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Difference between revisions of "An introduction to gynecologic pathology"
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An introduction to gynecologic pathology (view source)
Revision as of 18:13, 29 April 2011
, 18:13, 29 April 2011re-arr. add wolffian adnexal tumour
(→Endosalpingiosis: misdiagnosis) |
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The ovary is affected by a huge number of tumours. | The ovary is affected by a huge number of tumours. | ||
=Site specific= | |||
==Vulva== | ==Vulva== | ||
{{Main|Vulva}} | {{Main|Vulva}} | ||
| Line 18: | Line 19: | ||
Gynecologic cytology is mostly cervical cytology and cervical cytology is the biggest part of [[cytology]]. | Gynecologic cytology is mostly cervical cytology and cervical cytology is the biggest part of [[cytology]]. | ||
==Ovary== | |||
{{main|Ovary}} | |||
{{main|Ovarian tumours}} | |||
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)== | |||
{{main|Uterine 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".<ref name=pmid19574767>{{Cite journal | last1 = Hirst | first1 = JE. | last2 = Gard | first2 = GB. | last3 = McIllroy | first3 = K. | last4 = Nevell | first4 = D. | last5 = Field | first5 = M. | title = High rates of occult fallopian tube cancer diagnosed at prophylactic bilateral salpingo-oophorectomy. | journal = Int J Gynecol Cancer | volume = 19 | issue = 5 | pages = 826-9 | month = Jul | year = 2009 | doi = 10.1111/IGC.0b013e3181a1b5dc | PMID = 19574767 }}</ref> | |||
==Uterus== | |||
{{main|Uterine tumours}} | |||
==Endometrium== | ==Endometrium== | ||
| Line 29: | Line 45: | ||
A look at endometrial carcinoma. | A look at endometrial carcinoma. | ||
=Specific entities= | |||
==Endometriosis== | |||
{{main|Endometriosis}} | {{main|Endometriosis}} | ||
A common non-malignant affliction that causes infertility and morbidity. | A common non-malignant affliction that causes infertility and morbidity. | ||
== | ==Endosalpingiosis== | ||
{{ | ===General=== | ||
*Benign entity that may lead to a misdiagnosis of adenocarcinoma<ref name=pmid19415948>{{cite journal |author=Lin O |title=Challenges in the interpretation of peritoneal cytologic specimens |journal=Arch. Pathol. Lab. Med. |volume=133 |issue=5 |pages=739–42 |year=2009 |month=May |pmid=19415948 |doi= |url=}}</ref> or serous carcinoma. | |||
===Microscopic=== | |||
Features:<ref>URL: [http://radiographics.rsna.org/content/29/2/347.full http://radiographics.rsna.org/content/29/2/347.full]. Accessed on: 27 May 2010.</ref> | |||
*Cystic lesions with: | |||
**Ciliated (tubal type) epithelium, without endometrial stroma. | |||
***Endosalpingiosis is surrounded by fibrous stroma; tubal type epithelial surrounded by ovarian stroma is a variant of endometriosis. | |||
*Associated with psammoma bodies.<ref name=pmid1774734>{{cite journal |author=Hallman KB, Nahhas WA, Connelly PJ |title=Endosalpingiosis as a source of psammoma bodies in a Papanicolaou smear. A case report |journal=J Reprod Med |volume=36 |issue=9 |pages=675–8 |year=1991 |month=September |pmid=1774734 |doi= |url=}}</ref> | |||
Notes: | |||
*Not associated with hemorrhage.<ref>URL: [http://radiographics.rsna.org/content/29/2/347.full http://radiographics.rsna.org/content/29/2/347.full]. Accessed on: 27 May 2010.</ref> | |||
==Wolffian adnexal tumour== | |||
===General=== | |||
*Super rare. | |||
*Adnexal - as the name suggests. | |||
*Usu. benign.<ref>URL: [http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970577-0 http://www.pathconsultddx.com/pathCon/diagnosis?pii=S1559-8675%2806%2970577-0]. Accessed on: 29 April 2011.</ref> | |||
== | ===Microscopic=== | ||
Features: | |||
*Tubular/glandular spaces. | |||
DDx: | |||
*[[Brenner tumour]]. | |||
=Introduction to gynecologic tumours= | |||
'''Where to start when considering a malignant (epithelial) tumour of the gynecologic tract:''' | '''Where to start when considering a malignant (epithelial) tumour of the gynecologic tract:''' | ||
{| class="wikitable" | {| class="wikitable" | ||
| Line 77: | Line 98: | ||
|} | |} | ||
=Benign stuff= | |||
'''Where to start when it looks benign:''' | '''Where to start when it looks benign:''' | ||
{| class="wikitable" | {| class="wikitable" | ||
| Line 98: | Line 119: | ||
*Common in post-menopausal women. | *Common in post-menopausal women. | ||
=== | ===Microscopic=== | ||
Features: | |||
*Well-defined cell borders/spaced. | *Well-defined cell borders/spaced. | ||
*Eosinophilic cytoplasm. | *Eosinophilic cytoplasm. | ||
| Line 113: | Line 135: | ||
*aka Wolffian duct - precursor of male reproductive tract.<ref>{{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> | *aka Wolffian duct - precursor of male reproductive tract.<ref>{{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> | ||
=== | ===Microscopic=== | ||
Features:<ref>Sternberg SE. Histology for Pathologists. 2nd Ed. P.893.</ref> | |||
*Cuboidal cells in glands/tubules - may surround cleft. | |||
DDx: | DDx: | ||
| Line 151: | Line 174: | ||
Image: [http://commons.wikimedia.org/wiki/File:Luteinized_follicular_cyst.jpg Luteinized follicular cyst (WC)]. | Image: [http://commons.wikimedia.org/wiki/File:Luteinized_follicular_cyst.jpg Luteinized follicular cyst (WC)]. | ||
= | =Other= | ||
== | ==Pregnancy== | ||
{{main|Chorionic villi}} | |||
Chorionic villi are the minimum needed to diagnose pregnancy histologically. | |||
{{main|Gestational trophoblastic disease}} | |||
When reproduction goes wrong. | |||
{{main|Placenta}} | |||
A big endocrine organ that gets completely ignored by almost everyone. | |||
=See also= | |||
*[[Testicular tumours]]. | *[[Testicular tumours]]. | ||
*[[Gastrointestinal pathology]]. | *[[Gastrointestinal pathology]]. | ||
=References= | |||
{{reflist|2}} | {{reflist|2}} | ||
[[Category:Gynecologic pathology]] | [[Category:Gynecologic pathology]] | ||