Female reproductive system

89 Chronic cervicitis302 Naboth cysts141 Cervical squamous cell carcinoma45 Endometrial hyperplasia129 Endometrial carcinoma37 Follicular cysts65 Mucinous cystadenoma96 Granulosa cell tumor997 Mature teratoma

Female reproductive system

286 CIN (slides with CIN I and CIN II)

90 CIN III

61 Leiomyoma

62 Leiomyosarcoma

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Leiomyoma

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Leiomyosarcoma

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Chronic cervicitis

- this process is invariably associated with an inflammatory infiltrate composed of a mixture of polymorphonuclear leukocytes and mononuclear cells, and if the inflammation is severe, it may be associated with loss of the epithelial lining (erosion or ulceration) and epithelial repair

- reserve cells in the transformation zone may undergo columnar or squamous differentiation (metaplasia)

Chronic cervicitis

Chronic cervicitis

Naboth cysts

during the squamous metaplasia (the process of transformation from a columnar to a squamous lining),the squamous epithelium can overgrow and obliterate the surface columnar papillae, so it covers and obstructs crypt openings, with the accumulation of mucus in deeper crypts (glands) to form mucous (nabothian) cysts

Naboth cysts

Cervical epithelium without CIN

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CIN

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CIN III

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Cervical squamous cell carcinoma

- irregularly shaped nests and clusters of squamous cells invading stroma, often with eosinophilic cytoplasm, atypical nuclei with coarse chromatin, prominent nucleoli, and abnormal mitotic figures

- keratinizing or non-keratinizing

Cervical squamous cell carcinoma

Cervical squamous cell carcinoma

Endometrial hyperplasia

Simple hyperplasia

-glands cystically dilated, with occasional outpouchings surrounded by abundant cellular stroma

- sometimes glands only minimally dilated but focally crowded

- cells lining glands are pseudostratified and columnar and cytologic atypia is absent.

Complex hyperplasia

- crowded glands with little intervening stroma

- back-to-back glands with papillary intraluminal infoldings

- usually gland outlines highly complex but can be tubular

- epithelial stratification usually prominent

Endometrial hyperplasia

Endometrial hyperplasia

Endometrial carcinoma

- neoplastic glands resembling proliferative-type endometrial glands, with nuclear stratification, cribriform glandular patterns, papillary growth patterns, and evidence of stromal invasion

- grading is based on architectural pattern and nuclear features. Architectural grade is determined by the extent to which the tumor is composed of solid masses of cells as compared with well-defined glands

Endometrial carcinoma

Endometrial carcinoma

Mature teratoma

Mucinous cystadenoma

- cysts lined by a single layer of non-stratified columnar mucinous epithelium that is either of intestinal type or endocervical type

Mucinous cystadenoma

Mucinous cystadenoma

Follicular cysts

- usually multiple

- range in size up to 2 cm in diameter

- filled with a clear serous fluid

- granulosa lining cells can be identified histologically if the intraluminal pressure has not been too great

- the outer theca cells may be conspicuous with increased cytoplasm and a pale appearance (luteinized)

Follicular cysts

Follicular cysts

Granulosa cell tumor

- variety of patterns, including microfollicular, macrofollicular, trabecular, solid-tubular, gyriform, and diffuse (sarcomatoid)

- better differentiated forms show follicular structures composed of granulosa cells arranged around a central eosinophilic hyaline or fibrillar material (Call-Exner bodies)

- the typical cytologic feature is a longitudinal nuclear groove giving the nucleus the appearance of a coffee bean

- mitotic activity can be rare to abundant

Granulosa cell tumor

Granulosa cell tumor

Mature teratoma

- cystic structure lined predominantly by skin and cutaneous adnexal structures, usually with abundant sebaceous and sweat glands

- hair almost always present

- other components include cartilage, bone, bronchial or gastrointestinal epithelium, and mature glial tissue

- if only skin and adnexal structures present can be termed dermoid cyst

- thyroid tissue can be found in up to 20% of cases (when thyroid tissue is the predominant tissue the lesion is called struma ovarii)

Mature teratoma