Histopathology of the Endometrium

ISBN-13: 9783642966408 / Angielski / Miękka / 2012 / 359 str.

Gisela Dallenbach-Hellweg; F. D. Dallenbach

Opis

Although the purpose and scope of this monograph remain unchanged, I have been obliged to revise and rewrite many sections to keep pace with the recent growth in knowledge of endometrial pathology and physiology. New knowledge emanates from every quarter, engendered by improved meth ods of study in virtually every subspecialty, by exemplary cooperation between disciplines, and especially by the exchange of ideas internationally. On the other hand, the catalogue of diseases is everchanging. Some, once common, become rare or even disappear. Others suddenly appear, unique and previously unknown. Increased longevity, modern ways of living and new methods of treat ment have modified or augmented the clinical and diagnostic problems confront ing us. Accordingly, therapy with hormones and intrauterine contraception re ceive special attention, commensurate with the importance afforded them today. Under the precept "nil nocere," the almost unlimited uses for these agents warrant that their effects be carefully monitored by precise morphological stud ies, a prerequisite that succeeds only when clinician and pathologist cooperate closely. The sections on procedures for obtaining endometrial tissue, on steroid receptors, on functional disturbances, and on spontaneous abortion have been changed or expanded to incorporate new facts from recent discoveries that now appear significant. Only time, however, will prove their true value. Much of historical interest in the text has been left intact, for "who wants to read into the future, must consult the past" (Andre Malraux)."

Spis treści

A. Methods of Obtaining, Preparing, and Interpreting the Endometrium.- 1. Indications for Curettage.- 2. Selection of the Proper Time for Curettage.- 3. Procedures for Obtaining Endometrial Tissue.- 4. Preparation of the Endometrial Specimen.- a) Fixation.- b) Embedding.- c) Orientation.- d) Staining.- 5. Components of Curettings and Their Diagnostic Value.- 6. Statistical Analysis of the Histological Results.- B. The Normal Histology of the Endometrium.- 1. The Individual Structures.- a) The Glandular Epithelium.- b) The Superficial Epithelium.- c) The Stromal Cells.- d) The Reticulum Fibers.- e) The Ground Substance.- f) The Vessels.- g) The Nerves.- 2. Histochemical Localization of Enzymes; the Reciprocal Action between Enzymes and Hormones.- 3. Structural Changes Induced in the Endometrium by the Physiological Action of the Ovarian Hormones.- a) Molecular Biology of Steroid Hormones.- b) Endometrial Steroid Receptors.- c) Estrogen.- d) Progesterone.- e) Relaxin.- 4. Changes in Structures in the Endometrium During Nidation.- 5. The Endometrium before Puberty.- 6. The Normal Menstrual Cycle and Its Possible Variations.- a) The Normal Proliferative Phase.- b) The Normal Secretory Phase.- c) Menstruation.- d) Regeneration.- e) Possible Variations in the Endometrium During the Normal Cycle.- 7. The Endometrium in the Climacterium and after the Menopause.- C. The Histopathology of the Endometrium.- 1. Morphological Effects of Circulatory and Coagulation Disturbances.- a) Edema.- b) Chronic Passive Hyperemia; Hemorrhage Caused by Extragenital Diseases.- 2. Functional (Hormonal) Disturbances.- a) Atrophic Endometrium from Non-Functioning Ovaries.- b) Resting Endometrium Resulting from Inadequate Ovarian Function (Ovarian Insufficiency, Hypofolliculinism).- c) The Endometrium Associated with a Persistent Follicle.- ?) The Anovulatory Cycle.- ?) Glandular-Cystic Hyperplasia.- Adenomatous Hyperplasia.- ?) Special Forms of Glandular-Cystic Hyperplasia (Focal Hyperplasia, Polyps, Glandular and Stromal Hyperplasias).- d) The Deficient Secretory Phase Associated with Premature Regression of the Corpus Luteum.- e) The Endometrium Associated with Persistent Corpus Luteum.- ?) Irregular Shedding.- ?) Dymenorrhoea Membranacea.- f) The Endometrium Associated with Sterility.- g) Functional Disturbances During the Climacteric.- h) The Effect of Hormone-Producing Ovarian Tumors on the Endometrium.- i) The Functional Disturbances of the Endocervical Mucosa.- 3. Endometritis.- a) Acute Endometritis.- b) Chronic Nonspecific Endometritis.- c) Tuberculous Endometritis.- d) Specific Endometritis Caused by Rare Microorganisms.- e) The Foreign Body Granuloma.- f) Endocervicitis.- 4. Neoplasms.- a) Benign Tumors.- b) Carcinoma of the Endometrium.- c) Sarcoma of the Endometrium.- d) Malignant Mixed Mesodermal Tumors.- e) Metastatic Tumors.- f) Primary Carcinomas of the Cervix (Ectocervix and Endocervix) as Components of Curettings.- 5. Iatrogenic Changes of the Endometrium.- a) After Hormonal Therapy.- ?) Estrogens.- ?) Gestagens.- ?) Both Hormones.- ?) Oral Contraceptive Agents.- ?) Treatment with Gonadotropins.- b) After Intrauterine Contraceptive Device.- c) After Intrauterine Instillation.- d) Regeneration after Curettage.- D. The Diagnosis of Pregnancy from Curettings.- 1. The Early Intrauterine Pregnancy and Its Disturbances.- a) Therapeutic Abortion (induced abortion).- b) Spontaneous Abortion and Criminal Abortion.- c) Hydatidiform Mole and Choriocarcinoma.- 2. The Endometrium Associated with Extrauterine Pregnancy.- 3. The Postpartum Endometrium.- References.