No.16
TBS TBS TBS 1 2 2 Low High 2 3 TBS ASC-USASC-H TBS TBS TBS
TBS ASCASC-US,ASC-H TBS ASC ASC LSIL ASC-US HSIL ASC-H ASC 1 ASC HPV HPV TBS HPV HPV ASC-US ASC-US
ASC-H ASC-US ASC-US ASC-H ASC-H ASC-H HSIL HSIL 1 5 HSIL 5 2 TBS ASC ASC-H TBS 1 TBS TBSTBS
701-0192 577 human papilloma virus(hpv) 1) 1 1a 1b a 2 atypical glandular cells Bethesda System 2001final atypical glandular cells 1 35 N/C 1 atypical glandular cells 3 endocervical glandular dysplasia(egd) Zaino 2 2 3 3 2a N/C 1
23 2b 4 a,b Endocervical adenocarcinoma in situ(acis) endocervical glandular dysplasia(egd) a N/C 23 4 Endocervical adenocarcinoma in situ(acis) 3a,b,c 3 a,b,c Endocervical adenocarcinoma in situ(acis) 4a,b 3c 3b 3a 1)2)3) 4) 46) 2 5 5a,b 2
5 a,b 5 a 6a,b 7a,b adenoma malignum Lobular endocervical glandular hyperplasia (LEGH) 8a,b,c 7,8 6a,b. 7a,b 8a,b,c adenoma malignum MGGMC1 3
LEGH 911 Lobular endocervical glandular hyperplasia (LEGH) LEGH 1011) 1) 9a,b,c2) 78 LEGH 1 8a,b,cLEGH 10a,b,c 6 9 a,b,c Lobular endocervical glandular hyperplasia (LEGH) LEGH 1 LEGH LEGH LEGH LEGH (Table 1) 10a,b,c Lobular endocervical glandular hyperplasia (LEGH) LEGH 11a,b 12 4
collagenous stroma 13a,b,c,d ) 11 a,b,c,d VS a,b c,d 11c,d (2) diethylstillbestrol (DBS) 2/3 vaginal adenosis 13) hobnail collagenous stroma 12a,b,c 14) 13 a,b,c 2003 Ioffe 16 03 4 03 45 6 (Table 2) 12 a,b,c,d 5
Ioffe 188 349LEGH 377 424 6 ( 5) () ( 3)( 2) 5 Abramas 17) 03% 14a 14b 14 a,b 28a 28b 2001 ASC squamous intraepithelial lesionsil (AGC) 4 (LEGH) Ioffe 1) Solomon,D., Nayar,R.: The Bethesda System for Reporting cervical cytology. 2rd ed., Springer, New York, 2004 2) Zaino,R.J.,: Symposium part I: adenocarcinoma in situ, glandular dysplasia, and early invasive adenocarcinoma of the uterine cervix. Int J Gynecol Pathol. 2002, 21: 314-26 3) van Aspert-van Erp AJM, van't Hof-Grootenboer AE, Brugal G, et al.: Endocervical columnar cell intraepithelial neoplasia. I. Discreminating cytomororphologic criteria. Acta Cytol, 1995, 39: 1199-1215 4) Bousfield,L., Pacey,F., Young,Q. et al.: Osborn R. Related Articles, Links Expanded cytologic criteria for the diagnosis of adenocarcinoma in situ of the cervix and related lesions. Acta Cytol. 1980, 24: 283-96 5) Lee,K.R., Manna,E.A., Jones,M.A. : Related Articles, Links Comparative cytologic features of adenocarcinoma in situ of the uterine cervix. Acta Cytol. 1991, 35: 117-126 6),,,,1995, 14: 23-26 7) Hata,S., Mikami,Y., Manabe,T.: Diagnostic significance of endocervical glandular cells with "golden-yellow" mucin on pap smear. Diagn Cytopathol. 2002, 27: 80-84 8),,,2006, 45.134-140 9) Nucci, M.R., Clement, P.B., Young, R.H. Lobular endocervical glandular hyperplasia, not otherwise specified: a clinicopathologic analysis of thirteen cases of a distinctive pseudoneoplastic lesion and comparison with fourteen cases of adenoma malignum. Am J Surg Pathol 1999, 23: 886-891 10) Mikami,Y., Hata,S., Fujiwara,K. et al. Endocervical Glandular Hyperplasia with Intestinal and Pyloric Gland Metaplasia: Worrisome Benign Mimic of "Adenoma Malignum" Gynecologic Oncology 1999, 74: 504-511 11) Mikami,Y., Hata,S., Melamed,J. et al. : Lobular 6
endocervical glandular hyperplasia is a metaplastic process with a pyloric gland phenotype histopatholology, 2001, l39: 364-372 12) Ajit.D., Dighe,S., Gujral,S.: Cytologic features of villoglandular adenocarcinoma of the cervix. Acta Cytol. 2004, 48: 288-289 13) Herbst, A.L., Scully. R.E.: Adenocarcinoma of the vagina in adolescence, a report of 7 cases including of clear cell carcinomas. Cancer 1970, 25: 745-757 14),,, 1996, 35:549-555 15),,,, 1986, 25: 1103-1108 16) Ioffe,O.B., Sagae,S., Moritani,S., et al. : Proposal of a new scoring scheme for the diagnosis of noninvasive endocervical glandular lesions. Am J Surg Pathol. 2003, 27: 452-460 17) Abramas,H.L., Spiro,R., Goldstein,N.: Metastases in carcinoma, analysis of 1000 autopsied cases. Cancer. 1950, 3: 74-85 7
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