帖最后由 于 2010-01-07 23:21:00 编辑
另有很重要的一点：子宫内膜不管是活检还是诊刮（biopsy or curettage), 所有组织都得包埋切片。All the endometrial pecimen should be summitted for histologic examination. The reason is apparent: carcinoma is sometimes quite focal.
If a hysterectory is done for endometrial carcinoma or precursors, all the endometrium together with some myometrium should be submitted for histologic examination. You don't need to submit all the myometrium (it is most time almost impossible), but you need to have the endometrial-myometrial junction to evaluate for myometrial invasion. If you see gross myometrial invasion, you need the full thickness of the endo-myometrium in this area to measure the depth of myometrial invasion.
abin译：另有很重要的一点：子宫内膜不管是活检还是诊刮（biopsy or curettage), 所有组织都得包埋切片。原因很明显：癌有时很局限。
如果因内膜癌或癌前病变切除了子宫，所有内膜和部分肌层都应该取材。不需要将肌层全部送检（大多数情况下不可能），但需要检查内膜-肌层交界处以评估肌层浸润情况。如果大体看到浸润，需要把内膜-肌层全层检查，以测量肌层浸润深度。
