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Female & Gestational Pathology - Coggle Diagram
Female & Gestational Pathology
Vulva
Infectious
BARTHOLIN CYST
CONDYLOMA
HPV6 & 11
koilocytes
warty neoplasm (genital warts)
Non-Neoplastic
LICHEN SCLEROSIS
parchment-like vulvar skin
postmenopausal
autoimmune
inc. risk squamous cell carcinoma
Lichen Simplex Chronicus (aka Vulvar squamous cell hyperplasia)
similar to lichen scler, but more associated with
leukoplakia
with thick leathery vulvar skin & chronic irritation/scratching
epithelium proliferates downward
Neoplastic
Neoplasias
vulvar intraepithelial neoplasia (VIN)
can progress to ...
severe form (Vin3) aka carcinoma in situ
EXTRAMAMMARY PAGET DISEASE
PAS (periodic acid--schiff) positive, keratin positive, & S-100 negative
epidermis of vulva
Vulvar Melanoma
PAS negative, keratin-, & S-100 positive
Vulvar Carcinoma
Long standing lichen sclerosis
Can progress to ...
HPV
koilocytic change
Subtypes
vulvar SCC
leukoplakia (parchment-like vulvar skin)
keratin pearls
Vagina
Non-infectious
Carcinoma
EMBRYONAL
RHABDO
MYOSARCOMA
malignant mesenchymal proliferation of immature skeletal muscle
Grape-like (botryoides) mass protruding from the vagina
under 5 years old
Red raspberry
malignancy of immature skeletal muscle (think neural tube, myotome, and sarcoma develop.
VAGINAL CARCINOMA
squamous epithelium
HPV
Clear cell adenocarcinoma
clear cytoplasm
Adenosis
Increased incidence in females who were exposed to diethylstilbestrol (DES) in
utero
focal persistence of columnar epithelium in upper vagina (embryonically supposed to be replaced by squamous epithelium)
is a risk factor for ...
infections
often have vaginal discharge
Types
Bacterial
Trichomoniasis
Vulvovaginal candidiasis
Mucopurulent cervicitis
HSV
Atrophic vaginitis, Contact dermatitis, foreign bodies
Mucosal lining: Non-keratinising squamous epithelium
Cervix
SCREENING AND PREVENTION OF CERVICAL CARCINOMA
CERVICAL CARCINOMA
Most common: Squamous cell carcinoma
Adenocarcinoma (2nd most common)
HPV
CERVICAL INTRAEPITHELIAL NEOPLASIA
Cervicitis
Uterus
menstrual abnormalities
ASHERMAN SYNDROME
Secondary amenorrhea due to loss of the basalis and scarring
destruction to the basal layer:
Without the basal layer, the functional layer cannot regenerate
ANOVULATORY CYCLE
Endometrium
Endometritis
CHRONIC ENDOMETRITIS
lymphocytes & plasma cells
presentation: uterine bleeding, pain, infertility
ACUTE ENDOMETRITIS
bacterial infection
Presentation: fever, uterine bleeding, pelvic pain
Endometriosis
cyclic abdominal pain coinciding with menses
Laparoscopy shows hemorrhagic 0.2–0.5 cm lesions on peritoneal surfaces
what is it? endometrial glands and stroma are found outside the uterus (ectopic endometrium)
The triad of postpartum fever, uterine tenderness, and foul-smelling lochia is classic for endometritis. Infections are common 1 week postpartum
ENDOMETRIAL HYPERPLASIA
endometrial polyp
presents: postmenopausal uterine bleeding
ENDOMETRIAL CARCINOMA
postmenopausal uterine bleeding
Endometrial adenocarcinoma
Serous Endometrial Adenocarcinoma
TP53
Endometrioid endometrial adenocarcinoma
associated w/ endometrial hyperplasia
PTEN
Harder than serous
adenomyosis
enlarged uterus
Mechanism: endometrial glands extend from the endometrium down
into the myometrium
Myometrium
LEIOMYOMA (FIBROIDS)
abnormal uterine bleeding, infertility, & pelvic mass
Benign neoplasm
appearance: white, whorled masses that distort uterus, (thin-walled, serous fluid-filled cysts near fimbriated end of fallopian tube)
pictures
LEIOMYOSARCOMA
do NOT arise from fibroids; de novo
necrosis & hemorrhage, mitotic activity, cellular atypia
Ovary
Neoplasias
The majority of ovarian neoplasms are ...
Epithelial
Mucinous
slightly cloudy fluid
mucinous cystadenocarcinoma
psammoma bodies
zones of lamellar concentric calcification
middle-aged women (30s–60s)
Endometroium
PTEN
? Clear cell carcinoma
Brenner Tumor
benign
transitional/urothelial cells
“coffee bean” nuclei
solid tumors with epithelial cells resembling the urinary tract
Serous
benign
Serous cystadenoma
can progress to borderline -->
Serous borderline tumor
Can progress to
cancerous
Serous carcinoma
Low grade
clear cells, mucinous morphology
1 more item...
High grade
middle-aged women (30s–60s
Fallopian tube
serous tubal intraepithelial carcinoma
progresses to
Ascites, fluid wave, paracentesis --> common spread to abdomen
Germ Cell
cystic teratoma
immature teratoma
malignant
immature neuroectoderm
necrosis
dysgerminoma
Turner syndrome
inc. LDH
cells w/ fried egg appearance
homolog of male Seminoma!!
yolk sac tumor
prepubertal females
Schiller-Duval bodies
(central vessel surround by rosette of tumor cells)
Mature teratoma
usually benign
Teratoma with somatic malignancy
Very Rare!!: mature teratoma develops tumor the same way any other somatic cell could
irregular calcifications
Sex chord Stromal
Thecoma-Fibroma
Fibroma (FM radio for fibroma meigs)
Meigs syndrome
ascites & right sided pleural effusion
Thecoma
causes abnormal uterine bleeding
estrogen producing
Combined Thecoma-Fibroma
Granulosa-thecal cell
estrogen produced
malingnant
elevated alpha-inhibin
call-exner body
Sertoli-Leydig
crystals of reinke
hirtuism
Metastatic
Common Sites of Metastatic Origin
Gastric/ stomach
Krukenberg tumor
signet ring cells
Appendiceal (pseudomyxoma peritonei)
colon
Breast
Cystic & Non-neoplastic
Cystic
Follicular Cyst
Luteal cyst
PCOS (Poly-cystic ovarian syndrome)
Ovarian Torsion
Inflammatory
PID (Pelvic Inflammatory Disease )
Granulomatous Disease
