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Thursday, September 09 2010 @ 10:24 PM CDT

Reproductive System
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Retiform tumors are often soft and spongy, cystic with edematous intraluminal polypoid excrescences, or combinations thereof. They are so named because they are characterized microscopically by growth patterns that simulate those of the rete testis. Accordingly the basic pattern is an irregular network of elongated, sometimes slit-like tubules and cysts which often contain papillae. The papillae may be short and rounded or blunt, often containing hyalinized cores, or larger with fibrous or edematous cores. Cysts may be markedly dilated with eosinophilic secretion imparting a struma-like appearance in some cases. Retiform SLCTs are misinterpreted most often as yolk sac tumor, a serous neoplasm or as a malignant mixed mesodermal tumor. Because of the young age of the patient and frequent papillae yolk sac tumor is often considered. The papillae in the retiform tumors do not have the central blood vessel of the classic papilla in a yolk sac tumor (the famed Schiller-Duval body), but rather are cellular (an uncommon features of the papillae in a yolk sac tumor) or are hyalinized, the latter to my knowledge never being a feature of the papillae of a yolk sac tumor. Like many ovarian tumors the retiform SLCT may contain hyaline bodies. Resemblance to a serous borderline tumor may be imparted by the presence of cellular papillary clusters in the cyst lumens. The clefts, papillae and a complex branching pattern associated with cellular stratification and atypicality may suggest a serous adenocarcinoma. The admixture of retiform tubules with immature mesenchymal tissue which may show heterologous differentiation can suggest the diagnosis of a malignant mixed mesodermal tumor.
Retiform Sertoli-Leydig Cell Tumor
Friday, May 15 2009 @ 03:29 PM CDT
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The histologic features of PEComa vary from a predominantly spindled morphology with cells arranged in short fascicles and cell nests to a predominantly epithelioid morphology arranged in a nested or sheet-like pattern. A prominent intrinsic vasculature is almost always present, ranging from an extensive, arborizing capillary network to thick-walled, often hyalinized larger caliber vessels. All PEComas express at least one melanocytic marker, with HMB-45 most frequently expressed (92%), followed by Melan-A (72%), and MiTF (50%). Folpe et al have classified PEComas into "benign," "uncertain malignant potential," and "malignant" categories based on tumor size (> 5 cm); infiltrative margins; high grade nuclear atypia and cellularity; mitotic index (> 1 MF/50 HPF); necrosis; and vascular invasion. Folpe AL, Mentzel T, Lehr HA, et al. Perivascular epithelioid cell neoplasms of soft tissue and gynecologic origin: a clinicopathologic study of 26 cases and review of the literature. Am J Surg Pathol 2005;29:1558-1575.
Perivascular Epithelioid Cell Tumor (PEComa)
Friday, May 15 2009 @ 02:20 PM CDT
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rare form of endometrial cancer with distinct morphological features on pathology; it is aggressive and has high recurrence rate. Like uterine papillary serous carcinoma CC does not develop from endometrial hyperplasia and is not hormone sensitive, rather it arises from an atrophic endometrium. Usually post-menopausal patients Not related to DES exposure Histologically resembles vaginal and ovarian clear cell carcinomas High grade tumor - not FIGO graded Microscopically: Tumor is composed of large clear cells with glycogen, distinct margins, papillary formations and hobnail cells; enlarged angulated nuclei with enlarged irregular nucleoli with at least focal cytoplasmic clearing; cytoplasm also eosinophilic; papillary, glandular or sheet-like architecture
Endometrial Clear Cell Carcinoma
Wednesday, April 22 2009 @ 03:42 PM CDT
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exocervix with marked acanthosis, parakeratosis and hyperkeratosis. There are occasional keratin cysts in the center of acanthotic rete pegs, and chronic inflammatory infiltrates in the underlying stroma. The epithelial fronds have cone-shaped edges and regular contours without evidence of infiltration. There are not stromal papillae in the upper part of the neoplastic epithelium. Verrucous carcinoma usually present as a large, warty and fungating tumor, often associated with secondary infection and regional lymphadenopathy. It is locally invasive, but rarely metastasizes. It has been associated with HPV-6 infection. Verrucous carcinoma should be differentiated from well differentiated squamous carcinoma and condyloma acuminatum. Verrucous carcinoma lacks prominent cellular atypia, frequent mitotic figures and stromal infiltration by isolated cords or clusters of keratinized cells, all of which are characteristic of squamous carcinoma. Condyloma acuminatum is distinguished by the presence of koilocytosis stromal fibrovascular cores in the proliferating epithelium, and the absence of stromal invasion.
Verrucous carcinoma of uterine cervix
Wednesday, April 15 2009 @ 10:52 PM CDT
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The dysgerminoma is a tumor homologous to the testicular seminoma and extragonadal germinomas. Three percent of pure dysgerminomas show focal direct differentiation into syncytiotrophoblastic cells which are capable of secreting HCG. Dysgerminomas account for 0.7% of all ovarian tumors. Despite their rarity, they are the most common malignant germ cell neoplasm of the adolescent female. Dysgerminomas spread locally and involve the pelvic, para-aortic, retroperitoneal, and eventually, supraclavicular nodes. 77-89% of them are well encapsulated and limited to one ovary. 10%-15% are bilateral, and minute clinically unrecognized neoplasms have been reported in as many as 5-30% of cases. Despite its less aggressive behavior and marked radiosensitivity as compared to other malignant germ cell neoplasms, the malignant potential should not be minimized. It may spread to local lymph nodes via the lymphatic system. Hematogenous spread to distant organs is late in occurrence. The 5 year survival rate for pure dysgerminomas has been quoted to be 75-90%.
Dysgerminoma
Wednesday, April 15 2009 @ 10:33 PM CDT
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Shown is a smooth muscle with entrapped endometrial glands. The smooth muscle is moderately cellular. The endometrial glands show mild atypia and focal squamous metaplasia. These histological findings are characteristic of atypical polypoid adenomyoma (APAM), an unusual polypoid tumor of the endometrium. APAM usually occurs in premenopausal women, mostly in the third and fourth decade. The presenting symptom is almost always abnormal bleeding. Pelvic examination is usually negative, but sometimes tumor can be visible as polypoid mass projecting through the external os. APAM usually involves lower uterine segment. It measures on average 2 cm in diameter and can be pedunculated or sessile but always well demarcated from the underlying myometrium.
Atypical adenomyoma
Wednesday, April 15 2009 @ 10:25 PM CDT
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Collection of hemosiderin-laden macrophages in the stroma usually due to a previous surgery like tubal ligation or excision of cysts.
Pigmentosis tubae
Thursday, April 02 2009 @ 10:12 AM CDT
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The World Health Organization recently recognized a family of neoplasms showing at least partial morphological or immunohistochemical evidence of a putative perivascular epithelioid cell (PEC) differentiation: Angiomyolipoma (AML), Clear cell "sugar"
Uterine Perivascular Epithelioid Cell Tumor
Saturday, August 02 2008 @ 05:12 PM CDT
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http://www.thedoctorsdoctor.com/diseases/uterus_leiomyosarcoma.htm
Epithelioid Leiomyosarcoma
Saturday, August 02 2008 @ 05:12 PM CDT
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Struma ovarii is defined by the presence of an ovarian tumor containing thyroid tissue as the predominant cell type. They typically occur as part of a teratoma but may occasionally be encountered with serous or mucinous cystadenomas. Malignant transformat
Struma Ovarii
Saturday, August 02 2008 @ 05:12 PM CDT
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This is a benign Leiomyoma with hydropid/degenerative change. If extensive it could lead to a cystic changes(cystci degeneration). DDX: Myxoid leiomyosarcoma Uterine smoothmuscle tumours: Practical approach to diagnosis A. Al-Nafussi Currant diagn
Nodular Hydropic Leiomyoma
Saturday, August 02 2008 @ 05:12 PM CDT
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SL shows bizarrely shaped multinucleated and mononucleated giant cells with hyperchromatic nuclei and intranuclear cytoplasmic inclusions intermingled with cells showing typical benign smooth muscle differentiation. Mitotic count shoud be bellow 2/10hpf a
Symplastic Leiomyoma
Saturday, August 02 2008 @ 05:12 PM CDT
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