2图，怎么诊断

名称：图1
描述：1

名称：图2
描述：2

颈管 腺上皮团！

 阳性的吧

 好片片

图一感觉问题不大，图二的极性有点乱，感觉不是正常那么简单

HSIL

 这个又咋整?就两张图.

1，核增大了么？2，核拥挤了么？3.细胞边界不清了不？4，腺切缘消失了么？5.立体感不？6，核仁见不？7染色质怎么样？

鉴定完毕

答：AGC,后缀事实填一个

The residual fluid of the Pap was prepared for  a cell block. How will you release your Pap test now?

名称：图1
描述：1

名称：图2
描述：2

 这么好的病例，看的老师不多呀。现在怎么理解呢？

内膜吗？

What we learn from this case?

AGC is a very difficult diagnosis. About 20% AGC can have significant lesions including squamous lesions, endocervical lesions and endometrial leasions. In other words, most of AGC cases are benign. We have to be very cautious to make dx of AGC on Pap. Clinical information, age, previous Pap, HPV results et al should be considered.

In hypercellular specimen if you think it may be a malignant case you can try a cell block. It may be helpful.

It is difficult to evaluate AGC origin on Pap. It is often difficult in cervical biopsy specimen. Please do not need to commit your self.

High risk HPV testing may be helpful for assessment of risk for AGC women. The chance od high grade lesions (squamous and cervical glandular) is very low in women with AGC and negative HPV testing. Of cause HPV infection has no relation to endometrial carcinoma.

The most importance we should remember is that Pap test is screening test.

Ok, I finish my case and hope your guys like the case.

Thank all people who read or joined in the discussion for this case

 腺癌的细胞学难在常常是核的异型性改变轻微，仅仅是排列、极向、拥挤度和浆少等等，而我们细胞学诊断主要是依靠核的异型性，所以非常困难！

腺上皮异常在诊断中是个难点，所给二幅图片，具备有宫颈腺上皮来源的特征，异型性主要表现为核的增大、]密集、重叠，片状，如果从有限的表现中做出诊断？如何把握尺度？需要更好学习与总结！