By P. Stoll, P. Stoll Jr. (auth.), Gisela Dallenbach-Hellweg (eds.)
Few topics in gynecology, not to mention in drugs quite often, have provoked such inter est or learn as cervical melanoma. even if the wealth of monographs and books post ed at the topic would appear to obviate the necessity for extra, the nice advances made within the scientific sciences and in gynecological event and strategies lately demand, if now not require, a brand new e-book on cervical melanoma to collect the most recent principles and developments in its tools of analysis, analysis, and remedy. even though precancerous lesions became extra universal, the variety of girls constructing invasive cervical carcinomas has now not elevated, owing partly to courses of sufferer schooling, partially to screening examinations backed via the govt. The gynecologist is now in a position to observe with well-tried and proved options precan cerous states of the cervix, and to regard those successfully prior to they turn into invasive melanoma. as a result, contemporary pursuits in cervical melanoma have shifted from the vintage descrip tion of invasive carcinoma to more moderen reports of reason, prognosis, remedy, and terminol ogy of its precursors. because the reader will examine, epidemiological stories as courses for the long run account for, and justifiably so, an enormous a part of this e-book. New wisdom approximately alterations within the morphology of cervical carcinoma confirms its dependency on hormonal stimulation. in addition, modem studies serve to provide an explanation for which treatment is better. Overlapping of innovations and evaluations among a few chapters couldn't be avoided.
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The cytologist uses this fact, together with a range of characteristic abnonnalities, to allot the cells to their place among the different fonns of dysplasia outlined above. All these details are then assembled in the final synopsis. Within certain limits the number of abnonnal cells in a smear can serve as an additional guide to the severity of the lesion. The more severe the dysplasia, the greater is 52 the number of exfoliated abnormal cells. This is due to their shortened generation time and their higher desquamation rate (Ferenczy 1977;Patten 1969).
In such cases special care is needed to distinguish between regenerating epithelium and proliferating neoplastic cells (Fig. 18). Fig. 18. Regenerating epithelium. x 40 Reserve cells are for the most part rounded in shape and have a centrally situated nucleus. Their chromatin structure is finely granular and shows no obvious areas of condensation which might be taken for nucleoli. Their cytoplasm is delicate and cyanophilic. They are smaller than basal cells (Soost and Baur 1980) and can best be recognized when they are still adherent to the deep surface of the columnar cells.
However, by no means all tumors have an increased chromatin content. Furthermore, it should be remembered that the impression of hyperchromasia depends on two factors, namely nuclear volume and chromatin content. A nucleus with a normal chromatin content will appear hyperchromatic if it is shrunk but hypochromatic if it is enlarged; in other words the impression of hyperchromasia or hypochromasia is to some extent determined by degenerative changes. From this it follows that the two phenomena must be considered in conjunction if they are to be properly evaluated.