Female Reproductive System

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Female Reproductive System

• Major Topics for Discussion
• Ovarian and endometrial cycles
• Pelvic inflammatory disease
• Pathology of cervix
• Pathology of uterus
• Pathology of ovaries
• Gestational trophoblastic disease

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Normal Anatomy of Female Reproductive System
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Ovarian Endometrial Cycles
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Pelvic Inflammatory Disease
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Bartholin Gland Cyst
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Clear Cell Adenocarcinoma of Vagina (linked to
diethylstilbestrol exposure)
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Pathology of the Cervix

• Pap Smear Results
• HPV Infection (Cervicitis)
• Cervical Intraepithelial Neoplasia
• Cervical Squamous Cell Carcinoma

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ENDO - Cervix
EXO - Cervix
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Squamo-Columnar Junction
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Growth of the Cervix at Puberty Triggers Squamous
Metaplasia in the Transformation Zone
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Normal Cervical Squamous Epithelial Cells (Pap
Smear - note small pyknotic nuclei in the most
superficial cells)
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Cervical Dysplasia (Pap Smear)
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Cervical Dysplasia (Pap Smear)
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Examination with a colposcope reveals cervical
dysplasia (note mosaic pattern with punctate
vessels)
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Cervicitis
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HPV and pathogenesis of cervical squamous cell
carcinoma
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HPV

• Condyloma accuminatum

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Koilocytic Atypia (HPV Halo)
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Koilocytes (HPV-Infected cells)
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Biopsy of a condyloma shows koilocytes with
perinuclear halos - reflecting HPV infection.
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CIN-1 (Mild)
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CIN-2 (Moderate)
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CIN-3 (Severe)
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Cervical Carcinoma In Situ
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Cervical Squamous Cell Carcinoma
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Lymphatic Invasion
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Pathology of the Uterus

• Endometrial Polyp
• Endometrial Adenocarcinoma
• Leiomyoma (Uterine Fibroid)

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• Adenocarcinoma
• Linked to estrogen
• Post-menopausal
• Preceded by atypical hyperplasia

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Uterine Fibroid - Smooth Muscle Tumor of
Myometrium - Leiomyoma
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Leiomyomas of the Uterus
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Adenomyosis
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Endometriosis
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Causes of Female Infertility
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Pathology of Ovaries

• Follicular Cysts
• Polycystic Ovary Syndrome
• Neoplasms (epithelial, stromal, germ cell)

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Folliclular Cyst
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Polycystic Ovary Syndrome
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Mucinous Adenoma
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Serous Cyst Adenocarcinoma of Ovary
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Benign Dermoid Cyst(Mature Cystic Teratoma)
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Estrogen-Producing Granulosa Cell Tumor
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Placenta and Gestational Trophoblastic Disease
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Abnormal Patterns of Implantation
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Ectopic Pregnancy
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Hydatidiform Mole

• Hyperplastic chorionic villi
• Complete mole
• Incomplete mole
• Rare malignant outgrowth choriocarcinoma

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Path Key Words

• Adenomyosis
• Cervical dysplasia (CIN-I/II)
• Clear cell adenocarcinoma
• Dermoid cyst
• Dysgerminoma
• Endometrialadenocarcinoma
• Endometriosis
• Granulosa cell tumor
• Herpes simplex type 2
• Human papilloma virus(HPV)

• Hydatiform mole
• Infertility
• Leiomyoma
• Pelvic inflammatory disease
• Placenta accreta
• Polycystic ovary syndrome
• Serous cystadenocarcinoma
• Squamous cell carcinoma
• Yolk sac carcinoma