生殖系统和乳腺疾病1-子宫疾病

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1、生殖系统和乳腺疾病（一）DiseasesofgenitalsystemandmammaryglandDepartmentofPathologySouthernMedicalUniversity9/2/20211宫颈疾病子宫子宫颈9/2/20212宫颈疾病ContentChroniccervicitis;Cervicalepithelialdysplasia;Cervicalcarcinoma;Leiomyomaoftheuterus;Endomertrialadenocarcinoma9/2/20213宫颈疾病9/2/20214宫颈疾病Theyellowdashedlinemarkst

2、heouterboundaryofthetransformationzone.Outsidetheboundarythelong-establishedandthickstratifiedsquamousepitheliumappearswhiteorlightpinkfollowingthediluteacidtreatment.Insidetheboundary,thetransformationzoneischaracterizedbyareasofthinepithelium,whichappearredoralmostinflamed.9/2/20215宫颈疾病1.生育期妇女

3、最常见2.多继发于分娩、流产等→子宫颈损伤3.临床:白带过多一、慢性子宫颈炎(Chroniccervicitis)9/2/20216宫颈疾病常见感染:链球菌、肠球菌、大肠杆菌、葡萄球菌等特殊感染:沙眼衣原体、淋球菌、病毒(单纯疱疹病毒、人乳头状瘤病毒、巨细胞病毒等)、结核菌、寄生虫及放线菌等Etiology9/2/20217宫颈疾病肉眼：宫颈粘膜充血、肿胀，颗粒状或糜烂状Pathologicalchanges9/2/20218宫颈疾病子宫颈粘膜充血水肿间质单核C、淋巴C、浆C浸润子宫颈柱状上皮、腺上皮增生或鳞状化生子宫颈息肉(cervicalpolyp)有时子宫颈囊肿(纳博特囊肿,Na

4、bothiancyst)镜下：9/2/20219宫颈疾病Thisisnormalcervicalnon-keratinizingsquamousepithelium.Thesquamouscellsshowmaturationfrombasallayertosurface.Thisischroniccervicitisatthesquamo-columnarjunctionofthecervix.Smallrounddarklymphocytesareseeninthesubmucosa,andthereisalsohemorrhage.9/2/202110宫颈疾病Squamousme

5、taplasiaofcervix9/2/202111宫颈疾病Cervicalpolyp9/2/202112宫颈疾病Nabothiancyst9/2/202113宫颈疾病Inthecervix,koilocytoticchangewithhumanpapillomavirus(HPV)infection,withvacuolizationofepithelialcells.9/2/202114宫颈疾病子宫颈糜烂假性糜烂-柱状上皮代替鳞状上皮，多见真性糜烂-鳞状上皮坏死脱落Cervicalerosionoccurswhenthesurfaceofthecervixisreplacedwit

6、hinflamedtissuefromthecervicalcanal.Theconditionmaybecausedbytrauma,infectionorchemicals.9/2/202115宫颈疾病二、子宫颈上皮非典型增生和原位癌子宫颈上皮非典型增生－癌前病变异型细胞增生，从基底层向表层发展原位癌上皮全层为异型细胞所替代，未突破基底膜好发部位：子宫颈鳞-柱上皮交界带(移行带)(Cervicalepithelialdysplasiaandcarcinomainsitu)9/2/202116宫颈疾病异型细胞：类似正常基底细胞或体积较小，大小不等，细胞排列紊乱，可见核分裂。9/2/2

7、02117宫颈疾病Ⅰ级（轻度）→异型细胞限于上皮下1/3↓（CINⅠ）多数可消退Ⅱ级（中度）→异型细胞累及上皮下2/3↓（CINⅡ）Ⅲ级（重度）→异型细胞超过上皮2/3以上↓（CINⅢ）原位癌→上皮全层细胞异型，极性消失，但基底膜完整↓（CINⅢ）原位癌累及腺体（仍为原位癌）↓浸润癌→突破基底膜，向上皮下浸润扩展9/2/202118宫颈疾病重度非典型增生和原位癌没有明显界限，原位癌的异型细胞多形性更显著，核分裂多见。9/2/202119宫颈疾病