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。

 “If this is  endometrial biopsy, a curettage is certainly needed.  If this is a curettage, patient needs to be evaluated completely and treated.”

如果这是宫内膜活检，则需要诊刮检查；如果是诊刮，则需要全面的估计和处理。（结合临床、影像，全面考虑，综合处理）

 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.

 如果切片染色和图片清晰度有进一步可供仔细观察的话，或许分析得更加妥当，毕竟图片的视野有限，需要仔细看切片可能更好说。

从现有的图片看，正如Dr.Zhao所云，复杂性增生过长的诊断可以成立。然而，小灶区偶见腺内乳头结构（图2、4、5、6、7、9）；还有正如Dr.abin所说，小灶见融合性生长（图4、5、7、9），小灶区可见腺壁复层（图1、3、4、6、7、9）。但没见腺壁坏死或局部坏死。所以，癌不敢讲，但复杂性增生伴局灶不典型增生是可能可以报的，值得多看切片进一步探讨。

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