Libre Pathology - User contributions [en]

Ovary

2017-08-05T10:08:25Z

John:

The '''ovary''' has a wealth of [[pathology]]. It has benign tumours and malignant ones. It is a significant part of [[gynecologic pathology]].

=Normal ovary=
*Corpora albicans - pale/white body with lobulated contour.
**Involuted corpus luteum.
**Not seen pre-pubertal.
**Number increase with age.
*Ovarian follicles.
*Stroma - '''hyperchromatic''' - spindle morphology, whorling.
**If the cells have a round morphology... think about [[endometriosis]].

===Images===
www:
*[http://media.photobucket.com/image/ovary%20histology/lovesthesunset/anatomy%20and%20physiology/ovarycorpusluteum.jpg Ovarian stroma (photobucket.com)].
<gallery>
Image:Corpus_albicans.JPG| Corpus albicans. (WC)
</gallery>

=Cysts - overview=
==General==
*Very common.

Most common:
*Serous cystadenoma.
**Usually uniloculated.
**Morphology: ciliated, columnar.
*Mucinous cystadenoma.
**Usually multiloculated.<ref>IAV. 6 February 2009.</ref>
***Memory device: '''m'''ultiloculated = '''m'''ucinous.
*Endometrioma (see [[endometriosis]]).
*Simple cyst.
*[[Corpus luteum cyst]].
*Cancerous cyst (see [[ovarian cancer]]).

Notes:
*Epithelium is often lost in processing - may make interpretation challenging
*Ovarian surface epithelium (previously call ''germinal epithelium'') - covers the ovary
**Cuboidal/flat epithelium.<ref>{{cite journal |author=Auersperg N, Wong AS, Choi KC, Kang SK, Leung PC |title=Ovarian surface epithelium: biology, endocrinology, and pathology |journal=Endocr. Rev. |volume=22 |issue=2 |pages=255–88 |year=2001 |month=April |pmid=11294827 |doi= |url=http://edrv.endojournals.org/cgi/pmidlookup?view=long&pmid=11294827}}</ref>
**Has ovarian stroma underneath.
**Hobnail morphology (free surface larger than basement membrane surface).<ref>ALS. 5 February 2009.</ref>

Ovarian surface vs. mesothelium:
*Image: [http://edrv.endojournals.org/cgi/content/full/22/2/255/F2 ovarian surface epithelium] - endojournals.org.
*Image: [http://internetattitude.com/bioimage/OldSlides/bio231histo800x600/Mesothelium%20Simple%20Squamous%20x440.JPG mesothelium] - internetattitude.com.

=Specific benign diagnoses=
==Endometriosis==
{{main|Endometriosis}}

==Corpus luteum cyst==
===General===
*Normal in childbearing age women.

===Gross===
*Classically yellow.

===Microscopic===
Features:
*Pseudocyst lined by stratified, pale staining (luteinized) cells.
*+/-Hemorrhagic centre.

Images:
*[http://commons.wikimedia.org/wiki/File:Luteinized_follicular_cyst.jpg Luteinized cells in a follicular cyst (WC)].
*[http://php.med.unsw.edu.au/embryology/index.php?title=File:Ovary_corpus_luteum.jpg Corpus luteum (unsw.edu.au)].

==Benign mesothelial inclusion cyst==
*[[AKA]] ''mesothelial inclusion cyst''.
*[[AKA]] ''[[peritoneal inclusion cyst]]''.{{fact}}
*[[AKA]] ''cortical inclusion cyst''.<ref name=pmid11207821>{{Cite journal | last1 = Feeley | first1 = KM. | last2 = Wells | first2 = M. | title = Precursor lesions of ovarian epithelial malignancy. | journal = Histopathology | volume = 38 | issue = 2 | pages = 87-95 | month = Feb | year = 2001 | doi = | PMID = 11207821 }}</ref>{{fact}}
*[[AKA]] ''surface epithelial inclusion cyst''.

===General===
*May be found incidentally, e.g. during C-section.

Epidemiology:
*Associated with previous surgery.

===Gross===
*May mimic mucinous tumour - to unexperienced.<ref>GAG 26 Feb 2009.</ref>
*Thin-wall.<ref name=pmid16092670>{{cite journal |author=Urbanczyk K, Skotniczny K, Kucinski J, Friediger J |title=Mesothelial inclusion cysts (so-called benign cystic mesothelioma)--a clinicopathological analysis of six cases |journal=Pol J Pathol |volume=56 |issue=2 |pages=81-7 |year=2005 |pmid=16092670 |doi= |url=}}</ref>
*Clear/translucent fluid.

===Microscopic===
Features:
*Benign mesothelium.
**Single layer of squamoid or cuboid mesothelial cells.<ref name=pmid16092670/>

DDx:
*[[Serous cystadenoma of the ovary]] - must be >=1 cm.<ref name=Ref_GP384>{{Ref GP|384}}</ref>

Image:
*[http://www.jultrasoundmed.org/content/27/3/327/F3.expansion.html Cortical inclusion cyst (jultrasounmed.org)].<ref name=pmid18314510>{{Cite journal | last1 = Asch | first1 = E. | last2 = Levine | first2 = D. | last3 = Kim | first3 = Y. | last4 = Hecht | first4 = JL. | title = Histologic, surgical, and imaging correlations of adnexal masses. | journal = J Ultrasound Med | volume = 27 | issue = 3 | pages = 327-42 | month = Mar | year = 2008 | doi = | PMID = 18314510 }}</ref>

===[[IHC]]===
*[[CK]] +ve, [[calretinin]] +ve.<ref name=pmid16092670/>

===Sign out===
<pre>
OVARY, LEFT, BIOPSY:
- BENIGN CORTICAL INCLUSION CYST.
</pre>

==Ovarian infarct==
{{Main|Ovarian infarct}}

==Pregnancy luteoma==
*[[AKA]] ''luteoma of [[pregnancy]]''.
{{Main|Pregnancy luteoma}}

=Ovarian tumours=
{{main|Ovarian tumours}}

For a ''very'' brief overview of gynecologic tumours see: ''[[Gynecologic pathology]]''.

=See also=
*[[Gynecologic pathology]].
*[[Testis]].

=References=
{{reflist|2}}

[[Category:Gynecologic pathology]]

User talk:Michael

2017-06-26T18:34:49Z

John: /* Thanks */

[[Image:Yakyakyak.gif|center]]
==Editing==
HI Michael - I was trying to form a page for mesenchymal chondrosarcoma with much failure - so I stuck what I was working on in the chondrosarc summary. If you can form a page for it great - if not I'll alter the format it's is in now. Cheers - [[User:Sarah|Sarah]] ([[User talk:Sarah|talk]]) 23:43, 19 November 2014 (EST)

Thanks Michael - I couldnt figure out how to get to a redirecting page that already exists. Cheers - [[User:Sarah|Sarah]] ([[User talk:Sarah|talk]]) 05:53, 20 November 2014 (EST)

Thanks again Michael - Totally helpful. [[User:Sarah|Sarah]] ([[User talk:Sarah|talk]]) 21:01, 22 November 2014 (EST)

==Citing textbooks==
Hi Michael -- What do you suggest for referencing if I'm citing a textbook, as they don't have a simple PMID I can use? For example, for a lot of smear stuff I tend to refer to Dr. Joseph's book (Diagnostic Neuropathology Smears). Is there any way to use something like Mendeley Desktop to help with references? [[User:Ana|Ana]] ([[User talk:Ana|talk]]) 08:10, 17 February 2015 (MST)

==Images==
Hi Michael - I'm adding images into Wiki Commons with help from some non-pathologist assistants (OK - they are my kids). I'm going in after to clean up. I wont be insulted if anyone wants to remove some of the dodgy images from Libre but I include them as though technically they may be poor, they show something of interest. Regarding the breast - IMO - if one removes the in between or spongy diagnoses (like 'atypia') and focuses on diagnoses that actually have major effect on treatment, pathologists do great (and at a relatively low cost). Exceptional cases are thankfully usually pretty rare - including issues such as atypical Spitz vs level 3 melanoma. For these exceptional situations, effort should focus on molecular discriminants as it's pretty clear that routine histo is pretty worthless in those cases. Unfortunately, much of the 'pathologists suck' literature includes variance in unimportant diagnoses ie mild vs moderate atypia and/or misrepresentations of a few exceptional situations. BTW - I am going to try to ad a page on triple neg breast CA as that is a confusing issue that ties in to several diagnoses. [[User:Sarah|Sarah]] ([[User talk:Sarah|talk]]) 19:47, 19 March 2015 (EDT)

==Infobox==
Hi Michael - see [[Myxopapillary_ependymoma]]. I copied the source from another infobox, but LP doesn't render this stuff. What I am missing? --[[User:Jensflorian|Jensflorian]] ([[User talk:Jensflorian|talk]]) 10:41, 27 April 2015 (EDT)

==Anything on the wishlist? Policy development==
Hi Michael - Guidelines on histopathological images are certainly helpful. How many pictures in a gallery for a single specimen? Different magnifications? Immunostaining figures?
Minimum requirement for a sufficent picture (size, quality, balance)? Format (jpeg / tif) and copyright restrictions?
* Other thoughts:
** Is there any open source format for slide scanning? -> Idea: Virtual microscopy with annotations.
** Commented videos on basic microscopying / specimen analysis? (will be a time-consuming task).
--[[User:Jensflorian|Jensflorian]] ([[User talk:Jensflorian|talk]]) 02:31, 13 May 2015 (EDT)

== TSA edits etc.. ==

Hi Michael,
I tried to add to the TSA article from a paper from Chetty that is still in press, e.g. the IHC findings etc. How do I format an in press and link it and do you hate that I added to the box, should I have added to the main article instead?

Learning slowly, now that I'm barely not drowning...
(Bettington & Chetty, 2015 Human Pathology, in press)**

Slowly will revise the other things I've done with the guys (yuan, nizar and greg and maybe tra!).
[[User:Tate|Tate]] ([[User talk:Tate|talk]]) 21:36, 19 May 2015 (EDT)Tate

== Account creator ==
Hi Michael,
Sure, i can do that, let me know as I'd like to get greg, nizar, tra, robyn, sarah, sanaz, and stephanie B involved too!!
Thanks,
Tate [[User:Tate|Tate]] ([[User talk:Tate|talk]]) 10:22, 22 May 2015 (EDT)Tate
([[User talk:Tate|talk]])

== References hidden ==
Hi Michael,
have a look at case [[Case_121]] - how do I hide the references into the comments?
--[[User:Jensflorian|Jensflorian]] ([[User talk:Jensflorian|talk]]) 05:02, 29 February 2016 (EST)

== Cite generator ==
Hi Michael,
Currently I do get only empty results when entering the PMID. Is this just temporary?
--[[User:Jensflorian|Jensflorian]] ([[User talk:Jensflorian|talk]]) 08:30, 5 April 2016 (EDT)

== Thanks ==

Hi, thanks for the reply, I think the site is great so please don't take my suggestion as a criticism.--[[User:John|John]] ([[User talk:John|talk]]) 14:34, 26 June 2017 (EDT)

User talk:Michael

2017-06-26T18:34:33Z

John: /* Thanks */

[[Image:Yakyakyak.gif|center]]
==Editing==
HI Michael - I was trying to form a page for mesenchymal chondrosarcoma with much failure - so I stuck what I was working on in the chondrosarc summary. If you can form a page for it great - if not I'll alter the format it's is in now. Cheers - [[User:Sarah|Sarah]] ([[User talk:Sarah|talk]]) 23:43, 19 November 2014 (EST)

Thanks Michael - I couldnt figure out how to get to a redirecting page that already exists. Cheers - [[User:Sarah|Sarah]] ([[User talk:Sarah|talk]]) 05:53, 20 November 2014 (EST)

Thanks again Michael - Totally helpful. [[User:Sarah|Sarah]] ([[User talk:Sarah|talk]]) 21:01, 22 November 2014 (EST)

==Citing textbooks==
Hi Michael -- What do you suggest for referencing if I'm citing a textbook, as they don't have a simple PMID I can use? For example, for a lot of smear stuff I tend to refer to Dr. Joseph's book (Diagnostic Neuropathology Smears). Is there any way to use something like Mendeley Desktop to help with references? [[User:Ana|Ana]] ([[User talk:Ana|talk]]) 08:10, 17 February 2015 (MST)

==Images==
Hi Michael - I'm adding images into Wiki Commons with help from some non-pathologist assistants (OK - they are my kids). I'm going in after to clean up. I wont be insulted if anyone wants to remove some of the dodgy images from Libre but I include them as though technically they may be poor, they show something of interest. Regarding the breast - IMO - if one removes the in between or spongy diagnoses (like 'atypia') and focuses on diagnoses that actually have major effect on treatment, pathologists do great (and at a relatively low cost). Exceptional cases are thankfully usually pretty rare - including issues such as atypical Spitz vs level 3 melanoma. For these exceptional situations, effort should focus on molecular discriminants as it's pretty clear that routine histo is pretty worthless in those cases. Unfortunately, much of the 'pathologists suck' literature includes variance in unimportant diagnoses ie mild vs moderate atypia and/or misrepresentations of a few exceptional situations. BTW - I am going to try to ad a page on triple neg breast CA as that is a confusing issue that ties in to several diagnoses. [[User:Sarah|Sarah]] ([[User talk:Sarah|talk]]) 19:47, 19 March 2015 (EDT)

==Infobox==
Hi Michael - see [[Myxopapillary_ependymoma]]. I copied the source from another infobox, but LP doesn't render this stuff. What I am missing? --[[User:Jensflorian|Jensflorian]] ([[User talk:Jensflorian|talk]]) 10:41, 27 April 2015 (EDT)

==Anything on the wishlist? Policy development==
Hi Michael - Guidelines on histopathological images are certainly helpful. How many pictures in a gallery for a single specimen? Different magnifications? Immunostaining figures?
Minimum requirement for a sufficent picture (size, quality, balance)? Format (jpeg / tif) and copyright restrictions?
* Other thoughts:
** Is there any open source format for slide scanning? -> Idea: Virtual microscopy with annotations.
** Commented videos on basic microscopying / specimen analysis? (will be a time-consuming task).
--[[User:Jensflorian|Jensflorian]] ([[User talk:Jensflorian|talk]]) 02:31, 13 May 2015 (EDT)

== TSA edits etc.. ==

Hi Michael,
I tried to add to the TSA article from a paper from Chetty that is still in press, e.g. the IHC findings etc. How do I format an in press and link it and do you hate that I added to the box, should I have added to the main article instead?

Learning slowly, now that I'm barely not drowning...
(Bettington & Chetty, 2015 Human Pathology, in press)**

Slowly will revise the other things I've done with the guys (yuan, nizar and greg and maybe tra!).
[[User:Tate|Tate]] ([[User talk:Tate|talk]]) 21:36, 19 May 2015 (EDT)Tate

== Account creator ==
Hi Michael,
Sure, i can do that, let me know as I'd like to get greg, nizar, tra, robyn, sarah, sanaz, and stephanie B involved too!!
Thanks,
Tate [[User:Tate|Tate]] ([[User talk:Tate|talk]]) 10:22, 22 May 2015 (EDT)Tate
([[User talk:Tate|talk]])

== References hidden ==
Hi Michael,
have a look at case [[Case_121]] - how do I hide the references into the comments?
--[[User:Jensflorian|Jensflorian]] ([[User talk:Jensflorian|talk]]) 05:02, 29 February 2016 (EST)

== Cite generator ==
Hi Michael,
Currently I do get only empty results when entering the PMID. Is this just temporary?
--[[User:Jensflorian|Jensflorian]] ([[User talk:Jensflorian|talk]]) 08:30, 5 April 2016 (EDT)

== Thanks ==

Hi, thanks for the reply, I think the site is great so please don't take my suggestion as a criticism.

[[User:John|John]] ([[User talk:John|talk]]) 14:34, 26 June 2017 (EDT)

User talk:Michael

2017-06-26T18:32:25Z

John: /* Thanks */ new section

Talk:Case 52

2017-05-22T10:34:28Z

John: ? broader range of IHC for this case

The list of IHC for which" Dr Torres asks why" includes the following choices that I think are reasonable
*CD56 - generally considered the most sensitive neuroendocrine marker (and least specific), routinely we use CD56, synaptophysin, CrgA, and...
*Ki67 - useful for assessing mitotic activity in typical vs atypical carcinoids
*PanCK or AE1/AE3: Given the differential includes an adeno I think a cytokeratin would be reasonable

Talk:Case 52

2017-05-22T10:33:43Z

John: ? broader range of IHC for this case

The list of IHC for which Dr Torres asks why includes the following choices that I think are reasonable
*CD56 - generally considered the most sensitive neuroendocrine marker (and least specific), routinely we use CD56, synaptophysin, CrgA, and...
*Ki67 - useful for assessing mitotic activity in typical vs atypical carcinoids
*PanCK or AE1/AE3: Given the differential includes an adeno I think a cytokeratin would be reasonable

Talk:Case 52

2017-05-22T10:31:17Z

John: ? broader range of IHC for this case

The list of IHC for which Dr Torres asks why includes the following choices that I think are reasonable
CD56 - generally considered the most sensitive neuroendocrine marker (and least specific), routinely we use CD56, synaptophysin, CrgA, and...
Ki67 - useful for assessing mitotic activity in typical vs atypical carcinoids
PanCK or AE1/AE3: Given the differential includes an adeno I think a cytokeratin would be reasonable