Figure 1.60 Endocervical adenocarcinoma. A, The cells are round rather than elongated as in adenocarcinoma in situ (AIS). They are crowded and hyperchromatic, and a tumor diathesis is present. Tumor diathesis on liquid-based preparations appears as clumps and as a granular ring around groups of malignant cells (“clinging diathesis”). B, High magnification reveals the crowding and large nucleoli.
Figure 1.61 Endocervical adenocarcinoma compared to reactive endocervical cells. A, Endocervical adenocarcinoma, well differentiated. The cells are enlarged and crowded, but the features are not conclusive for malignancy (note the absence of tumor diathesis). A diagnosis of atypical glandular cells was made. B, Histologic sections showed adenocarcinoma. C, Reactive endocervical cells. These cells appear similar to those in A. D, Biopsies in this patient confirmed reactive changes resulting from inflammation.
Figure 1.62 Endocervical adenocarcinoma. These malignant cells show variation in nuclear size, with prominent nucleoli and coarsely granular chromatin.
Figure 1.63 Minimal deviation adenocarcinoma. A, The cells are sometimes impossible to distinguish from normal endocervical cells, as in this case. B, A cone biopsy revealed deeply invasive, misshapen neoplastic glands.
（二）、子宫内膜腺癌
1、细胞学表现 ? 圆形细胞； ? 核增大；
? 核深染 ? 核仁明显
? 胞浆稀少或丰富的空泡化胞质； ? 胞浆内中性粒细胞
多数病例瘤细胞数量少，且仅1/3出现肿瘤素质。瘤细胞圆形，散在分布或群集，与良性内膜细胞相比，胞浆空泡大而多（Fig 1.64A），常伴有组织细胞。
浆液性癌细胞大，多形性明显，易于识别。坏死性背景内出现大量裸核是其特征性表现之一。
Figure 1.64 Endometrial adenocarcinoma compared to intrauterine device (IUD) effect. A, Endometrial adenocarcinoma, endometrioid type. These malignant cells are large, vacuolated, and associated with neutrophils. B, IUD effect. Benign cells in women with an IUD are indistinguishable morphologically from those of endometrial adenocarcinomas.
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