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Reproductive pathology, gynecologic, male, pregnancy complications, sex…

- - - - thining of epidermis with fibrosis/sclerosis of dermis; porcelain-white plaques with red or violet border; postmenopausal women; benign
    - - hyperplasia of vulvar squamous epithelium; leathery, thick vulvar skin; benign
    - - due to blockage of Bartholin gland duct causing accumulation of gland fluid; may lead to abscess; productive-age female; associated with N gonorrhoeae
  - - - carcinoma from squamous epithelial lining of vulva; leukoplakia; biopsy required
      - HPV related: associated with HPV 16,18; risk factors are multiple partners, early coitarche(初性交); in productive-age females
      - non-HPV: from lichen sclerosus; female >70 years old
    - - pruritus, erythema, crusting, ulcers
      - intreaepithelial adenocarcinoma
- - - - immature teratoma
        
        aggressive, contains fetal tissue, neuroectoderm; <age 20
      - yolk sac tumor
        
        aggressive, in ovaries or testes and sacrococcygeal area in young children; yellow, hemorrhagic, solid mass; 50% have Schiller-Duval bodies; AFP
      - dysgerminoma
        
        most common in adolescents; sheets of uniform fried egg cells; hCG, LDH
    - - granulosa cell tumor
        
        most common malignant stromal tumor; women in their 50s; produce estrogen and/or progesterone, postmenopausal bleeding, sexual precocity(早熟), breast tenderness
        
        Call-Exner bodies
    - - serous cystadenocarcinoma
        
        most common maliganat ovarian neoplasm; psammoma body
      - mucinous cystadenocarcinoma
        
        may be matastatic from appendiceal or other GI tumors; pseudomyxoma peritonei (intraperitoneal accumulation of mucinous material
    - - Krukenberg tumor
        
        GI malignancy metastasizes to ovaries→mucin-secreting signet cell(印環細胞) adenocarcinoma; bilateral ovarian mass
  - - - mature cystic teratoma(dermoid cyst)
        
        female 10-30 years old; all 3 germ layers; pain; rarely, form with thyroid tissue→hyperthyroidism
    - - fibroma
        
        bundles of spindle shaped fibroblasts; Meigs syndrome (ovarian fibroma, ascites, hydrothorax)
      - thecoma(卵胞膜細胞腫)
        
        like granulosa cell tumors, may produce estrogen; abnormal uteric bleeding in a postmenopausal woman
    - - serous cystadenoma
        
        most common; lined with fallopian tube-like epithelium; often bilateral
      - mucinous cystadenoma
        
        multiloculated, large; lined by mucus-secreting epithelium
      - endometrioma
        
        endometriosis within ovary with cyst formation; pelvis pain, dysmenorrhea, dyspareunia(性交疼痛); chocolate cyst
    - - Brenner tumor
        
        resembles bladder epithelium; solid tumor that is pale yellow-tan and appear encapsulated; coffee bean nuclei on HE stain
- - - - malignant; ↑hCG; syncytiotrophoblastic and cytotrophoblastic elements; hematogenous metastasis; gynecomastia, hyperthyroidism
    - - malignant; painless; homogenous; mostcommon; large cells in lobules with watery cytoplasm and fried egg appearance; ↑placental ALP; excellent prognosis
    - - benign in child; may be malignant in adults
    - - malignant; hemorrhagic mass with necrosis; painful; worse prognosis; ↑hCG
    - - yellow, mucinous, agressive; Schiller Duval bodies; ↑AFP; <3 years old
- - - - uterovaginal agenesis in genotypic female, androgen insensitivity in genotypic male
    - - male genotype with insufficient production of testosterone
    - - hypergonadotropic hypogonadism, hypogonadotropic hypogonadism
- - - - benign, painless, lump due to injury to breast tissue
      - calcified oil cyst; necrotic fat and giant cells
    - - during breastfeeding; S. aureus is most common
      - treat with antibiotics
  - - - small fibroepithelial tumor within lactiferous ducts; nipple charge; ↑cancer risk
    - - large mass; cysts with leaf like lobulations
    - - most common in women<35 years old; small, well-defined, mobile mass; ↑size and tenderness with ↑ estrogen
  - - - sclerosing adenosis
        
        acini and stromal fibrosis, associated with calcifications
      - epithelial hyperplasia
        
        in terminal duct or lobular epithelium
- - - - comedocarcinoma(面疱癌)
        
        ductal, central necrosis
      - Paget disease
        
        from DCIS or invasive breast cancer; eczematous(湿疹) patches on nipple; Paget cells
      - ductal carcinoma in situ
        
        fills ductal lumen; from ductal atypia; microcalcification on mammography
    - - invasive lobular carcinoma
        
        orderly row of cells; blateral
      - medullary carcinoma
        
        fleshy, cellular, lymphocytic infiltrate
      - invasive ductal carcinoma
        
        most common; firm, fibrous mass with sharp margins and small, glandular, duct-like cells; deform suspensory ligaments(提靱帯)→simpling of skin
      - inflammatory breast cancer
        
        dermal lymphatic invasion by cancer; Peau d'orange; poor prognosis