Images: GU / GYN Pathology Flashcards
Renal pelvic pTCC
Ureteral pTCC
Bladder pTCC
Bladder flat CIS
Papilloma
Papilloma
Papilloma
LGUC
LGUC
HGUC
HGUC
Flat urothelial CIS
Invasive UC
Invasive UC
Urine cytology: UC
Bladder SCC
Bladder SCC
Bladder SCC: schistosomiasis
Bladder SCC: schistosomiasis
Bladder SCC: keratin pearl
Bladder SCC: intercellular bridges & intracellular keratin
Bladder adenocarcinoma
Bladder adenocarcinoma: in situ
Atypical columnar cells limited to surface glands; no invasion
Bladder adenocarcinoma: NOS
Infiltrating glands lined w/ atyical cells; no apparent mucin production
Bladder adenocarcinoma: mucinous (colloid)
Cells in small clusters float in mucin pools, infiltrating bladder wall
Bladder adenocarcinoma: mucinous with signet-ring cells
Signet-ring cells & abundant mucin in pools
BPH
BPH
BPH
BPH vs. Prostate Cancer
Cancer: peripheral zone; ill-defined border; yellow discoloration
BPH: transitional zone / periurethral; whitish
Prostatic adenocarcinoma
Prostatic adenocarcinoma
Prostatatic intraepithelial neoplasia (PIN)
Prostatic duct retains basal layer; atyical hyperplastic duct epithelium
Prostatic adnocarcinoma: GS 3
Individual well-formed glands with no basal layer
Prostatic adenocarcinoma: GS 4
Cribriform pattern (glands within glands)
Prostatic adenocarcinoma: GS 5
Central necrosis
Prostatic adenocarcinoma: GS 5
Individual cells
Prostatic adenocarcinoma: GS 5
Solid sheet
Metastatic osteoblastic prostatic carcinoma
Cryptorchidism
Seminiferous tubule w/ Sertoli cells, no spermatogenesis
Cryptorchidism
Seminiferous tubule w/ Sertoli cells, no spermatogenesis
Testicular torsion
Hemorrhagic infarction of testis
Testicular torsion
Only ghostly outline of parenchyma visible; tissue is nonviable
Condyloma acuminata
Anogenital HPV; genital wart
Condylomata acuminata
Exophytic papillary architecture
Condylomata acuminata
Exophytic papillary architecture
Condylomata acuminata
Perinuclear cytoplasmic halo, multinucleation, nuclear enlargement
Condylomata acuminata
Nuclear enlargement, hyperchromasia, multinucleation, perinuclear halo
Classic VIN
Basaloid & warty carcinoma
Basaloid vulvar carcinoma
Basaloid & warty carcinoma
Differentiated VIN
Keratinized squamous carcinoma
Well-differentiated vulvar SCC
Keratinized squamous carcinoma; keratin pearls
Vulvar SCC
VAIN
Vaginal SCC
Atypical squamous cells in neoplastic islands invading into stroma
LSIL
Koilocytes
LSIL
Histology
LSIL
Cytology
HSIL
Abnormal nuclei; no cytoplasmic differentiation in upper & middle thirds
HSIL: increased N/C ratios
Cytology
HSIL: irregular nuclear membranes
Cytology
Normal cervical epithelium
Histology
LSIL (CIN 1): koilocytic atypia
Histology
HSIL (CIN 2): progressive atypia
Histology
HSIL (CIN 3): diffuse atypia; loss of maturation
Histology
Normal exfoliated superficial squamous cells
Cytology
LSIL (CIN 1): koilocytic atypia
Cytology
HSIL (CIN 2)
HSIL (CIN 3)
Invasive cervical SCC
Fungating mass
Invasive cervical SCC
Cervical adenocarcinoma, usual type
Cervical adenocarcinoma, usual type
Cervical AIS
Maliginant epithelium within gland, no invasion into stroma
Cervical AIS
Crowded, atypical epithelial cells with hyperchromatic nuclei
Proliferative endometrium
Tubular shaped glands; pseudostratified nuclei; mitotic figures present
Secretory endometrium
Simple endometrial hyerplasia
Mild crowding of glands; “swiss cheese” appearance; no cytologic atypia
Simple endometrial hyperplasia
Correctly polarized nuclei; absence of eosinophilic macronucleoli
Complex endometrial hyperplasia
Moderate glandular crowding; branched glandular shapes; lack of atypia
Complex endometrial hyperplasia
Moderate-to-severe glandular crowding; no cytologic atypia
Complex endometrial hyperplasia
Moderate glandular crowding; no cytologic atypia
Atypical endometrial hyperplasia
Severe glandular crowding; nuclear atypia
Atypical endometrial hyperplasia
Severe glandular crowding; nuclear atypia
Endometrial hyerplasia without atypia
Glandular crowding w/ areas of back-to-back glands; no cytologic atypia
Atypical endometrial hyperplasia
Severe glandular crowding & abnornal cytologic features
Atypical endometrial hyperplasia
Rounded, vesicular nuclei w/ prominent nucleoli
Endometrial carcinoma, type 1
Fungating mass in the uterus
Well-differentiated (grade 1) endometrioid adenocarcioma
Preserved architecture but lack of intervening stroma; < 5% solid growth
Well-differentiated (grade 1) endometrioid adenocarcioma
Preserved glandular architecture but lack of intervening stroma
Moderately differentiated (grade 2) endometrioid adenocarcinoma
Glandular architecture admixed w/ solid areas; < 50% solid growth
Poorly differentiated (grade 3) endometrioid adenocarcinoma
Predominantly solid growth (> 50%)
Endometrial intraepithelial carcinoma (EIC)
Malignant cells with no stromal invasion
IHC: p53 in EIC
Strong, diffuse expression of p53
Serous endometrial carcinoma
Papillary growth composed of malignant cells w/ marked cytologic atypia
IHC: p53 in serous endometrial carcinoma
Accumulation of p53 in nuclei
Primordial & primary ovarian follicles
Primary follicles exhibit a single layer of granulosa cells
Secondary ovarian follicle
Demonstrates early perioocyte clearing caused by accumulation of fluid
Early antral (Graafian) ovarian follicle
Distinct zone of fluid accumulation & eccentrically placed oocyte
Luteinized follicle lining cells
Follicular cysts in ovarian cortex
Yellow corpus luteum & white corpora albicantia
Intratubular germ cell neoplasia
IHC: PLAP in intratubular GCT
Seminoma
Fleshy cream-to-tan lobulated mass
Seminoma
Fleshy cream-to-tan lobulated mass
Seminoma
Fleshy cream-to-tan lobulated mass
Seminoma, classic type
Large round cells with clear cytoplasm & large central nuclei
Seminoma, spermatocytic type
3 cell sizes: small, medium, large; mitotic figures; no lymphocytes
Seminoma, spermatocytic type
3 cell sizes: small, medium, large; mitotic figures; no lymphocytes
Seminoma, spermatocytic type
Large tumor of myxoid apperance bulging from cut surface
Embryonal carcinoma
Solid nodular cut surface with numerous areas of necrosis & hemorrhage
Embryonal carcinoma
Solid nodular cut surface with numerous areas of necrosis & hemorrhage
Embryonal carcinoma
Solid sheets of tumor cells
Embryonal carcinoma
Glandular pattern of tumor cells; areas of necrosis
Teratoma
Red = hemorrhagic areas; white = cartilage
Teratoma
Black = cystic areas; yellow = adipose tissue; white = cartilage
Endodermal sinus tumor
Endodermal sinus tumor
Endodermal sinus tumor
Reticular growth pattern (lacelike network)
Endodermal sinus tumor
Schiller-Duval body = histological hallmark; pathognomonic
Endodermal sinus tumor
Eosinophilic hyalin globules
Choriocarcinoma (pure)
Strikingly hemorrhagic apeparance = characteristic
Choriocarcinoma
Necrosis, hemorrhage
Choriocarcinoma
Choriocarcinoma
Cytos: small, uninucleated; Syncytios: large, multinucleated; hemorrhage
Mixed testicular GCT
Seminoma: solid, homogenous gray areas; Other: variegated w/ hemorrhage
Leydig cell tumor
Granular, yellowish tumor replacing most of testis
Leydig cell tumor
Reinke crystals = histological hallmark
Sertoli cell tumor
Tan white firm or gelatinous cut surface
Sertoli cell tumor
Tan white firm or gelatinous cut surface
Sertoli cell tumor
Neoplastic Sertoli cells arranged in tubules
Ovarian serous cystadenoma
Large, translucent cyst filled with yellowish fluid
Ovarian serous cystadenoma
Simple columnar ciliated & non-cilated epithelium
Ovarian serous papillary cystadenoma
Multilobulated cystic tumor
Ovarian serous papillary cystadenoma
Stromal papillae with simple columar epithelium; benign
Ovarian serous papillary cystadenocarcinoma
Yellow irregular papillary growth within cyst
Ovarian papillary serous cystadenocarcinoma
Invasion of underlying stroma by malignant serous epithelial ells
Ovarian papillary serous cystadenocarcinoma
Invasion of underlying stroma
Ovarian serous adenocarcinoma
Ovary tissue replaced by large bilateral masses
Ovarian serous carcinoma
Omental caking: omentum studded with islands of ovarian serous carcinoma
Ovarian serous carcinoma
Omental caking; normal omentum = lobulated adipose tissue
High-grade ovarian serous carcinoma
Stroma invasion; cells grow in solid nests w/ slit-like spaces (arrow)
Low-grade ovarian serous carcinoma
Micropapillae; uniform round nuclei w/ evenly distributed chromatin
High-grade ovarian serous carcinoma
Complex macropapillae; pleomorphic nuclei, irregular chromatin
Ovarian mucinous cystadenoma
Mucinous cells w/ abundant gland-like or papillary growth
Ovarian mucinous cystadenoma
Mucinous cells w/ abundant gland-like or papillary growth
Ovarian mucinous cystadenoma
Mucinous cells w/ abundant gland-like or papillary growth
Ovarian mucinous cystadenocarcinoma
Complex architecture; nuclear atypia; stromal invasion
Ovarian mucinous cystadenocarcinoma
Complex architecture; nuclear atypia; stromal invasion
Ovarian endometrioid carcinoma
Ovarian endometrioid adenocarcinoma
Similar to uterine endometrioid carcinoma: glandular & squamoid features
Ovarian endometrioid adenocarcinoma
Nuclei are cleared out & pleomorphic; glandular spaces w/ necrosis
Ovarian clear cell carcinoma
Ovarian clear cell carcinoma
Hobnail cells = histological hallmark
Ovarian dysgerminoma
Ovarian dysgerminoma
Large cells in nests, trabeculae; septae infiltated by lymphocytes
Ovarian teratoma
Ovarian eratoma
Mature cystic teratoma (dermoid cyst)
Cyst containing teeth
Mature cystic teratoma (dermoid cyst)
Cartilage; granular epithelium; thyroid follicles
Mature cystic teratoma (dermoid cyst)
Cystic tumor filled with hair & sebaceous material
Mature cystic teratoma (dermoid cyst)
Skin & adnexal structures
Immature ovarian teratoma
Contains primitive neuroepithelium
Struma ovarii
Teratoma composed primarily of thyroid elements (follicles, colloid)
Carcinoid teratoma
Ovarian embryonal carcinoma
Ovarian embryonal carcinoma
Ovarian embryonal carcinoma
Endodermal sinus tumor
Reticular, myxoid, solid, glandular, polyvesicular patterns
Endodermal sinus tumor
Schiller-Duval body = histological hallmark
Endodermal sinus tumor
Schiller-Duval body = histological hallmark
Endodermal sinus tumor
Hyalin PAS+ bodies: AFP
Ovarian fibroma
Firm, white whorled masses
Ovarian fibroma
Firm, white whorled masses
Ovarian fibroma
Fasicles of closely packed spindle cells in storiform arrangement
Ovarian fibroma
Well-circumscribed w/ a smooth surface & homogenous white cut section
Ovarian fibroma
Short fascicles of bland spindle cells with a storiform arrangement
Ovarian thecoma
Yellow, lipid-rich
Ovarian thecoma
Ovarian thecoma
Fascicles of spindle cells w/ central nuclei & moderate pale cytoplasm
Thecoma
Tumor has a solid, glistening, homogenous, tan-yellow cut surface
Tumor composed of spindle-to-plump cells w/ pale-to-vacuolated cytoplasm
Tumor composed of spindle-to-plump cells w/ pale-to-vacuolated cytoplasm
Granulosa cell tumor
Granulosa cell tumor, microfollicular type
Call-Exner bodies: small follicles filled w/ eosinophic secretions
Granulosa cell tumor, microfollicular type
Call-Exner bodies: small follicles filled w/ eosinophic secretions
Granulosa cell tumor
Cells arranged in sheets punctuated by small follicle-like structures
IHC: inhibit in granulosa cell tumor
Strong IHC positivity w/ antibody to inhibin = characteristic
Ovarian Sertoli cell tumor
Hollow or solid tubules lined by cuboidal cells w/ vacuolated cytoplasm
Sertoli-Leydig cell tumor
Well-differentiated; open Sertoli cell tubules w/ round Leydig cells
Sertoli-Leydig cell tumor
Reinke crystals = histological hallmark
Metastatic ovarian cancer
Krukenberg tumor
Metastatic ovarian cancer
