This study evaluates the morphologic features of squamous epithelial repair of the uterine cervix, a condition describing a state of regeneration, and compares them with the features of its two histologic mimics, squamous metaplasia and mild dysplasia. The materials examined were from 20 patients with a histologic diagnosis of repair, 42 with cervical biopsy specimens of acceptable quality obtained within 3 weeks of a cervical smear showing repair, and 20 each with squamous metaplasia or mild dysplasia. Specimens with repair disclosed distinctive morphologic characteristics. On low-power magnification, the stroma was chronically inflamed (100%), often floridly (55%). The nuclei were uniform with absent or minimal pleomorphism (90%). The chromatin was bland and evenly distributed (70%). Nucleoli of a bull's eye or macronucleolar appearance (45%) were easily found. Mildly dysplastic epithelium, unlike reparative epithelium, was infrequently associated with an intensely inflamed stroma (20%); its nuclei were pleomorphic (100%) and commonly displayed coarse chromatin (75%) and mitoses (60%). Metaplastic epithelium ws also infrequently associated with an intensely inflamed stroma (10%). Nuclear pleomorphism (10%) and mitotic figures were infrequent (10%), never atypical (0%), and always basally located. Most nuclei had nucleoli, but the majority were small (80%). This study indicates that most cases of repair, mild dysplasia, and metaplasia can be readily distinguished, although due to overlapping features, some cases are difficult to classify as shown by interobserver variability.

译文

这项研究评估了子宫颈鳞状上皮修复的形态学特征,这是一种描述再生状态的状况,并将其与两种组织学模拟物 (鳞状化生和轻度不典型增生) 的特征进行了比较。检查的材料来自20例组织学诊断为修复的患者,42例在宫颈涂片显示修复后3周内获得质量可接受的宫颈活检标本,以及20例鳞状上皮化生或轻度不典型增生。修复标本显示出独特的形态学特征。在低倍率放大时,基质长期发炎 (100%),通常是花哨的 (55%)。核是均匀的,不存在或极小的多形性 (90%)。染色质平淡且均匀分布 (70%)。很容易发现牛眼的核仁或大核仁外观 (45%)。与修复性上皮不同,轻度发育不良的上皮很少与强烈发炎的基质相关 (20%); 它的核是多形的 (100%),通常显示粗染色质 (75%) 和有丝分裂 (60%)。化生上皮也很少与强烈发炎的基质相关 (10%)。核多形性 (10%) 和有丝分裂图很少 (10%),从不非典型 (0%),并且始终位于基部。大多数核具有核仁,但大多数是小的 (80%)。这项研究表明,大多数修复,轻度不典型增生和化生的情况都可以很容易地区分,尽管由于重叠的特征,某些情况很难像观察者间变异性所显示的那样进行分类。

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