Is she postmenapausal (LMP '05? I suppose the biopsy was done in '08).  Do you see mitosis in the glandular epithelium?  I am trying to decide if this is abnormal secretory endometrium (epithelium should show columnar cells without mitoses) or complex hyperplasia (proliferative epithelium with mitoses) with mucinous metaplasia.  Pic 9 shows mucinous epithelium.  It is always worrisome to see mucinous metaplasia in endometrium.  Pic 8 is a kind of artifact called telescoping which often happens during secretory phase.  Negative for atypical hyperplasia or malignancy.  I think of abnormal secretory endometrium because i see secretion in the lumen but cannot assign a date. Pic 10 shows predecidua-like changes, maybe progesterone treatment effect or she is truely at late secretory phase.  Difficult.

 mingfuyu老师，国内“08-07-05”表示2008年7月5日，与欧美格式不一样。所以病史提示：不规则流血一月余。应该还未绝经。

图7是人为假象，图8是嗜酸性乳头状化生。其它图没有令人担心的病变。

学习了.

 部分腺体显示旺盛的分泌及A-S反应，图10、11间质中似有核大异型的细胞。妊娠滋养细胞能排除吗？图片上看不清，建议染下CK.

具体临床表现不清楚，“不规则阴道流血”之前有无停经史？“末次月经”是否是“不规则流血”的一部分？

考虑单纯性增生伴分泌反应

学习了

分泌反应，但有些地方反应欠佳