子宫腺肌病的临床诊断

目的：总结子宫腺肌病的临床特点，以期提高对该病的认识及术前诊断率。方法：对45例子宫腺肌病患者的临床资料进行回顾性分析。结果：术前临床诊断15例(33．33％)，误诊漏诊30例(66．67％)。结论：子宫腺肌病的术前诊断率较低，必须提高对本病的认识，并结合B超、MR／及血清CA125测定等辅助检查才能提高术前诊断率。     

子宫腺肌病的病理超声分型研究

目的探讨子宫腺肌病的阴道超声声像图特征,旨在提高对子宫腺肌病的超声诊断准确率.方法分析82例经腹腔镜及病理确诊为子宫腺肌病的声像图分型特征.结果根据病理分析,将子宫腺肌病病理形态学特征在声像图上的表现分为三型:①局灶型53例(64.6%).②腺肌瘤型11例(13.4%).③弥漫型18例(22.0%).结论经阴道超声的分型诊断有利于对子宫腺肌病超声特征的重新认识,提高诊断率.     

Adenomyosis of the uterus: an enigma

Adenomyosis has been an entity of some interest for many years, but little is known today of its pathogenesis. There is almost universal agreement that it is associated with an accentuation of the myometrial muscle pattern, multiparity, and endometrial hyperplasia. Some authors suggest that the myometrium is vulnerable to invasion by endometrial hyperplasia. Others postulate that the myometrium is vulnerable to invasion by endometrial glands because of the absence of a basement membrane. Women in the fourth and fifth decades of life are most commonly afflicted. Preoperative diagnosis is not common.     

E-钙粘蛋白在子宫腺肌病组织中的表达

目的　检查E 钙粘蛋白 (E cadherin ,E cad)在子宫腺肌病病灶中的分布及其mRNA的表达 ,以探讨其在子宫腺肌病发病机制中的作用。方法　采用免疫组化二步法和原位杂交技术 ,检查E -cad在子宫腺肌病病灶中的表达及其mRNA的转录水平 ,并以正常子宫内膜作对照。采用图像分析技术检测E -cad及其mRNA表达的平均光密度值。结果　免疫组化显示 ,在正常的内膜中E -cad主要表达在腺上皮细胞的细胞膜 ,以侧面膜为主 ;在腺肌病病灶的表达明显减少 (P <0 .0 1)。原位杂交显示 ,在腺肌病病灶和正常内膜中 ,E -cad的mRNA均表达于腺上皮细胞的胞浆 ,但在后者中的表达强度明显高于前者 ,其平均光密度值有显著性差异 (P <0 .0 1)。结论　E 钙粘蛋白在腺肌病病灶中低表达及其mRNA的低转录水平是子宫腺肌病发病机制中的一个较重要的因素。     

子宫腺肌病的病理超声分型研究

目的探讨子宫腺肌病的阴道超声声像图特征，旨在提高对子宫腺肌病的超声诊断准确率．方法分析82例经腹腔镜及病理确诊为子宫腺肌病的声像图分型特征．结果根据病理分析，将子宫腺肌病病理形态学特征在声像图上的表现分为三型：①局灶型53例(64．6％)．②腺肌瘤型11例(13．4％)．③弥漫型18例(22．0％)．结论经阴道超声的分型诊断有利于对子宫腺肌病超声特征的重新认识，提高诊断率．     

Adenomyosis: a retrospective view

Adenomyosis has been referred to as diagnostically elusive due to the difficulty of clinical identification and unknown etiology. In a retrospective study of 178 consecutive uteri removed or biopsied at Howard University Hospital significant differences in the average age and peak incidence, correct preoperative diagnosis, and association with leiomyoma was noted when compared with the current literature. The data suggest that in black Americans symptomatic essential adenomyosis occurs earlier and that dilation and curettage may have an etiologic role. In general, adenomyosis is more frequently associated with leiomyoma but essential adenomyosis was diagnosed most consistently when uterine enlargement was noted during the menstrual period. The authors conclude that adenomyosis should be considered in all cases of abnormal uterine bleeding and dysmenorrhea. Early diagnosis by ultrasonographic testing may lead to an identifiable cause of this disease and result in methods of prevention or early medical therapy.     

Leiomyosarcoma of the gallbladder

A case of leiomyosarcoma of the gallbladder in a 55-year-old woman is presented. The definitive diagnosis of leiomyosarcoma according to the histologic structure of the tumor was made by electron-microscopic study. Ultrastructure of this tumor type is characteristic of presence of myofilaments and cytoplasmic vesicles in the cytoplasm.     

Paraganglioma of the gallbladder

A case of incidental Gallbladder Paraganglioma is presented. This is the third case found until now in this organ. The parasympathetic origin of this neoplasm is thus discussed.     

Inversion of the gallbladder

A case of inversion of the gallbladder is described, in which the fundus was inverted into the body of the organ. A localized area of adenomyomatosis (adenomyoma) was present at the apex of the invertum.     

Cholesterosis of the gallbladder

Altogether 238 gall bladders from the necropsy cases and 260 those removed surgically were examined morphologically. Various forms of cholesterosis were found in 5 cases from the first group and in 12 cases from the second. The gall bladder mucous membrane was studied by scanning electron microscopy. Low incidence of this disease is noted in the Central Asia. The mucous membrane surface in health and cholesterosis is described. The conclusion is drawn about the link of the cholesterosis incidence with the traditional nutrition in this area.     

Malacoplakia of the gallbladder

A case of malacoplakia of the gallbladder is described. The cytoplasm of histiocytes in the gallbladder wall was filled with granules positive for periodic acid-Schiff, von Kossa's, and Perls' stains, which is highly suggestive of malacoplakia. Both local inflammation and recent neoplasia could have played a role in the histogenesis of the malacoplakia.