By Gisela Dallenbach-Hellweg, F.D. Dallenbach
Even if the aim and scope of this monograph stay unchanged, i've been obliged to revise and rewrite many sections to maintain speed with the hot development in wisdom of endometrial pathology and body structure. New wisdom emanates from each area, engendered through more advantageous meth ods of research in almost each subspecialty, by way of exemplary cooperation among disciplines, and particularly by means of the alternate of rules across the world. nevertheless, of illnesses is everchanging. a few, as soon as universal, develop into infrequent or maybe disappear. Others unexpectedly seem, distinct and formerly unknown. elevated durability, smooth methods of residing and new equipment of deal with ment have changed or augmented the scientific and diagnostic difficulties confront ing us. for that reason, remedy with hormones and intrauterine birth control re ceive targeted consciousness, commensurate with the significance afforded them this day. less than the principle "nil nocere," the just about limitless makes use of for those brokers warrant that their results be rigorously monitored through particular morphological stud ies, a prerequisite that succeeds merely whilst clinician and pathologist cooperate heavily. The sections on methods for acquiring endometrial tissue, on steroid receptors, on useful disturbances, and on spontaneous abortion were replaced or increased to include new proof from contemporary discoveries that now look major. simply time, even if, will end up their actual price. a lot of historic curiosity within the textual content has been left intact, for "who desires to learn into the longer term, needs to seek advice the previous" (Andre Malraux).
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Additional info for Histopathology of the Endometrium
The endometrial granulocytes, about as numerous premenstrualIy as the predecidual celIs, were mistaken originally for polymorphonuclear leukocytes until studies disclosed their true nature. During the normal menstrual cycle the polymorphonuclear leukocytes infiltrate the dissociated endometrium only after menstruation has set in. No leukocyte infiltration of normal endometrium takes place before menstruations begins. A special type of predecidual cell that occasionally may be seen is the metachromatic cell (ASPLUND and HOLMGREN, 1947; McKAY, 1950; RUMBOLZ and GREENE, 1957; HELLWEG, 1959; Fig.
The great increase of clear cells in glandular-cystic hyperplasia found by all investigators parallels the rise in mitotic rate of the hyperplastic epithelium. In contrast, SARBACH (1955) believes some of the clear cells represent degenerating forms developing after an unsuccessful mitosis caused by excessive stimulation with estrogen. MULLER (1951) and FEYRTER (1952) assumed the clear cells were active as endocrine cells. FEYRTER even included them among the clear cells of the" generalized endocrine organ of epithelia" which he described.
Thus, the superficial epithelium also differs from the glandular epithelium functionally. That difference is easy to understand when we consider how important its secretion might be for the adherence and implantation of the blastocyst. As revealed by scanning electron microscopy, during the secretory phase the cilia degenerate, and as the apical surface of the cell continues to bulge into the uterine cavity the size and number of its microvilli decrease (JOHANNISSON and NILSSON, 1972). 26 The Normal Histology of the Endometrium c) The Stromal Cells The endometrial stroma consists of pluripotential mesenchymal cells, which at the beginning of the menstrual cycle are uniformly spindle-shaped, poorly differentiated, and joined to one another by cytoplasmic processes.