Gisela Dallenbach-Hellweg – författare

The new edition of this atlas integrates all significant advances made in the past 15 years in molecular pathology,tumor virology,and genetics of cervical cancer. It emphasizes the importance of these advances in facilitating its pathological diagnosis and in op- mizing clinical management and prognosis. A new chapter on immunohistochemistry has been added,which includes refined detection methods,e. g. ,the overexpression of INK4a p16 as a molecular marker in the early differential diagnosis of premalignant - sions. The section on etiology and pathogenesis in human papillomavirus-induced neoplasia has been incorporated to represent new insights into the sequences of cel- lar and nuclear deregulation at the molecular level. All chapters have been revised to - clude the newest advances and relevant experiences in how to interpret and manage cervical disease; they are supported by the addition of 35 new microphotographic ill- trations. The tumor nomenclature is adapted to the latest edition of the WHO classi- cation; the morphology code of the international classification of diseases for oncology (ICD-O) has been added.We have also updated the list of references by adding recent relevant publications. Again,the staff of Springer-Verlag deserve our thanks for their patience and skill in preparing the manuscript and in reproducing the microphotographs. Heidelberg,February 2005 Gisela Dallenbach-Hellweg, Magnus von Knebel Doeberitz, and Marcus J. Trunk Heading2 Preface to the First Edition During the past decade our understanding of the histopathology of the cervix uteri has changed greatly.

This new edition differs from the preceding ones in that there has been extensive revision of most chapters. Recent advances in research gained by immunohistochemical, molecular biological, and cytogenetic methods are included, as far as they are applicable for daily diagnostic work. The chapter on neoplasms, in particular, has been greatly expanded in accordance with the new WHO International Histological Classification of genital tract tumors, covering all pertinent differential diagnostic aspects. The chapter on malignant lymphomas and hematopoetic neoplasms involving the endometrium is a new contribution to this edition (F. D. , Ulm). We have revised the chapter on gestational diseases, incorpor- ing recent advances in the differential diagnosis of gestational trophoblastic tumors. New discoveries and experiences in correlating structure and function in infertility and in h- mone replacement therapy of peri- and postmenopausal patients are also included. Many new microphotographs have been added to illustrate the advances in tumor research and in immunohistochemical detection methods. We have updated the list of references including recent relevant publications. To the correspondents and consultants who have contributed valuable observations and suggestions, bringing thereby to our attention omissions in the second edition, we acknowledge our cordial thanks. We thank Dr. Wolfram Klapper, Director of the L- phom Register of the University of Kiel, for case material for making the micropho- graphic illustrations of lymphomas. The staff of Springer-Verlag has earned our gratitude for their skill in preparing this new edition.

This new edition differs from the preceding ones in that there has been extensive revision of most chapters. Recent advances in research gained by immunohistochemical, molecular biological, and cytogenetic methods are included, as far as they are applicable for daily diagnostic work. The chapter on neoplasms, in particular, has been greatly expanded in accordance with the new WHO International Histological Classification of genital tract tumors, covering all pertinent differential diagnostic aspects. The chapter on malignant lymphomas and hematopoetic neoplasms involving the endometrium is a new contribution to this edition (F. D. , Ulm). We have revised the chapter on gestational diseases, incorpor- ing recent advances in the differential diagnosis of gestational trophoblastic tumors. New discoveries and experiences in correlating structure and function in infertility and in h- mone replacement therapy of peri- and postmenopausal patients are also included. Many new microphotographs have been added to illustrate the advances in tumor research and in immunohistochemical detection methods. We have updated the list of references including recent relevant publications. To the correspondents and consultants who have contributed valuable observations and suggestions, bringing thereby to our attention omissions in the second edition, we acknowledge our cordial thanks. We thank Dr. Wolfram Klapper, Director of the L- phom Register of the University of Kiel, for case material for making the micropho- graphic illustrations of lymphomas. The staff of Springer-Verlag has earned our gratitude for their skill in preparing this new edition.

The new edition of this atlas integrates all significant advances made in the past 15 years in molecular pathology,tumor virology,and genetics of cervical cancer. It emphasizes the importance of these advances in facilitating its pathological diagnosis and in op- mizing clinical management and prognosis. A new chapter on immunohistochemistry has been added,which includes refined detection methods,e. g. ,the overexpression of INK4a p16 as a molecular marker in the early differential diagnosis of premalignant - sions. The section on etiology and pathogenesis in human papillomavirus-induced neoplasia has been incorporated to represent new insights into the sequences of cel- lar and nuclear deregulation at the molecular level. All chapters have been revised to - clude the newest advances and relevant experiences in how to interpret and manage cervical disease; they are supported by the addition of 35 new microphotographic ill- trations. The tumor nomenclature is adapted to the latest edition of the WHO classi- cation; the morphology code of the international classification of diseases for oncology (ICD-O) has been added.We have also updated the list of references by adding recent relevant publications. Again,the staff of Springer-Verlag deserve our thanks for their patience and skill in preparing the manuscript and in reproducing the microphotographs. Heidelberg,February 2005 Gisela Dallenbach-Hellweg, Magnus von Knebel Doeberitz, and Marcus J. Trunk Heading2 Preface to the First Edition During the past decade our understanding of the histopathology of the cervix uteri has changed greatly.

Soweit Lebensabläufe mit einem Formwandel einhergehen, läßt sich von der Form her die Funktion interpretieren. Es konnte sich daher eine funktionelle Morphologie entwickeln, unter der wir die Deutung des morphologischen Befundes hinsichtlich seiner funktionellen Aussagekraft im Augenblick der Gewebsentnahme verstehen. Erfaßt werden soll dabei das Funktionsverhalten an Ort und Stelle als Reaktion auf einen übergeordneten Reiz. Eine befriedigende Lösung dieser Auf­ gabe ist nur durch die enge Zusammenarbeit zwischen Kliniker und Morphologen erreichbar, wobei u.a. der Wahl des Entnahmezeitpunkts entscheidende Bedeu­ tung zukommt: Das Erfolgsorgan muß den Funktionsreiz durch Formwandel bereits morphologisch beantwortet haben; die dadurch bedingte zeitliche Ver­ zögerung in der gestaltlichen Reaktion muß berücksichtigt werden. Auf diese Weise lassen sich die Art des Funktionswandels, sein Ablauf in der Zeit (durch wiederholte Entnahmen), seine Stärke und vor allem die biologische Wirksamkeit des funktionellen Reizes auf die Peripherie mit größerer Sicherheit beurteilen, als es durch eine Bestimmung der wirksamen Substanzen auf bio­ chemischem Wege möglich wäre. Mag sich diese Tatsache mit dem Fortschreiten unserer Erkenntnisse zugunsten der Biochemie verschieben, in der Praxis wird der nachzuweisende morphologische Effekt am Erfolgsorgan die Grundlage bleiben, die das Krankheitsgeschehen bestimmen läßt und das ärztliche Handeln festlegt. Neben die funktionelle Morphologie tritt im gleichen Präparat auch immer die Beurteilung lokaler Veränderungen, die nach dem heutigen Stand unserer Kennt­ nisse nicht oder nicht sicher durch funktionelle Steuerung hervorgerufen werden.

Reevaluation of tumor classification, differential diagnosisand differential therapy based on modern knowledge. Revisionof all chapters to incorporate new facts based on recentdiscoveries.

Reevaluation of tumor classification, differential diagnosisand differential therapy based on modern knowledge. Revisionof all chapters to incorporate new facts based on recentdiscoveries.

This atlas provides a comprehensive overview of the diagnostic value of phase-contrast microscopy in the cytologic examination of smears taken in the gynecological practice. The range of applications and methods are fully described. The text summarizes distinguishing factors of single cell and the overall clinical picture. The atlas section contains large-format photomicrographs of cells and cell clusters.

This atlas provides a comprehensive overview of the diagnostic value of phase-contrast microscopy in the cytologic examination of smears taken in the gynecological practice. The range of applications and methods are fully described. The text summarizes distinguishing factors of single cell and the overall clinical picture. The atlas section contains large-format photomicrographs of cells and cell clusters.

Although the purpose and scope of this monograph remain unchanged, I have been obliged to revise and rewrite many sections to keep pace with the recent growth in knowledge of endometrial pathology and physiology. New knowledge emanates from every quarter, engendered by improved meth­ ods of study in virtually every subspecialty, by exemplary cooperation between disciplines, and especially by the exchange of ideas internationally. On the other hand, the catalogue of diseases is everchanging. Some, once common, become rare or even disappear. Others suddenly appear, unique and previously unknown. Increased longevity, modern ways of living and new methods of treat­ ment have modified or augmented the clinical and diagnostic problems confront­ ing us. Accordingly, therapy with hormones and intrauterine contraception re­ ceive special attention, commensurate with the importance afforded them today. Under the precept "nil nocere," the almost unlimited uses for these agents warrant that their effects be carefully monitored by precise morphological stud­ ies, a prerequisite that succeeds only when clinician and pathologist cooperate closely. The sections on procedures for obtaining endometrial tissue, on steroid receptors, on functional disturbances, and on spontaneous abortion have been changed or expanded to incorporate new facts from recent discoveries that now appear significant. Only time, however, will prove their true value. Much of historical interest in the text has been left intact, for "who wants to read into the future, must consult the past" (Andre Malraux).

Although the purpose and scope of this monograph remain unchanged, I have been obliged to revise and rewrite many sections to keep pace with the recent growth in knowledge of endometrial pathology and physiology. New knowledge emanates from every quarter, engendered by improved meth­ ods of study in virtually every subspecialty, by exemplary cooperation between disciplines, and especially by the exchange of ideas internationally. On the other hand, the catalogue of diseases is everchanging. Some, once common, become rare or even disappear. Others suddenly appear, unique and previously unknown. Increased longevity, modern ways of living and new methods of treat­ ment have modified or augmented the clinical and diagnostic problems confront­ ing us. Accordingly, therapy with hormones and intrauterine contraception re­ ceive special attention, commensurate with the importance afforded them today. Under the precept "nil nocere," the almost unlimited uses for these agents warrant that their effects be carefully monitored by precise morphological stud­ ies, a prerequisite that succeeds only when clinician and pathologist cooperate closely. The sections on procedures for obtaining endometrial tissue, on steroid receptors, on functional disturbances, and on spontaneous abortion have been changed or expanded to incorporate new facts from recent discoveries that now appear significant. Only time, however, will prove their true value. Much of historical interest in the text has been left intact, for "who wants to read into the future, must consult the past" (Andre Malraux).

For this second, expanded edition, most of the chapters have been extensively revised to include the latest immunohistochemical and molecular biological methods. With its clearly thought-out structure, this atlas enables the pathologist to find, classify, and differentially diagnose each disease. 280 top-quality illustrations - over half in full colour - are each accompanied by a description of the pathology of the disease, a summary of the causes, an explanation of its clinical importance, and treatment options, emphasising the importance of constant mutual co-operation with the attending gynaecologist. Microphotographs are arranged systematically according to morphology, and each is followed by a short description together with the aetiology and morphologic and differential diagnosis of the different conditions. Hemming Poulsen is head of the WHO Collaborating Center for the Histological Classification of tumours and the new chapter on neoplasms, for example, reflects this new WHO classification. Additional chapters cover gestational diseases as well as new findings in infertility and hormone replacement therapy.

The endometrium differs from all other tissues of the body in that it rhythmically changes its structure and function. For many years the meaning of these changes remained puzzling and obscure. At about the turn of the century some investi­ gators held the physiological fluctuations of the menstrual cycle to be inflamma­ tory changes. Later, when stricter criteria for the pathology of the endometrium were applied, morphologists misinterpreted pathological fluctuations in the cycle either as physiological variations, or they overlooked them entirely. Today as previously the pathologist is often confronted with the dilemma that he is unable to adequately diagnose the endometrium merely from the structural changes. Accordingly, the gynecologist finds the pathological report of little value. In like manner, if the clinical information given the pathologist is incomplete, then he cannot form a clear notion of the clinical problem. Although the detection of focal lesions of the endometrium is important, of much greater consequence is the recognition of functional (hormonally controlled) variations and their cyclic course, for it is from these that the clinician is guided in deciding what therapy he should use. The ability to detect such functional changes requires not only that the morphologist possess a thorough knowledge of the physiological and pathological anatomy of the endometrium but also that he receive exact information about the patient''s menstrual history and have in­ sight into clinical problems.

An atlas covering the normal and pathologic histology of the uterine cervix. Differential diagnosis is given in detail yet related to clinical aspects, so that a functional de- scription of benefit in daily practice is achieved.