Female Reproductive Pathology

Question 1

Examples of reproductive pathology in females

Answer 1

• Disorders of sexual development
• Pathology of the ovary
• Pathology of the uterus and external genitalia
• Pathology of the mammary gland

Question 2

Sexual development

Answer 2

1. Genetic Sex
   Establishment of sex chromosomes at fertilisation
2. Gonadal sex
   Modelling of embryonic gonadal tissue
3. Phenotypic Sex
   Controlled programmed regression and growth of genital tissues

Question 3

Establishment of sex chromosomes at fertilisation

Answer 3

• XX or XY
• The Gene Sex Determining region on Y (SRY) is the testis determining gene

Question 4

Controlled programmed regression and growth of genital tissues

Answer 4

Establishment of genital phenotype

Question 5

Disorders of sexual development classification

Answer 5

Based on whether karyotype is abnormal or normal
1 - Abnormal or missing sex chromosome
2 - Normal female karyotype
3 - Normal male karyotype

Question 6

Karotype definition

Answer 6

An individuals complete set of chromosomes
Either XX or XY

Question 7

How to assess classification of sexual developmental disorder

Answer 7

1. Sex chromosomes and the presence or absence of genes such as the sex determining region of the Y chromosome (SRY)
2. Gonadal type
3. Genital phenotype

Question 8

What is persistent Müllerian duct syndrome (XY karyotype and uterus)?

Answer 8

Normal male karyotype disorder

Question 9

What is polled syndrome of goats (XX karyotype with testes)?

Answer 9

Normal female karyotype disorder

Question 10

What are freemartin calves (chimeras XX/XY)?

Answer 10

Abnormal or missing sex chromosome disorder

Question 11

What is a chimera?

Answer 11

An organisms whose cells are derived from two or more zygotes
* Contains at least two different sets of DNA, most often originating from the fusion of as many different zygotes

Question 12

Explain bovie freemartinism

Answer 12

○ Genetic female born co-twin with a male
○ It is believed that the male foetus sterilises the female by testis-determining factors and anastomoses
○ Blood of the twins is exchanged and leads to permanent colonisation by haematopoietic cells
○ Some freemartin foetuses XX are true hermaphrodite

Question 13

True hermaphrodite definition

Answer 13

Histological evidence of ovarian and testicular tissue
ambiguity of external and/or internal genitalia
* Karyotype is more often XX

Question 14

Male pseudohermaphrodite

Answer 14

• Karyotype is XY
• Gonads recognisable as testis
• Incompletely masculinised and ambiguous external and internal genitalia

Question 15

Female pseudohermaphrodite

Answer 15

• Karyotype is XX
• Feminine internal genitalia
• Masculinised external genitalia

Question 16

Examples of ovarian pathology

Answer 16

• Ovotestis
• Ovarian/paraovarian cysts
• Neoplasia

Question 17

Ovarian cysts

Answer 17

• Follicular cysts and luteinized cysts
• Cystic rete ovarii
• Cysts of the subsurface epithelial structures (SES)

Question 18

Paraovarian cysts

Answer 18

• Cystic epoophoron or paroophoron (cysts of mesonephric tubules)
• Hydatids of Morgagni (cysts of paramesonephric ducts)
• Cyst of mesonephric duct

Question 19

Ovarian neoplasia examples

Answer 19

• Sex cord-stromal tumours
• Tumours of surface epithelium and SES
• Germ cell tumours
• Others

Question 20

Sex cord-stromal tumours

Answer 20

Granulosa cell tumours - most common
Thecoma or luteoma

• Usually non-malignant

Question 21

Histopathology of sex-cord stromal tumours

Answer 21

Sometimes presence of Call-exner bodies

Question 22

Gross pathology of sex cord-stromal tumours

Answer 22

Large
Either multinodular or symmetrical
Uni or bilateral
Include solid and cystic areas
With or without scattered areas of haemorrhagic necrosis

Question 23

Tumours of surface epithelium

Answer 23

Papillary and cystic adenoma
Adenocarcinomas

Question 24

Germ cell tumours

Answer 24

Teratomas - generally benign
Dysgerminoma - rare

Question 25

Other neoplasms of ovaries

Answer 25

• Endodermal sinus tumors (yolk sac tumors)
• Choriocarcinomas
• Embryonal carcinomas

Question 26

Examples of pathology of uterus and external genitalia

Answer 26

Congenital lesions of uterus
Inflammatory disorders of uterus
Neoplasms of uterus
Neoplasms of external genitalia

Question 27

Congenital lesions of uterus

Answer 27

Segmental aplasia
Mesonephric cysts

Question 28

Inflammatory disorders of uterus

Answer 28

○ Result of ascending infection when the cervix is open
○ Uterine resistance varies during the oestrous cycle, susceptibility being greatest during the luteal phase of the cycle
○ Haematogenous infections are less common
Usually involved in microbial/viral disorders
○ Inflammation limited to the endometrium is endometritis; involvement of the entire thickness of the wall is metritis
○ Pyometra:
Acute or chronic suppurative infection of the uterus with accumulation of pus in the uterine lumen

Question 29

Neoplasms of uterus

Answer 29

○ Smooth muscle tumours (leiomyoma)
○ Endometrial carcinoma in the cow

Question 30

Neoplasms of external genitalia

Answer 30

○ Smooth muscle tumors (leiomyoma)
○ Canine transmissible venereal tumour
○ Squamous cell carcinoma
○ Fibropapilloma of the vulva in the cattle

Question 31

Pathology of mammary gland

Answer 31

Mastitis in farm animals
Mammary tumours in small animals

Question 32

Farm animal Mastitis

Answer 32

Typically due to ascending infection
Bacteria are most common pathogens
* Mostly opportunistic

Question 33

Opportunistic mastitis causing bacteria

Answer 33

E. coli
Enterobacter
Klebsiella
Citrobacter
Serratia

Question 34

Other pathogens causing mastitis

Answer 34

Mycoplasma bovis
Nocardia spp.
Mycobacterium bovis
Fungi and algae (Prototheca zopfii)
Streptococcus agalactinae
Staphylococcus aureus

Question 35

Benign mammary tumours in small animals

Answer 35

Adenomas
* Represent more than half of mammary masses
* Histologicallt benign appearance
Lack of invasion
Minimal anisokaryosis/pleomorphism
Low mitotic index

Question 36

Mammary carcinomas

Answer 36

Dogs
* Large number of types/subtypes - wide heterogeneity
Cats
* 75-90% are intermediate or high grade carcinomas
* Simple and less heterogenous