Difference between revisions of "An introduction to gynecologic pathology"

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An introduction to gynecologic pathology (view source)

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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.
 
===Gross===
*Classically anterior-lateral wall of the [[vagina]].<ref name=Ref_GP97>{{Ref GP|97}}</ref>
 
===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.
*[[Minimal deviation adenocarcinoma of the uterine cervix]].
*[[Mesonephric adenocarcinoma]] - has cellular atypia.
*[[Wolffian duct hyperplasia]].
*[[Vaginal inclusion cyst]].
*[[Nabothian 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.
*PAX2 +ve (nuclear - strong & diffuse).<ref name=pmid20061933>{{Cite journal  | last1 = Rabban | first1 = JT. | last2 = McAlhany | first2 = S. | last3 = Lerwill | first3 = MF. | last4 = Grenert | first4 = JP. | last5 = Zaloudek | first5 = CJ. | title = PAX2 distinguishes benign mesonephric and mullerian glandular lesions of the cervix from endocervical adenocarcinoma, including minimal deviation adenocarcinoma. | journal = Am J Surg Pathol | volume = 34 | issue = 2 | pages = 137-46 | month = Feb | year = 2010 | doi = 10.1097/PAS.0b013e3181c89c98 | PMID = 20061933 }}</ref>
**Cancers often lose staining.


==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
48,455

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