《the cervix uteri and its diseases P556》

SECTION Ⅰ．THE NORMAL CERVIX1

Chapter 1．DEVELOPMENTAL ANATOMY3

Mesonephric and Müllerian Ducts3

Cervix Uteri6

Evolution of Cervical Mucosa12

Squamous Epithelium13

Columnar Epithelium16

Glandular Structures17

Submucosa26

Chapter 2．GROSS ANATOMY30

Isthmus Uteri30

Cervix Uteri34

Surface Markings35

Ligaments37

Blood Supply39

Nerves40

Lymphatic System41

Chapter 3．HISTOLOGY46

Squamous Epithelium47

Columnar Epithelium53

Squamous Prosoplasia(Squamous Metaplasia；Epidermidization)56

Stages of Squamous Prosoplasia58

Squamocolumnar Prosoplasia64

Theories of Origin66

Squamocolumnar Transitional Zone71

Glandular Structures79

Regression of the Mucosa and Tunnel Clusters92

Tunnel Clusters95

Chapter 4．PHYSIOLOGY103

Sphincteric Action of Internal Os103

Physicochemical Properties of Secretions104

Cellular Activity107

SECTION Ⅱ．DIAGNOSTIC PROCEDURES109

Chapter 5．SUBJECTIVE AND OBJECTIVE EVIDENCE OF CERVICAL DISEASE111

Chapter 6．CYTOLOGY114

Indications for Vaginal Smears115

Preparation of Vaginal Smears115

Cytologic Examination117

Chapter 7．TISSUE BIOPSY126

Schiller Test126

Biopsy of Ectocervix127

Cone Biopsy129

Chapter 8．COLPOSCOPY133

Technique of Examination135

Findings135

Chapter 9．ROENTGENOLOGIC EXAMINATION140

Technique140

Findings141

SECTION Ⅲ．CONGENITAL ANOMALIES AND TRAUMATIC AND FUNCTIONAL DISORDERS143

Chapter 10．CONGENITAL ANOMALIES145

Defects of Müllerian Ducts145

Mesonephric Duct Remnants150

Congenital Erosion151

Chapter 11．INJURIES AND THE RETAINED CERVIX155

Injuries155

Lacerations155

Perforations156

Traumatic Ulcerations157

Sequelae157

Treatment158

The Retained Cervix159

Elongation of the Cervix161

Chapter 12．STRICTURES AND ATRESIA163

Etiology163

Signs and Symptoms166

Treatment169

Chapter 13．THE CERVICAL FACTOR IN INFERTILITY172

Anatomicopathologic Lesions173

Functional Disorders174

SECTION Ⅳ．INFLAMMATORY DISEASES179

Chapter 14．CERVICITIS AND EROSION181

Acute Cervicitis181

Clinical Manifestations182

Pathology182

Diagnosis183

Treatment183

Chronic Cervicitis184

Clinical Manifestations184

Pathology186

Erosion188

Differential Diagnosis195

Treatment195

Erosion and Extensive Endocervicitis198

Chapter 15．THE INFECTIOUS GRANULOMAS203

Tuberculosis203

Syphilis208

Granuloma Inguinale212

Lymphogranuloma Venereum214

Chancroid215

Chapter 16．FUNGOUS，PARASITIC，AND UNCLASSIFIED INFLAMMATIONS217

Actinomycosis217

Schistosomiasis(Bilharziasis)219

Echinococcosis222

Cervicovaginitis Emphysematosa224

SECTION Ⅴ．NEWGROWTHS229

Chapter 17．BENIGN NEWGROWTHS231

Mucous Polyp231

Papilloma240

Myoma244

Fibroma；Fibromyxoma；Fibroadenoma249

Endometriosis250

Mesonephric Cysts，Adenomatous Hyperplasia，and Papillary Adenoma254

Vascular Tumors256

Lipoma259

Focal Hyperplasia(Tunnel Clusters)；Mucocele260

Chapter 18．DYSPLASIA，CARCINOMA IN SITU，AND PRECLINICAL INVASION263

Field Theory of Cancer264

Site of Origin266

Potential Neoplastic Fields268

Clinical Significance275

Management278

Preinvasive Carcinoma278

Incidence280

Clinical Relationships282

Histopathology283

Histochemistry293

Duration of Preinvasive Stage296

Diagnosis297

Clinical Staging298

Management298

Prognosis299

Preclinical Invasion300

Management308

Chapter 19．INVASIVE CARCINOMA315

Etiology315

Symptoms and Signs318

Cervical Cancer and Uterine Complications320

Clinical Classification321

Histopathology323

Squamous Cell Carcinoma324

Columnar Cell Carcinoma331

Squamocolumnar Cell Carcinoma336

Mesonephric Duct Carcinoma341

Metastatic Carcinoma347

Choriocarcinoma347

Melanocarcinoma347

Extension of Cervical Carcinoma351

Diagnosis356

Prognosis and Causes of Death357

Chemotherapy357

Chapter 20．THE TREATMENT OF INVASIVE CARCINOMA—RADIOSENSITIVITY—LYMPH NODE INVOLVEMENT—RESULTS361

Historical Development361

General Principles363

Radiosensitivity367

Nature of Tumor368

Tumor Response368

Lymph Node Involvement376

Results of Treatment377

Chapter 21．RADIOTHERAPY OF INVASIVE CARCINOMA380

Effects of Radiation on Cervical Cancer380

Preparation of Patient for Treatment388

General Considerations390

Units of Measurement391

Factor of Distance392

Quality of Radiation393

Time Factor394

Volume Factor395

Dosimetry395

Optimal Dosage398

Methods of Treatment399

Irradiation of Primary Growth400

Intracavitary Radium400

Intracavitary Cobalt-60411

Transvaginal Roentgen Therapy411

Irradiation of the Parametria413

External Irradiation415

Radioactive Colloidal Gold420

Radioactive Cobalt Implants421

Care of the Patient During Radiotherapy421

Interstitial Irradiation423

Some Problems of Radiotherapy425

Sequelae of Radiotherapy428

Results432

Chapter 22．THE SURGICAL TREATMENT OF INVASIVE CARCINOMA438

Radical Hysterectomy with Bilateral Pelvic Lymphadenectomy438

Preoperative Preparation of Patient441

The Operation442

Results456

Radical Vaginal Hysterectomy458

Pelvic Lymphadenectomy458

Pelvic Exenteration460

Surgical Treatment of Local Recurrence460

Chapter 23．INVASIVE CARCINOMA：SUMMARY OF METHODS OF TREATMENT—RECURRENCES—PALLIATION AND TERMINAL CARE463

Follow-up Visits464

Recurrences464

Palliation and Terminal Care466

Radiotherapy467

Surgery467

Medical Care468

Pain Control469

Chapter 24．SARCOMA472

Incidence473

Clinical Characteristics473

Pathology475

Histogenesis482

Extension483

Diagnosis483

Treatment483

Prognosis483

SECTION Ⅵ．PREGNANCY485

Chapter 25．THE CERVIX DURING PREGNANCY487

Normal Anatomic and Functional Changes487

Surface Markings488

Mucosa489

Glandular Structures490

Stroma499

Cervical Mucus501

Erosion503

Involution506

Chapter 26．CERVICAL COMPLICATIONS AND INJURIES OF PREGNANCY AND LABOR508

Pregnancy508

Cervical Pregnancy510

Cervical Dystocia511

Lacerations513

Annular Detachment515

Chapter 27．THE INCOMPETENT CERVIX519

The Incompetent Os in the Nonpregnant Woman520

Management522

The Incompetent Os During Pregnancy523

Chapter 28．CARCINOMA AND PREGNANCY532

Dysplasia and Preinvasive Carcinoma533

Invasive Carcinoma534

INDEX539