Histology

Question 1

Has ovulation occurred yet? Which day is this?

Answer 1

Secretory endometrium - day 17
Uniform sub-nuclear cacuoles, single row of nuclei, edema in the stroma (1st evidence of ovulation)

Question 2

Has ovulation occured yet? Which day is this?

Answer 2

No –> normal, proliferative endometrium

Question 3

Has ovulation occurred yet? Which day is this?

Answer 3

Secretory endometrium day 20-21
MArked stromal edema (“naked nuclei”) vaculoses have gone into lumen

Question 4

Has ovulation occurred yet? Which day is this?

Answer 4

Secretory endometrium day 23-24
Promoinent spiral arteries, pre-decidual change around arteries

Question 5

Has ovulation occurred yet? Which day is this?

Answer 5

Secretory endometrium day 26-27 confluent sheets of predecidea, lumphocytes

Question 6

What is this?

Answer 6

Follicular atresia

Question 7

What is this?

Answer 7

Vas deferens
Epithelium also pseudo stratified with stereocillia (like epididmis), contains 3 layers of smooth muscle the propel sperm

Question 8

Answer 8

Secondary follicle
The zona granulosa (ZG) proliferates
& a fluid filled space (follicular
antrum, FA) appears
The theca folliculi differentiates
into two layers: theca interna (TI)
& theca externa (TE)
TI cells secrete androstenedione,
which is transferred to the follicular
cells for testosterone production,
testosterone is converted to estradiol
TE is connective tissue capsule-like
layer, continuous with ovarian stroma

Question 9

Answer 9

Corpus Luteum

Question 10

Answer 10

Breast tissue - pregnancy
The alveolar duct epithelium proliferates to form numerous secretory alveoli L, breast lobule; S, septa of interlobular tissue

Question 11

Answer 11

Benign prostatic hyperplasia - stromal hyperplasia
Hyperplasia of the stroma happens first

Question 12

Answer 12

BPH - Nodular glandular hyperplasia

Question 13

Answer 13

Carcinoma of prostate
key features - increased number of acini, acini grow in haphazard pattern, violates normal architecture

Question 14

Answer 14

Perineural invasion - CAP

Question 15

Answer 15

Immature testis
No germ cell epithelium, no puberty

Question 16

Answer 16

Seminoma - homogenous form, macroscopically heomogenous tumor, seminoma cells - prominnent nucleoli, cytoplasm clearing (glycogen)
tumor infiltrating lymphocytes

Question 17

Answer 17

Teratoma - differentiated (looks like bronchois) organogenesis tumor

Question 18

Answer 18

Choriocarcinoma staining for HCG

Question 19

Answer 19

Choriocarcinoma
STGC = syncytiotrophoblastic giant cells

Question 20

Answer 20

Yolk sack tumor
Key feature - stains for AFP (alpha fetal protein)

Question 21

Answer 21

Glandular and stromal breakdown seen in DUB

Question 22

Answer 22

Stromal blue balls – seen is dysfunctional uterine bleeding –> collapse of stroma

Question 23

Answer 23

Cysti endometrial atrophy
Glands are cystically enlarged
Lining is flat and attenuated
without mitotic activity
Stroma is less cellular and
fibrotic

Question 24

Answer 24

Biopsy of cystic atrophy of endometrium
Scant strips of bland epithelial
cells and blood

Question 25

Answer 25

Endometrial polyp: BASAL ENDOMETRIUM DERIVED! Larger tissue fragments with dense stroma and thick walled arteries Glands ireegular, dilated, may be crowded focally separate fragments of normal endometrium

Question 26

Answer 26

Endometrial polyps

Question 27

Answer 27

Intramural and submucosal leiomyoma

Question 28

Answer 28

Question 29

Answer 29

Question 30

Answer 30

Leiomyosarcoma invasion of surrounding tissue, vascular invasion

Question 31

Answer 31

Leiomyosarcoma histology mitotic activity, marked nucclear atypia, bizarre giant cells

Question 32

Answer 32

Endometriosis

Question 33

Answer 33

Endometriotic "chocolate cyst"

Question 34

Answer 34

Endometrial hyperplasia

Question 35

Answer 35

Simple endometrial hyperplasia

Question 36

Answer 36

Complex endometrial hyperplasia

Question 37

Answer 37

Endometrial hyperplasia with atypia

Question 38

Answer 38

``` Endometrial carcinoma Desmoplastic response (part of malignancy criteria) ```

Question 39

Answer 39

Endometrial carcinoma ## Footnote Cribiform glands

Question 40

Answer 40

Endometrial carcinoma - papillary pattern

Question 41

Answer 41

Endometrial carcinoma Type 1 (estrogen responsive, indolent) Glands and tumor cells are similar to those of atypical hyperplasia of endometrium •More complex proliferation •Confluent proliferation of cells

Question 42

Answer 42

Endometrial carcinoma - type 2, clear cell type ## Footnote * Clear, vacuolated cytoplasm * Markedly atypical nuclei •May be admixed with serous carcinoma

Question 43

Answer 43

Endometrial carcinoma - type 2 serous type •Marked nuclear atypia •Macronucleoli •Numerous abnormal mitoses •Calcifications (Psammoma bodies)

Question 44

Answer 44

Condyloma - HPV infection

Question 45

Answer 45

CIN 3/HSIL abnormal cells from basal to surface

Question 46

Answer 46

CIN 3

Question 47

Answer 47

Serous carcinoma •Papillae, slit-like spaces, solid areas •Markedly atypical cells •Necrosis, hemorrhage •Many mitoses, including atypical forms

Question 48

Answer 48

Mucinous carcinoma •Glands and solid areas •Atypical, mucinous epithelial cells

Question 49

Answer 49

Endometrioid carcinoma •Resembles usual (type I) endometrial carcinomas

Question 50

Answer 50

Clear cell carcinoma •Glands, papillae, solid areas •Markedly atypical cells with clear cytoplasm

Question 51

Answer 51

Mature cystic teratoma

Question 52

Answer 52

more malignant than the thecomas which are usually benign

Question 53

Answer 53

mostly benign can produce estrogens

Question 54

Answer 54

Question 55

Answer 55

Adenomyosis: functional endometrial nests in myometrium producing foci of hemorrhagic cysts in uterine wall

Question 56

Answer 56

ovarian stroma and surface epithelia

Question 57

Answer 57

Ovary epithelial inclusion cyst

Question 58

Answer 58

Benign cystadenomas are lined by a single layer of bland epithelial cells --\> serous with cilia

Question 59

Answer 59

Benign cystadenomas are lined by a single layer of bland epithelial cells --\> mucinous type

Question 60

Answer 60

Krukenberg tumor “Signet ring” tumor cells (cytoplasm filled with mucin pushing nucleus to side)

Question 61

Answer 61

dcis

Question 62

Answer 62

Lobular carcinoma in situ

Question 63

Answer 63

invasive ductal carcinoma

Question 64

Answer 64

Invasive Lobular Carcinoma

Question 65

Answer 65

fibroadenoma

Question 66

Answer 66

Phyllodes tumor is the other major fibroepithelial neoplasm in the breast. It also grows in a mixed or biphasic pattern; however, the stroma dominates over the glandular component. Invasion at the periphery is seen in some PTs – a cancer-like growth pattern that is never seen in fibroadenoma.