妇产科学课件：子宫肌瘤(英文版).ppt

1Uterinemyoma

2DefinitionandIntroductionMyoma,fibroid,fibromyomaOneofthemostcommonesttumors,presentin20-25%ofreproductive-agewomenBenignuterineneoplasms,composedprimarilyofsmoothmuscle

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5PathogenesisNotclearEstrogenandit’sreceptorsinhigherconcentrationsProgesteronemaybeacceleratethemitosisofcellsHeredity(25%-50%):12,14,7chromosomecorrelatedwithmyoma

6PathologyGrossly:buff-coloredroundedsmoothfirm

7PathologyMicroscope:Individualcellsarespindleshaped（梭形）,haveelongatednulcei,andarequiteuniforminsizeFibreareintermixedwiththesmoothmusclebundles

8ClassificationaccordingtothesituationCorpus:90%Cervical:10%accordingtotherelationshipbetweenmyomaanduterinewallSubmucous:10%-15%Intramural:60%-70%Subserous:20%

9DegenerationThemyomalosethetypicalstructure(thespiralshape)Benigndegeneration1、hyaline2、cystic3、red4、calcificationMalignanttransformation:sarcomatouschange(0.4-0.8%)

10ClinicalsymptomSymptoms:presentin35-50%patientsSymptomsdependonthelocation,size,degenerationandwhetherornotthepatientispregnant

11AbnormaluterinebleedingPainPressuresymptomsInfertilitySpontaneousabortionMassClinicalsymptom

12ClinicalsymptomSignsAbdominalexam:Speculumexam:cervicalmyomaBimanualexam:Thediagosisisobviouswhenthenormaluterinecontourisdistortedbyoneormoresmooth,spherical,firmmasses,butoftenitisdifficulttobeabsolutelycertainthatsuchmassesarepartoftheuterus

13ClinicalsymptomLaboratoryandspecialexaminationsUltrasoundLabexam:anemia(menorrhagia)Hysteroscopy:identification,removalsubmucousLaparoscopy:thepreciseoriginofmyoma,myomectomy

14DiagnosisHistorySymptomsandsignsSpecialexam:especiallytheoutcomesofultrasound

15DifferentialdiagnosisOvariancarcinomaHyperplasiaandenlargedfallopiantubesTubo-ovarianabscessEndometriosisPregnantuteruspolypsMalformationofuteru