Female reproductive system and breast

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Female reproductive system and breast

• 303 Endometriosis
• 308 Ectopic (tubal) pregnancy
• 92 Hydatidiform mole
• 93 Choriocarcinoma
• 94 Fibrocystic breast change
• 22 Hyaline degeneration of the fibrous tissue
• 66 Fibroadenoma
• 159 Phyllodes tumor
• 95 Invasive breast carcinoma

flashback
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Endometriosis
Three elements usually present - benign
endometrial glands, - endometrial stroma, -
evidence of recent or remote hemorrhage (blood,
siderophages) Any two of the three elements are
sufficient to make the diagnosis. Exceptions
- in vagina, endometrial stroma must be seen to
rule out adenosis of endometrial type - same
histology within myometrium is diagnosed as
adenomyosis
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Endometriosis
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Endometriosis
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Ectopic (tubal) pregnancy
- villi and fetal tissue present within the tubal
lumen -trophoblastic cells infiltrating the
muscular wall of the fallopian tube - usually
minimal decidual tissue - hemorrhage
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Ectopic (tubal) pregnancy
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Ectopic (tubal) pregnancy
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Hydatidiform mole
- villi are edematous and enlarged - many villi
display central cistern formation characterized
by a prominent central space that is entirely
acellular - trophoblastic proliferation is
variable, but is always circumferentially
distributed rather than polarized - villi are
usually avascular - trophoblast may show
cytologic atypia
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Hydatidiform mole
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Hydatidiform mole
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Choriocarcinoma
- sheets of trophoblastic cells without chronic
villi invading surrounding tissues and permeating
vascular spaces - a mixture of cytotrophoblast,
intermediate trophoblast, and syncytiotrophoblast
- cytologic atypia usually pronounced with
abnormal mitotic figures - hemorrhage and
necrosis (- cytotrophoblast consists of
polygonal cells with distinct cell membranes and
clear cytoplasm, with round nuclei with prominent
nucleoli - syncytiotrophoblast consists of
multinucleated tumor cells with eosinophilic to
basophilic cytoplasm- intermediate trophoblast
is similar to cytotrophoblast but has larger more
atypical nuclei)
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Choriocarcinoma
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Choriocarcinoma
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Fibrocystic breast change
There are three principal patterns of morphologic
change - cyst formation, often with apocrine
metaplasia(Cysts are lined either by a flattened
atrophic epithelium or by cells altered by
apocrine metaplasia. Metaplastic cells have an
abundant granular, eosinophilic cytoplasm, with
round nuclei, resembling the apocrine epithelium
of sweat glands. Papillary projections may be
present in cysts and calcifications are common.
- fibrosis (chronic inflammation and fibrous
scarring contribute to the palpable firmness of
the breast) - adenosis (An increase in the number
of acini per lobule. A normal physiologic
adenosis occurs during pregnancy throughout the
breast. In nonpregnant women, adenosis can occur
as a focal change. The acini are often enlarged
(blunt duct adenosis) and are not distorted as is
seen in sclerosing adenosis. Calcifications are
occasionally present within lumens.)
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Fibrocystic breast change
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Fibrocystic breast change
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Hyaline degeneration of the fibrous tissue
flashback
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Fibroadenoma
- well demarcated nodule of small, round or
slit-like, evenly spaced acini and ducts, usually
forming a branching, canalicular pattern - the
stroma is usually delicate, cellular, and often
myxoid, resembling intralobular stroma, enclosing
glandular and cystic spaces lined by epithelium -
the epithelium may be surrounded by stroma or
compressed and distorted by it
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Fibroadenoma
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Fibroadenoma
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Phyllodes tumor
- similar to fibroadenoma, but with increase in
either abundance or cellularity (or both) of
stromal component, and possibly dilation of the
canalicular network of epithelium - this can
produce the classical low-power appearance of a
cabbage leaf-like structure extending into a
cyst-like space
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Phyllodes tumor
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Phyllodes tumor
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Invasive breast carcinoma
Poorly differentiated invasive carcinoma of no
special type - ragged sheets of pleomorphic
cells without or with poor tubule formation
infiltrating the adjacent stroma
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Invasive breast carcinoma
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Invasive breast carcinoma
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Invasive breast carcinoma