the cervix uteri and its diseasesPDF电子书下载

SECTION Ⅰ．THE NORMAL CERVIX 1

Chapter 1．DEVELOPMENTAL ANATOMY 3

Mesonephric and Müllerian Ducts 3

Cervix Uteri 6

Evolution of Cervical Mucosa 12

Squamous Epithelium 13

Columnar Epithelium 16

Glandular Structures 17

Submucosa 26

Chapter 2．GROSS ANATOMY 30

Isthmus Uteri 30

Cervix Uteri 34

Surface Markings 35

Ligaments 37

Blood Supply 39

Nerves 40

Lymphatic System 41

Chapter 3．HISTOLOGY 46

Squamous Epithelium 47

Columnar Epithelium 53

Squamous Prosoplasia(Squamous Metaplasia；Epidermidization) 56

Stages of Squamous Prosoplasia 58

Squamocolumnar Prosoplasia 64

Theories of Origin 66

Squamocolumnar Transitional Zone 71

Glandular Structures 79

Regression of the Mucosa and Tunnel Clusters 92

Tunnel Clusters 95

Chapter 4．PHYSIOLOGY 103

Sphincteric Action of Internal Os 103

Physicochemical Properties of Secretions 104

Cellular Activity 107

SECTION Ⅱ．DIAGNOSTIC PROCEDURES 109

Chapter 5．SUBJECTIVE AND OBJECTIVE EVIDENCE OF CERVICAL DISEASE 111

Chapter 6．CYTOLOGY 114

Indications for Vaginal Smears 115

Preparation of Vaginal Smears 115

Cytologic Examination 117

Chapter 7．TISSUE BIOPSY 126

Schiller Test 126

Biopsy of Ectocervix 127

Cone Biopsy 129

Chapter 8．COLPOSCOPY 133

Technique of Examination 135

Findings 135

Chapter 9．ROENTGENOLOGIC EXAMINATION 140

Technique 140

Findings 141

SECTION Ⅲ．CONGENITAL ANOMALIES AND TRAUMATIC AND FUNCTIONAL DISORDERS 143

Chapter 10．CONGENITAL ANOMALIES 145

Defects of Müllerian Ducts 145

Mesonephric Duct Remnants 150

Congenital Erosion 151

Chapter 11．INJURIES AND THE RETAINED CERVIX 155

Injuries 155

Lacerations 155

Perforations 156

Traumatic Ulcerations 157

Sequelae 157

Treatment 158

The Retained Cervix 159

Elongation of the Cervix 161

Chapter 12．STRICTURES AND ATRESIA 163

Etiology 163

Signs and Symptoms 166

Treatment 169

Chapter 13．THE CERVICAL FACTOR IN INFERTILITY 172

Anatomicopathologic Lesions 173

Functional Disorders 174

SECTION Ⅳ．INFLAMMATORY DISEASES 179

Chapter 14．CERVICITIS AND EROSION 181

Acute Cervicitis 181

Clinical Manifestations 182

Pathology 182

Diagnosis 183

Treatment 183

Chronic Cervicitis 184

Clinical Manifestations 184

Pathology 186

Erosion 188

Differential Diagnosis 195

Treatment 195

Erosion and Extensive Endocervicitis 198

Chapter 15．THE INFECTIOUS GRANULOMAS 203

Tuberculosis 203

Syphilis 208

Granuloma Inguinale 212

Lymphogranuloma Venereum 214

Chancroid 215

Chapter 16．FUNGOUS，PARASITIC，AND UNCLASSIFIED INFLAMMATIONS 217

Actinomycosis 217

Schistosomiasis(Bilharziasis) 219

Echinococcosis 222

Cervicovaginitis Emphysematosa 224

SECTION Ⅴ．NEWGROWTHS 229

Chapter 17．BENIGN NEWGROWTHS 231

Mucous Polyp 231

Papilloma 240

Myoma 244

Fibroma；Fibromyxoma；Fibroadenoma 249

Endometriosis 250

Mesonephric Cysts，Adenomatous Hyperplasia，and Papillary Adenoma 254

Vascular Tumors 256

Lipoma 259

Focal Hyperplasia(Tunnel Clusters)；Mucocele 260

Chapter 18．DYSPLASIA，CARCINOMA IN SITU，AND PRECLINICAL INVASION 263

Field Theory of Cancer 264

Site of Origin 266

Potential Neoplastic Fields 268

Clinical Significance 275

Management 278

Preinvasive Carcinoma 278

Incidence 280

Clinical Relationships 282

Histopathology 283

Histochemistry 293

Duration of Preinvasive Stage 296

Diagnosis 297

Clinical Staging 298

Management 298

Prognosis 299

Preclinical Invasion 300

Management 308

Chapter 19．INVASIVE CARCINOMA 315

Etiology 315

Symptoms and Signs 318

Cervical Cancer and Uterine Complications 320

Clinical Classification 321

Histopathology 323

Squamous Cell Carcinoma 324

Columnar Cell Carcinoma 331

Squamocolumnar Cell Carcinoma 336

Mesonephric Duct Carcinoma 341

Metastatic Carcinoma 347

Choriocarcinoma 347

Melanocarcinoma 347

Extension of Cervical Carcinoma 351

Diagnosis 356

Prognosis and Causes of Death 357

Chemotherapy 357

Chapter 20．THE TREATMENT OF INVASIVE CARCINOMA—RADIOSENSITIVITY—LYMPH NODE INVOLVEMENT—RESULTS 361

Historical Development 361

General Principles 363

Radiosensitivity 367

Nature of Tumor 368

Tumor Response 368

Lymph Node Involvement 376

Results of Treatment 377

Chapter 21．RADIOTHERAPY OF INVASIVE CARCINOMA 380

Effects of Radiation on Cervical Cancer 380

Preparation of Patient for Treatment 388

General Considerations 390

Units of Measurement 391

Factor of Distance 392

Quality of Radiation 393

Time Factor 394

Volume Factor 395

Dosimetry 395

Optimal Dosage 398

Methods of Treatment 399

Irradiation of Primary Growth 400

Intracavitary Radium 400

Intracavitary Cobalt-60 411

Transvaginal Roentgen Therapy 411

Irradiation of the Parametria 413

External Irradiation 415

Radioactive Colloidal Gold 420

Radioactive Cobalt Implants 421

Care of the Patient During Radiotherapy 421

Interstitial Irradiation 423

Some Problems of Radiotherapy 425

Sequelae of Radiotherapy 428

Results 432

Chapter 22．THE SURGICAL TREATMENT OF INVASIVE CARCINOMA 438

Radical Hysterectomy with Bilateral Pelvic Lymphadenectomy 438

Preoperative Preparation of Patient 441

The Operation 442

Results 456

Radical Vaginal Hysterectomy 458

Pelvic Lymphadenectomy 458

Pelvic Exenteration 460

Surgical Treatment of Local Recurrence 460

Chapter 23．INVASIVE CARCINOMA：SUMMARY OF METHODS OF TREATMENT—RECURRENCES—PALLIATION AND TERMINAL CARE 463

Follow-up Visits 464

Recurrences 464

Palliation and Terminal Care 466

Radiotherapy 467

Surgery 467

Medical Care 468

Pain Control 469

Chapter 24．SARCOMA 472

Incidence 473

Clinical Characteristics 473

Pathology 475

Histogenesis 482

Extension 483

Diagnosis 483

Treatment 483

Prognosis 483

SECTION Ⅵ．PREGNANCY 485

Chapter 25．THE CERVIX DURING PREGNANCY 487

Normal Anatomic and Functional Changes 487

Surface Markings 488

Mucosa 489

Glandular Structures 490

Stroma 499

Cervical Mucus 501

Erosion 503

Involution 506

Chapter 26．CERVICAL COMPLICATIONS AND INJURIES OF PREGNANCY AND LABOR 508

Pregnancy 508

Cervical Pregnancy 510

Cervical Dystocia 511

Lacerations 513

Annular Detachment 515

Chapter 27．THE INCOMPETENT CERVIX 519

The Incompetent Os in the Nonpregnant Woman 520

Management 522

The Incompetent Os During Pregnancy 523

Chapter 28．CARCINOMA AND PREGNANCY 532

Dysplasia and Preinvasive Carcinoma 533

Invasive Carcinoma 534

INDEX 539