morphology Flashcards
in ovary
Sertoli or Leydig cells interspersed with stroma.
Well-differentiated: Sertoli-leydig Cell Tumors
in ovary
sarcomatous pattern w disorderly disposition of epi cell cords & Leydig cells may be absent.
Poorly-differentiated: Sertoli-leydig Cell Tumors
- Sharply circumscribed, discrete, round, firm, gray-white tumors
- whorled pattern of smooth mm. bundles resembling the uninvolved myometrium.
- oval nucleus & long, slender bipolar cytoplasmic processes.
- Scarce mitotic figures
- yellow-brown-red areas of softening.
Uterine Leiomyoma (fibroids)
- Exophytic, papillary architecture
- Prominent koilocytic atypia
Warty Carcinoma (of vulva)
Larger cysts near the fimbriated end of the tube or in the broad ligaments
lined with benign, serous (tubal type) epi
Hydatids of Morgagni
in ovary
-in the ovarian stroma composed of both fibroblasts & plump spindle cells w lipid droplets.
ovarian fibrothecoma
in ovary
- cells that look like granulosa cells of a developing ovarian follicle.
- yellow from stored lipids
- call-exner bodies
granulosa cell tumors of ovary
-Call-Exner bodies: small, distinct, gland-like structures filled with acidophilic material.
thinning of epidermis: parchment paper
lichen sclerosis leukoplakia
in ovary
Unilateral tumors
Large vesicular cells with clear cytoplasm (like seminoma).
Grow in sheets or cords.
Scant fibrous stroma infiltrated by mature lymphocytes +/- granulomas
dysgerminoma
- placental infarcts and syncytial knots
- retroplacental hematomas
- abn decidual vessels
preeclampsia placenta
proliferating, back-to-back, branching glands w nuclear atypia
atypical endometrial hyperplasia
prolif of glandular epi w lg, hyperchrimatic nuclei and dark appearance of glands
adenocarcinoma of cervix
in ovary
o Extensive mucinous ascites.
o Cystic epi implants on peritoneal surfaces, adhesions, and frequent involvement of the ovaries
Pseudomyxoma Peritonei
cowdry bodies
HSV
intraepithelial malignancy w cells larger than surrounding keratinocytes
extramammary paget dis
Eosinophilic epi metaplasia ~ menstrual epi BUT lacks progesterone dependent morphologic features (glandular secretory changes, stromal predecidualization) bc the corpus luteum does not develop.
Anovulatory Cycle
Delicate, friable mass of thin walled, translucent, cystic, grapelike structures with swollen, edematous (hydropic) villi.
hydatidiform mole
glandular and squamous epi of cervix
adenosquamous carcinoma of cervix
chocolate cysts/endometriomas:
endometriosis
-3-5cm cystic masses filled w brown fluid (hemosiderin deposits) from previous hemorrhage
Only a fraction of the villi are enlarged and edematous.
Trophoblastic hyperplasia is focal and less marked
Partial Mole
in ovary
o Extraembryonic differentiation of malignant germ cells of placental origin.
choriocarcinoma
- Surface epi: viral cytopathic changes (koilocytic atypia).
- Nuclear enlargement, hyperchromasia, cytoplasmic nuclear halo
Condyloma Acuminatum (genital wart)
Cells small w oval nuclei and cytoplasmic protrusions (tennis racket shape).
cells (often mistaken for inflamm. Polyps)
Embryonal Rhabdomyosarcoma (sarcoma bortyoides)
in ovary
Glomerulus-like structure with a central blood vessel enveloped by tumor cells in a space lined by tumor cells (schiller-duval body).
yolk sac tumor
in ovary
Solid + cystic areas of growth.
Epithelium consists of tubular glands resembling endometrium
endometriod tumors of ovary (mullerian epithelium)
inreased gland:stroma ratio
-back-to-back w maybe some intervening stroma
nonatypical endometrial hyperplasia
cysts lined w bright yellow tissue containing granulosa cells
luteal cysts (corpora lutea)
o Bulky, polypoid.
o May protrude thru the cervical os.
o Usually consist of adenocarcinoma (glandular) mixed with malignant mesenchymal elements (mm, cartilage, bone, etc).
Malignant Mixed Mullerian Tumors (MMMTS) (carcinosarcomas)
o Soft, fleshy, yellow-white tumor.
o Large, pale areas of necrosis + extensive hemorrhage.
o Invades underlying myometrium, often penetrating blood vessels.
choriocarcinoma
-Discrete white (hyperkeratotic) or slightly raised, pigmented lesion w Epidermal thickening
VIN (vulvar intraepithelial neoplasia)
in ovary
Solid grey to golden brown.
Grossly resemble granulosa cell tumors.
Sertoli-leydig Cell Tumors
in ovary
o Small, multilocular tumors with simple papillary processes.
o Pronounced proliferation of the fibrous stroma under the columnar epi
cystadenofibroma
- Exophytic or indurated and ulcerated
- Small tightly packed basaloid cells
- Foci of central necrosis
Basaloid Carcinoma (of vulva)
~small cell carcinoma of lung but on cervix
neuroendocrine carcinoma of cervix
in ovary
Complex patterns of growth.
Widespread infiltration of underlying stroma.
Marked nuclear atypia, pleomorphism, and multinucleation
Increased mitotic activity with atypical mitosis.
Cysts are lined with columnar epi.
66% are b/l.
Often involve the surface of the ovary
high grade serous tumors of ovary (mullerian epithelium)
Multinucleated squamous cells with eosinophilic to basophilic viral inclusions w a ‘ground glass’ appearance (viral cytopathic effect)
HSV
red glandular epithelium in vagina
vaginal adenosis
- invade teh uterine wall or project into the uterine lumen
- nuclear atypia w great mitotic index
Leiomyosarcoma
plasma cell on bx*
chronic endometritis
degeneration of basal cells, hyperkeratosis, sclerotic changes
lichen sclerosis leukoplakia
in ovary
- tumor w well-diff fibroblasts w scant interspersed collagenous stroma
- glistening intact ovarian serosa
ovarian fibroma
in ovary
-in the ovarian stroma composed of plump spindle cells with lipid droplets
ovarian thecoma
in ovary
Multiloculated tumors willed with sticky, gelatinous fluid rich in glycoproteins.
Lined by tall, columnar epi with apical mucin, lacking cilia.
Most show gastric or intestinal type differentiation.
-malignant mucinous tumors of ovary (mullerian epithelium)
o Nests + tongues of malignant squamous epi.
o Invade the underlying cervical stroma
scc of cervix
in ovary
o Normal stroma with nests of neoplastic epi cells resemble urothelium with mucinous glands in the ctr
Transitional Cell Tumors (Brenner Tumors) of ovary (mullerian epithelium)
in ovary
Smooth glistening cyst wall with no epi thickening or with small papillary projections.
Cysts are lined with columnar epi with lots of cilia.
benign serous tumors of ovary (mullerian epithelium)
Theca cells prolif and the perifollicular zone expands in response to gonadotropins released during preg
Theca Lutein Hyperplasia of Pregnancy
in ovary
Resembles hypersecretory gestational endometrium.
Solid: cells are arranged in sheets or tubules.
Cystic: cells line the spaces.
clear cell carcinoma of ovary (mullerian epithelium)
- cluster of polygonal cellsaround hilar vessels
- lg, lipid laden leydig cells
- reinke crystalloids
Hilus Cell tumors (pure Leydig cell tumors)
Guarnieri bodies
Molluscum contagiosum (poxvirus)
o Stroma appear neoplastic, while the glands appear reactive.
o Glands may be hyperplastic, atrophic or functional.
endometrial polyps
in ovary
u/l tumor w itestinal tissue that may be functional (5-HT)
Monodermal or Specialized Teratoma of ovary: Ovarian Carcinoid
tumor cells Grow as polypoid, rounded, bulky masses = grapelike clusters.
Embryonal Rhabdomyosarcoma (sarcoma bortyoides)
Seen in small, atrophic uteri.
Tumors are large and bulky or invasive into the myometrium.
Papillary growth pattern.
↑ nuclear atypia
-Type 2 endometrial serous carcinoma
in ovary
-unilocular cysts w hair and sebacisou material, teeth, and calcifications in the stratified squamous wall
mature teratoma (benign) of ovary
Marked atypia of the basal layer of the squamous epi
buut Normal differentiation of the superficial layers
Nests and tongues of malignant squamous epi
Prominent central keratin pearls
keratinizing scc of vulva
Loose, fibromyxomatous stroma covered by mucus secreting endocervical glands +/- inflamm.
endocervical polyps
t cells: band-like infiltrate
lichen sclerosis leukoplakia
red/blue to yellow/brown nodules on or beneath the mucosa and/or serosal surfaces. (powder burn marks)
endometriosis
-from Bleed in response to extrinsic (cyclic) & intrinsic hormonal stimulation
→ extensive fibrous adhesions between structures = obliteration of pouch of Douglas.
in ovary
u/l tumor w mature thyroid tissue that may be functional –> hyperthyroidism
Monodermal or Specialized Teratoma of ovary: Struma Ovarii
psammoma bodies (concentric calcifications)
serous tumors of ovary (mullerian epithelium)
cyst w clear, serous fluid, lined by gray, glistening mem and outer theca cells
cystic ovaria follicles
inovary
- Tumor tissue resembles embryonal and immature fetal tissue.
- Solid, bulky tumors with a smooth external surface.
- May see hair, sebaceous material, cartilage, bone, calcification
immature malignant teratomas of ovary
Grapelike structures = edematous (hydropic) villi)
All/most chorionic villi are enlarged.
Scalloped in shape with central cavitation (cisterns).
Covered by extensive trophoblastic proliferation of the entire villi circumference.
Complete Mole
- Tumor cells may be crowded in a cambium layer beneath vaginal epi.
- -Or the tumor cells can be within an edematous, loose fribomyxomatous stroma in the deep regions w inflamm.
Embryonal Rhabdomyosarcoma (sarcoma bortyoides)