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.

1;Preface to the Third Edition;5 2;Contents;6 3;1: Introduction to the First Edition;9 4;2: Technical Remarks;10 4.1;2.1 Procedures for Obtaining Endometrial Tissue;10 4.2;2.2 Selection of the Proper Time for Curettage;10 4.3;2.3 Preparation of the Endometrial Specimen;11 4.4;2.4 Interpretation of Endometrial Specimens;11 5;3: Normal Endometrium;13 5.1;3.1 Normal Menstrual Cycle;13 5.1.1;3.1.1 Proliferative Phase;13 5.1.1.1;Early Proliferative Phase;13 5.1.1.2;Midproliferative Phase;15 5.1.1.3;Late Proliferative Phase;17 5.1.2;3.1.2 Secretory Phase;18 5.1.3;3.1.3 Menstruation;41 5.1.4;3.1.4 Regeneration;44 5.2;3.2 Physiologic Variations in the Climacterium;44 5.2.1;3.2.1 Proliferative Phase;44 5.2.2;3.2.2 Secretory Phase;47 5.3;3.3 Normal Postmenopausal Endometrium;47 5.4;3.4 Isthmus Mucosa;49 6;4: Metaplastic Changes;51 6.1;4.1 Epithelial Metaplasia;51 6.1.1;4.1.1 Squamous Metaplasia and Ichthyosis;51 6.1.2;4.1.2 Mucinous Metaplasia;53 6.1.3;4.1.3 Papillary (Syncytial) Metaplasia;55 6.1.4;4.1.4 Tubal (Ciliated Cell) Metaplasia;55 6.1.5;4.1.5 Rare Forms of Metaplasia of Endometrial Glandular Epithelium;56 6.2;4.2 Stromal Metaplasia;58 7;5: Circulatory Disturbances;59 7.1;5.1 Pathologic Edema;59 7.2;5.2 Lymphatic Cysts;60 7.3;5.3 Apoplexia Uteri;61 8;6: Functional Disturbances;64 8.1;6.1 Anovulatory Disturbances;64 8.1.1;6.1.1 Atrophy;64 8.1.1.1;Diffuse Atrophy;64 8.1.1.2;Focal Pressure Atrophy;67 8.1.2;6.1.2 Resting Endometrium;68 8.1.3;6.1.3 Deficient Proliferation;68 8.1.4;6.1.4 Irregular (Disordered) Proliferation;70 8.1.4.1;6.1.4.1 Deficient or Irregular Proliferation with Focal Abortive Secretion;72 8.1.5;6.1.5 Anovulatory Withdrawal Bleeding;73 8.2;6.2 Endometrial Hyperplasia;75 8.2.1;6.2.1 Nonatypical Hyperplasia;75 8.2.1.1;6.2.1.1 Simple Hyperplasia;75 8.2.1.2;6.2.1.2 Complex (Adenomatous) Hyperplasia;82 8.2.2;6.2.2 Atypical Hyperplasia;89 8.2.3;6.2.6 Hyperplasia of Glands and Stroma;90 8.2.4;6.2.7 Focal Hyperplasia;90 8.2.5;6.2.8 Basal Hyperplasia;93 8.2.6;6.2.9 Endometrial Polyps;93 8.3;6.3 Ovulatory Disturbances;98 8.3.1;6.3.1 Deficient Secretory Phase;98 8.3.2;6.3.2 Irregular Shedding;103 8.3.3;6.3.3 Abnormal Decidual Shedding;110 8.4;6.4 Functional Endogenous Changes During the Perimenopausal Period;110 8.4.1;6.4.1 Secretory Hypertrophy;110 9;7: Iatrogenic Changes;114 9.1;7.1 After Hormone Therapy;114 9.1.1;7.1.1 Estrogen-Induced Hyperplasia;115 9.1.2;7.1.2 Gestagen Therapy;118 9.1.2.1;7.1.2.1 Arrested Secretion;118 9.1.2.2;7.1.2.2 Fibrous Atrophy;118 9.1.3;7.1.3 Gestagen Therapy of Atypical Hyperplasia or Adenocarcinoma;121 9.1.4;7.1.4 Combination Therapy;122 9.1.4.1;7.1.4.1 Abortive Secretion;122 9.1.4.2;7.1.4.2 Irregular Atrophy;128 9.1.4.3;7.1.4.3 Breakthrough Bleeding;128 9.1.4.4;7.1.4.4 Irregular Regeneration;128 9.1.4.5;7.1.4.5 Focal Stromal Hyperplasia;129 9.1.4.6;7.1.4.6 Pseudomelanosis;129 9.1.4.7;7.1.4.7 Focal Complex Hyperplasia;129 9.1.5;7.1.5 Hormones for Inducing Ovulation;129 9.1.5.1;7.1.5.2 Therapy with Clomiphen;130 9.1.5.2;7.1.6 Therapy with Tamoxifen;130 9.2;7.2 After Intrauterine Contraceptive Devices;130 9.2.1;7.2.1 Mechanical Decidualization;130 9.2.2;7.2.2 Perifocal Arrested Secretion;132 9.2.3;7.2.3 Surface Reaction Following Copper Devices;134 9.2.4;7.2.4 Endometritis;136 9.3;7.3 After Intrauterine Instillation;136 9.3.1;7.3.1 Histiocytic Storage Reaction;137 10;8: Endometritis;139 10.1;8.1 Acute Endometritis;139 10.2;8.2 Chronic Endometritis;141 10.3;8.3 Tuberculous Endometritis;143 10.4;8.4 Sarcoidosis;144 10.5;8.5 Actinomycosis;144 10.6;8.6 Foreign Body Granuloma;146 11;9: Neoplasms;149 11.1;9.1 Carcinomas;149 11.1.1;9.1.1 Adenocarcinomas of the Endometrioid Type;151 11.1.1.1;9.1.1.1 Early Adenocarcinoma;151 11.1.1.2;9.1.1.2 Well-Differentiated Adenocarcinoma;153 11.1.1.3;9.1.1.3 Dedifferentiated Adenocarcinoma;155 11.1.1.4;9.1.1.4 Secretory Adenocarcinoma;158 11.1.1.5;9.1.1.5 Estrogen Type of Adenocarcinoma;160 11.1.1.6;9.1.1.6 Sertoliform Variant of Adenocarcinoma;160 11.1.1.7;9.1.1.