Download Free Hormonal Pathology Of The Uterus Book in PDF and EPUB Free Download. You can read online Hormonal Pathology Of The Uterus and write the review.

Hormonal influences, both natural and iatrogenic, are implicated in the most frequent health issues of women. Endometrial cancer is now the most common gynecologic cancer in the United States and the industrialized world. This cancer is strongly related to hormonal and metabolic factors. In addition, breast cancer treated with hormone therapy (Tamoxifen) may, in some cases, be associated with uterine pathology. Hormone therapy is used to improve the physiological effects and counteract abnormal and deleterious effects of “natural” hormonal activity. Millions of women receive hormone therapy at some point of their life: using oral contraceptives, reproductive technology, treatment for post-menopausal symptoms, among other uses. This book addresses a range of women’s health issues, from fertility to neoplasms, and their relationship with natural and iatrogenic hormonal effects. Chapters include clinical and pathological descriptions, theoretical and practical medical issues, and original studies and cases. Controversial issues in certain hormone therapies are presented with updated concepts based on clinical studies and novel statistical methods. The book will be useful for specialized and general physicians, oncologists, endocrinologists, researchers, medical students, and others in the field of women’s health.
Changing approaches to diagnosis and clinical management of the uterus are comprehensively examined in this book. It gives a concise update of new concepts in physiology and pathology and their application in clinical practice. The book is designed especially for the gynecologist actively involved in patient care. Topics discussed include the pathophysiology of diethylstilbestrol (DES) changes, the immunology of the uterus, papillomaviruses and cervical neoplasia, endocervical carcinoma, mesenchymal tumors and diagnostic procedures such as colposcopy of the cervix, hysterosalpingography, and magnetic resonance imaging. The status of contemporary management is presented for hysteroscopy and hysteroscopic surgery, the congenital absence of the uterus and vagina, anovulatory dysfunctional uterine bleeding of the adolescent, uterine leiomyomata, genital prolapse, endometrial adenocarcinoma and childhood rhabdomyosarcoma of the vagina and uterus.
For this second, expanded edition, most of the chapters have been extensively revised to include the latest immunohistochemical and molecular biological methods. With its clearly thought-out structure, this atlas enables the pathologist to find, classify, and differentially diagnose each disease. 280 top-quality illustrations - over half in full colour - are each accompanied by a description of the pathology of the disease, a summary of the causes, an explanation of its clinical importance, and treatment options, emphasising the importance of constant mutual co-operation with the attending gynaecologist. Microphotographs are arranged systematically according to morphology, and each is followed by a short description together with the aetiology and morphologic and differential diagnosis of the different conditions. Hemming Poulsen is head of the WHO Collaborating Center for the Histological Classification of tumours and the new chapter on neoplasms, for example, reflects this new WHO classification. Additional chapters cover gestational diseases as well as new findings in infertility and hormone replacement therapy.
The endometrium differs from all other tissues of the body in that it rhythmically changes its structure and function. For many years the meaning of these changes remained puzzling and obscure. At about the turn of the century some investi gators held the physiological fluctuations of the menstrual cycle to be inflamma tory changes. Later, when stricter criteria for the pathology of the endometrium were applied, morphologists misinterpreted pathological fluctuations in the cycle either as physiological variations, or they overlooked them entirely. Today as previously the pathologist is often confronted with the dilemma that he is unable to adequately diagnose the endometrium merely from the structural changes. Accordingly, the gynecologist finds the pathological report of little value. In like manner, if the clinical information given the pathologist is incomplete, then he cannot form a clear notion of the clinical problem. Although the detection of focal lesions of the endometrium is important, of much greater consequence is the recognition of functional (hormonally controlled) variations and their cyclic course, for it is from these that the clinician is guided in deciding what therapy he should use. The ability to detect such functional changes requires not only that the morphologist possess a thorough knowledge of the physiological and pathological anatomy of the endometrium but also that he receive exact information about the patient's menstrual history and have in sight into clinical problems.
This Atlas of Uterine Pathology is comprehensive overview of the major pathologic processes that may be encountered in the uterine corpus and cervix. Each section is lavishly illustrated and covers normal histology as well as neoplastic and non-neoplastic diseases. Emphasis is placed on presenting the full morphologic and immunophenotypic spectrum of entities, including classical and variant pathology, in a manner that maximizes the utility of the information in routine diagnostic practice.
This new edition differs from the preceding ones in that there has been extensive revision of most chapters. Recent advances in research gained by immunohistochemical, molecular biological, and cytogenetic methods are included, as far as they are applicable for daily diagnostic work. The chapter on neoplasms, in particular, has been greatly expanded in accordance with the new WHO International Histological Classification of genital tract tumors, covering all pertinent differential diagnostic aspects. The chapter on malignant lymphomas and hematopoetic neoplasms involving the endometrium is a new contribution to this edition (F. D. , Ulm). We have revised the chapter on gestational diseases, incorpor- ing recent advances in the differential diagnosis of gestational trophoblastic tumors. New discoveries and experiences in correlating structure and function in infertility and in h- mone replacement therapy of peri- and postmenopausal patients are also included. Many new microphotographs have been added to illustrate the advances in tumor research and in immunohistochemical detection methods. We have updated the list of references including recent relevant publications. To the correspondents and consultants who have contributed valuable observations and suggestions, bringing thereby to our attention omissions in the second edition, we acknowledge our cordial thanks. We thank Dr. Wolfram Klapper, Director of the L- phom Register of the University of Kiel, for case material for making the micropho- graphic illustrations of lymphomas. The staff of Springer-Verlag has earned our gratitude for their skill in preparing this new edition.
This open access book deals with imaging of the abdomen and pelvis, an area that has seen considerable advances over the past several years, driven by clinical as well as technological developments. The respective chapters, written by internationally respected experts in their fields, focus on imaging diagnosis and interventional therapies in abdominal and pelvic disease; they cover all relevant imaging modalities, including magnetic resonance imaging, computed tomography, and positron emission tomography. As such, the book offers a comprehensive review of the state of the art in imaging of the abdomen and pelvis. It will be of interest to general radiologists, radiology residents, interventional radiologists, and clinicians from other specialties who want to update their knowledge in this area.
As compared with cytology’s use in other organ systems, direct cytological examination of the endometrium is not a widely practiced diagnostic procedure. This is an anomaly, because the endometrium is exceedingly available for cytological sampling, cytological sampling is comparably simple to perform, and, from the patient’s perspective, it is a gentle procedure as compared to other methods of specimen attainment. Over the years, as we personally gained more and more experience with specimen acquisition, processing and interpretation, we have come to look upon endometrial cytology as an effective method for ensuring endometrial normalcy and discovering and diagnosing malignant and premalignant states. In comparing endometrial cytology to endometrial biopsy, we have found that, in samples obtained by individuals experienced in specimen collection, cytology outperforms outpatient biopsy with regard to the patient’s tolerance of the procedure, adequacy of sampling among postmenopausal women, and detection of occult neoplasms. By devising a highly effective technical strategy to ensure the simultaneous creation of cell blocks and cytological samples from a single collection (that is detailed in the technical appendix of this work), we have moved endometrial brush collection into an arena of significance equaling—indeed exceeding—other methods of specimen collection and interpretation. Cytology, even in the absence of cell blocks, performs equally as well as biopsy in detecting outspoken hyperplasia or carcinoma. If nothing else, by reliably identifying benign, normal endometrial states, it serves to exclude more than 70% of women from unnecessary follow up testing with a high degree of confidence. Because brush sampling of the endometrium is limited to a depth of 1.5 to 2 mm, the method is not definitive for the detection of endometrial polyps, fibroids, stromal tumors, or tumors of the uterine wall musculature. However, endometrial cytology is useful for detecting benign estrogen-excess states such as disordered proliferation and various degrees of benign hyperplasia, for separating these states from frankly neoplastic states such as EIN and cancer, but not for subclassifying benign hyperplastic states in the absence of cell block preparations. When endometrial brushing with liquid fixation is used in conjunction with other techniques such as immunohistochemistry, concomitant biopsy or, more practically, hysteroscopy or sonohysterography, endometrial benignancy can be assured with a very high level of confidence (> 99%); indeed, manufacturing concomitant cell blocks of endometrial tissue fragments and using immunohistochemistry in selected cases significantly enhances the diagnostic specificity of the technique. In a woman with a patent cervix, endometrial brushing successfully collects material, even from late postmenopausal atrophic endometrium. It allows for the detection of serious diseases such as endometrial intraepithelial carcinoma under conditions where suction biopsy might miss or otherwise obviate the diagnosis. This work focuses on the background, collection technique, and reliability of endometrial cytology; it then overviews diagnostic criteria and diagnostic pitfalls encountered in the day-to-day practice of the art. Since endometrial cytology interpretation relies on intuiting tissue patterns from cytology preparations, a great deal of time is spent on cytohistological correlations and, where effective as part of a diagnostic strategy, on ancillary immunohistochemical staining. The discussion moves from normal states of the endometrium, through otherwise benign changes induced by an altered hormonal milieu or surface irritants, into neoplastic premalignant and malignant endometrial conditions. Finally, fixative and slide preparation techniques, that we deem as expeditious while serving to get the most information out of an endometrial cytology collection, are discussed in detail for the benefit of those who wish to recapitulate our work in their own practice.