Difference between revisions of "An introduction to gynecologic pathology"

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An introduction to gynecologic pathology (view source)

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*Abbreviated ''FATWO''.
*Abbreviated ''FATWO''.
*[[AKA]] ''Wolffian adnexal tumour''.
*[[AKA]] ''Wolffian adnexal tumour''.
===General===
{{Main|Female adnexal tumour of probable Wolffian origin}}
*Super rare.<ref name=pmid22611973>{{Cite journal  | last1 = Tianmin | first1 = X. | last2 = Weiqim | first2 = C. | last3 = Mianhua | first3 = C. | last4 = Xiaocui | first4 = L. | last5 = Hongwen | first5 = G. | last6 = Min | first6 = Y. | title = Tumor of the mesosalpinx: case report of a female adnexal tumor of probable Wolffian origin. | journal = Eur J Gynaecol Oncol | volume = 33 | issue = 2 | pages = 233-5 | month =  | year = 2012 | doi =  | PMID = 22611973 }}</ref>
*Adnexal - as the name suggests.
*Usually benign.
**May be malignant.<ref name=pmid21542539>{{Cite journal  | last1 = Heller | first1 = DS. | last2 = Kadire | first2 = B. | last3 = Cracchiolo | first3 = B. | title = Malignant female adnexal tumor of probable Wolffian origin: a case report. | journal = J Reprod Med | volume = 56 | issue = 3-4 | pages = 175-7 | month =  | year =  | doi =  | PMID = 21542539 }}</ref>
 
===Microscopic===
Features:
*Tubular/glandular spaces.
 
DDx:
*[[Brenner tumour]].


=Introduction to gynecologic tumours=
=Introduction to gynecologic tumours=
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| [[FATWO]], [[mesonephric adenocarcinoma]]
| [[FATWO]], [[mesonephric adenocarcinoma]]
| Develops into vas deferens in males.  
| Develops into vas deferens in males.  
| [http://www.uoguelph.ca/~rfoster/repropath/surgicalpath/female/cat/F%20fel%20anomaly%20mesonephric%20remnants%20YB108065%2011wl.jpg mesonephric r., cat (uoguelph.ca)]
| [[Image:Mesonephric duct remnant -- intermed mag.jpg|100px|thumb|center|MR (WC)]]
|-
|-
|[[Walthard cell rest]]
|[[Walthard cell rest]]
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| [[Brenner tumour]]
| [[Brenner tumour]]
| nil  
| nil  
| [http://commons.wikimedia.org/wiki/File:Walthard_cell_rest_-_very_high_mag.jpg Coffee bean n. (WC)], [http://commons.wikimedia.org/wiki/File:Walthard_cell_rest_-_very_low_mag.jpg WCR (WC)]
|[[Image:Walthard_cell_rest_-_very_high_mag.jpg|thumb|center|100px|WCR (WC)]][[Image:Walthard_cell_rest_-_very_low_mag.jpg|thumb|center|100px|WCR (WC)]]
|}
|}


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**Round nucleus +/- nucleolus.
**Round nucleus +/- nucleolus.


Images:
====Images====
*[http://path.upmc.edu/cases/case394.html Hilus cell hyperplasia (upmc.edu)].
*[http://path.upmc.edu/cases/case394.html Hilus cell hyperplasia (upmc.edu)].
===IHC===
Features:
*Inhibin +ve.
*Calretinin +ve.
*PLAP -ve.


==Mesonephric duct remnant==  
==Mesonephric duct remnant==  
:''Gartner duct cyst'', ''mesonephric duct cyst'' and ''Wolffian duct cyst'' redirect here.
*[[AKA]] ''Wolffian duct remnant''.
*[[AKA]] ''Wolffian duct remnant''.
*[[AKA]] ''Gartner duct''.<ref>URL: [http://webpathology.com/image.asp?n=3&Case=540 http://webpathology.com/image.asp?n=3&Case=540]. Accessed on: 22 October 2012.</ref>  
*[[AKA]] ''Gartner duct''.<ref>URL: [http://webpathology.com/image.asp?n=3&Case=540 http://webpathology.com/image.asp?n=3&Case=540]. Accessed on: 22 October 2012.</ref>  
 
{{Main|Mesonephric duct remnant}}
===General===
Epidemiology:
*Embryological remnant - benign.
**Wolffian duct = precursor of male reproductive tract.<ref name=pmid16567946>{{cite journal |author=Hannema SE, Print CG, Charnock-Jones DS, Coleman N, Hughes IA |title=Changes in gene expression during Wolffian duct development |journal=Horm. Res. |volume=65 |issue=4 |pages=200–9 |year=2006 |pmid=16567946 |doi=10.1159/000092408 |url=}}</ref>
 
Notes:
*This is ''not'' a finding that is reported.  The importance of this finding is knowing it isn't something neoplastic.
*Lame way of remember the synonyms ''Gartner, Mesonephric, and Wolffian'': ''GMW''... it is trying to be a ''BMW'' but in ''g''irls.
 
===Microscopic===
Features:<ref>Sternberg SE. Histology for Pathologists. 2nd Ed. P.893.</ref>
*Small duct -- typically ~50-100 micrometres in diameter.
**Duct lined by cuboidal cells with moderate eosinophilic cytoplasm.
DDx:
*[[Cervical adenocarcinoma]], not otherwise specified.
*[[Mesonephric adenocarcinoma]] - has cellular atypia.
*[[Wolffian duct hyperplasia]].
*[[Vaginal inclusion cyst]].
 
Images:
*[http://www.webpathology.com/image.asp?case=550&n=1 Mesonephric duct remnant - low mag. (webpathology.com)].
*[http://www.webpathology.com/image.asp?n=2&Case=550 Mesonephric duct remnant - high mag. (webpathology.com)].
 
===IHC===
Features:<ref name=Ref_WMSP442>{{Ref WMSP|442}}</ref>
*CD10 +ve.
*CK7 +ve.


==Walthard cell rest==
==Walthard cell rest==
===General===
*[[AKA]] ''Walthard cell nest''.
*[[AKA]] ''Walthard cell '''n'''est''.
{{Main|Walthard cell rest}}
*Benign.
 
====Epidemiology====
*Thought to be related to [[Brenner tumour]].
 
===Microscopic===
Features:<ref name=Ref_GP332>{{Ref_GP|332}}</ref>
*Collection of eosinophilic (i.e. pink) cuboidal cells; usually solid, may be cystic.
*Elliptical nucleus with single groove along major axis; "coffee bean" nucleus -- '''key feature'''.
 
Location:
*Usually in soft tissue of the uterine tube.
 
====Images====
<gallery>
Image:Walthard cell rest - very high mag.jpg | WCR - very high mag.
Image:Walthard cell rest - high mag.jpg | WCR - high mag.
Image:Walthard cell rest - intermed mag.jpg | WCR - intermed. mag.
Image:Walthard cell rest - low mag.jpg | WCR - low mag.
Image:Walthard cell rest - very low mag.jpg | WCR - very low mag.
</gallery>


==Paraurethral cyst==
==Paraurethral cyst==
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==Luteinized follicular cyst==
==Luteinized follicular cyst==
===General===
{{Main|Luteinized follicular cyst}}
*Benign.
 
===Microscopic===
Features:<ref>URL: [http://www.med-ed.virginia.edu/courses/path/gyn/ovary2.cfm http://www.med-ed.virginia.edu/courses/path/gyn/ovary2.cfm]. Accessed on: 20 May 2010.</ref>
*Stratified cuboidal/columnar epithelium-like cells with:
**Small nuclei and small nucleoli.
**Cytoplasm may be eosinophilic.
**Sit on spindled cells (theca interna) that is luteinized.
 
====Image====
<gallery>
Image:Luteinized_follicular_cyst.jpg | Luteinized follicular cyst. (WC/Nephron)
</gallery>


=Other=
=Other=
Michael
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