An introduction to gynecologic pathology
Gynecologic pathology, informally gyne path, is a big part of surgical pathology. Radiologists have a lot of trouble in this area. On CT it is not infrequently hard to pick-out the ovaries... and it is a reason they don't comment on 'em. The ovary is affected by a huge number of tumours.
- 1 Site specific
- 2 Specific entities
- 3 Introduction to gynecologic tumours
- 4 Benign stuff
- 5 Other
- 6 See also
- 7 References
This covers the topic of vulva.
This covers the topic of vagina.
The most common type of cervical cancer is: squamous cell carcinoma.
Common benign cause of bleeding.
Gynecologic cytology is mostly cervical cytology and cervical cytology is the biggest part of cytology.
The ovary has a wealth of pathology. It has benign tumours and malignant ones. The ovary article covers cysts of the ovary.
Uterine tube (Fallopian tube)
This was ignored in the past... current thinking is that it may be the real culprit in what is often labeled as "ovarian cancer".
Addresses dating of the endometrium.
Endometrial hyperplasia is considered the precursor of carcinoma.
A look at endometrial carcinoma.
A common non-malignant affliction that causes infertility and morbidity.
Peritoneal inclusion cyst
Female adnexal tumour of probable Wolffian origin
- Abbreviated FATWO.
- AKA Wolffian adnexal tumour.
Introduction to gynecologic tumours
Where to start when considering a malignant (epithelial) tumour of the gynecologic tract:
|Type||Histology||Differentiators||Associations||Typical age||Grade||IHC||Main DDx|
|Serous|| cilia, columnar cells
psammoma bodies, papillary arch.
|cilia, psammoma bodies||atrophy||usually 60s+||typically high grade||p53+ diffuse, WT-1 +ve, D2-40 +ve, CA-125 +ve||poorly diff. endometrioid|
|Endometrioid||gland forming, endometrium-like||squamous metaplasia||endometriosis, endometrial hyperplasia||40-60||typically low grade||WT-1 -ve||serous|
|Mucinous||mucinous glands, colon-like||mucin, lack of necrosis||(?)||varies (?)||often low||metastatic tumour (usually GI)|
Where to start when it looks benign:
|Hilus cells||well-defined cell borders, solid||eccentric, mild pleomorphism||eosinophilic||Hilus cell tumour||absent in childhood||Need one|
|Mesonephric remnant (AKA Wolffian duct)||cuboidal, glands/lumen present||ovoid, small||eosinophilic||FATWO, mesonephric adenocarcinoma||Develops into vas deferens in males.|
|Walthard cell rest||cuboidal, nested, solid||"coffee bean" shape||eosionphilic||Brenner tumour||nil|
- Present in embryo.
- Absent in childhood.
- Reappear at puberty.
- Common in post-menopausal women.
- Similar to Leydig cells:
- Typically found in small clusters.
- Eosinophilic cytoplasm.
- Round nucleus +/- nucleolus.
- Inhibin +ve.
- Calretinin +ve.
- PLAP -ve.
Mesonephric duct remnant
Walthard cell rest
- AKA Walthard cell nest.
Luteinized follicular cyst
Chorionic villi are the minimum needed to diagnose pregnancy histologically.
When reproduction goes wrong.
A big endocrine organ that gets completely ignored by almost everyone.
- Hirst, JE.; Gard, GB.; McIllroy, K.; Nevell, D.; Field, M. (Jul 2009). "High rates of occult fallopian tube cancer diagnosed at prophylactic bilateral salpingo-oophorectomy.". Int J Gynecol Cancer 19 (5): 826-9. doi:10.1111/IGC.0b013e3181a1b5dc. PMID 19574767.
- Vallerie, AM.; Lerner, JP.; Wright, JD.; Baxi, LV. (May 2009). "Peritoneal inclusion cysts: a review.". Obstet Gynecol Surv 64 (5): 321-34. doi:10.1097/OGX.0b013e31819f93d4. PMID 19386139.
- Sternberg, Stephen S. (1997). Histology for Pathologists (2nd ed.). Lippincott Williams & Wilkins. pp. 953. ISBN 978-0397517183.
- URL: http://path.upmc.edu/cases/case394/dx.html. Accessed on: 16 January 2012.
- URL: http://webpathology.com/image.asp?n=3&Case=540. Accessed on: 22 October 2012.