Histology for Pathology Female Genital Tract and Breast

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Histology for PathologyFemale Genital Tract and
Breast

• Theresa Kristopaitis, MD
• Associate Professor
• Director of Mechanisms of Human Disease
• Kelli A. Hutchens, MD, FCAP
• Assistant Professor
• Assistant Director of Mechanisms of Human Disease
• Loyola Stritch School of Medicine

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Objectives

• Ovary
• On a section of ovarian cortex identify stroma
  and follicles
• Define Graafian follicle
• Explain where granulosa cells are normally
  found in the ovary
• Define corpus luteum
• Define corpus albicans and identify in a section
  of ovary
• Fallopian Tube
• List the 2 types of cells that line the fallopian
  tube and their function

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Objectives

• Uterus / Cervix
• On a low power section identify the endometrium
  and myometrium
• Define endometrial basalis and functionalis
• Identify endometrial glands and stroma
• Describe the major changes of the endometrium
  through the menstrual cycle (ie menstrual,
  proliferative and secretory endometrium findings)
• Describe the epithelial lining of the endocervix
  and ectocervix
• Breast (Mammary Glands)
• List the flow of milk through the mammary glands
• Identify on histologic sections the major
  components of breast tissue (lobules of glands,
  stroma, and adipose tissue)
• Describe the epithelial lining of the
  intralobular ducts

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Medulla
Cortex
Image from Harvard University Medical School
Website
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Ovarian Cortex
Follicles
Mesothelium (also called germinal epithelium)
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Ovarian follicle

• Primordial follicle prior to puberty
• Primary follicle (after puberty)
• Primary oocyte surrounded by single layer of
  squamous cells (granulosa cells) embedded in
  ovarian stroma
• Secondary follicle
• increased thickness of granulosa cells and
  formation of the theca folliculi (stroma cells
  around the follicle)
• Graafian (pre-ovulatory) follicle final stage

Ovarian Stromal cells
Oocyte
Granulosa cells
Primary Follicle
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Mature Graafian Follicle
Oocyte

• Graafian (pre-ovulatory) follicle final stage
• Large antrum filled with fluid (liquor folliculi)
• Ready to release oocyte in response to LH surge
• Granulosa cells directly around the oocyte
  corona radiata
• Just prior to release oocyte resumes meiosis then
  arrests as a secondary oocyte

Granulosa Cells
Graafian (preovulatory) follicle (up to 2.5 cm)
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Site of follicular Rupture / Corpus Luteum
A. Granulosa cells B. Corpora albicans
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Corpus Luteum

• After ovulation, the remaining wall of the
  graafian follicle transforms into the corpus
  luteum
• The wall of the corpus luteum is folded and
  contains granulosa lutein cells derived from
  granulosa cells which secrete progesterone

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Corpus Albicans

• In the absence of fertilization the corpus luteum
  degenerates, decreases in size and form the
  corpus albicans which consists of dense
  connective tissue

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Fallopian Tubes / Oviducts

• Two, open ended tubes that receive the ovum
• Provide the ideal environment for fertilization
• Most often occurs in ampulla
• The wall is composed of
• Mucosa ciliated cells, secretory (peg) cells,
  and underlying lamina propria
• Muscularis layer
• Serosal layer

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Fallopian Tube / Oviducts

• Mucosa high power
• Ciliated cells (arrows)
• Help sweep oocyte towards uterus
• Nonciliated Peg cells (arrowheads)
• Produce secretions to protect oocyte and promote
  fertilization
• Lamina propria (a)

Mucosa
Serosa
Muscularis
Lumen
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Uterus

• Relative large organ between the fallopian tubes
  and the vagina
• 3 anatomic regions fundus, body, and cervix
• Site of implantation and placentation
• 3 layers
• Endometrium
• Myometrium
• Serosa

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Uterus low power
Endometrium
Myometrium (smooth muscle)
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Endometrium

• Functionalis
• Near the lumen
• Hormonally responsive
• Basalis
• Produces new cells to replace endometrium that
  was shed during
• menstruation

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Endometrium high power
Endometrial glands
Stroma
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The endometrium undergoes morphologic and
functional changes during the menstrual cycle
Corpus luteum
Graafian follicle
Regressing corpus luteum
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Proliferative Phase
Early post-menstrual Sparse glands Predominant
basalis
Early proliferative Endometrium thicker
under estrogen influence Glands straight and thin
Later Proliferative Darker more compact basal
layer
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Secretory Phase Endometrium
Mucoid secretions
Early Secretory Phase Endometrium Glands tortuous
progesterone effect, mucoid secretions stored
within the glands, pending a possible embryo
implantation
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Cervix

• Lower part of uterus
• Bulges into vagina
• Two parts with different histology and a
  transitional zone between them
• Endocervix Simple columnar glands
• Ectocervix Stratified squamous epithelium

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Cervix
Transition zone simple columnar epithelium of
the endocervix with overlying non-cornified
stratified squamous epithelium of the ectocervix
Endocervical glands
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Breast (Mammary Glands)

• Breasts are composed of two multilobed mammary
  glands embedded in connective and adipose tissue
• Glands are coumpound tubuloalveolar glands that
  open into a lactiferous duct which express their
  contents via the nipple
• Milk produced by the secretory alveoli first
  drains into intralobular ducts and then
  interlobular ducts to lactiferous sinus
• Intralobular ducts makes of the majority of the
  glandular tissue

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Breast Tissue
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Breast Ducts
Myoepithelial cells
Cuboidal epithelial cells