Images: GU / GYN Pathology Flashcards by Federico Girardi

Renal pelvic pTCC

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Ureteral pTCC

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Bladder pTCC

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Bladder flat CIS

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Papilloma

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Papilloma

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Papilloma

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LGUC

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LGUC

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HGUC

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HGUC

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Flat urothelial CIS

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Invasive UC

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Invasive UC

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Urine cytology: UC

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Bladder SCC

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Bladder SCC

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Bladder SCC: schistosomiasis

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Bladder SCC: schistosomiasis

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Bladder SCC: keratin pearl

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Bladder SCC: intercellular bridges & intracellular keratin

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Bladder adenocarcinoma

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Bladder adenocarcinoma: in situ

Atypical columnar cells limited to surface glands; no invasion

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Bladder adenocarcinoma: NOS

Infiltrating glands lined w/ atyical cells; no apparent mucin production

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Bladder adenocarcinoma: mucinous (colloid) | Cells in small clusters float in mucin pools, infiltrating bladder wall

Bladder adenocarcinoma: mucinous with signet-ring cells | Signet-ring cells & abundant mucin in pools

BPH

# BPH vs. Prostate Cancer

Cancer: peripheral zone; ill-defined border; yellow discoloration BPH: transitional zone / periurethral; whitish

Prostatic adenocarcinoma

Prostatatic intraepithelial neoplasia (PIN) | Prostatic duct retains basal layer; atyical hyperplastic duct epithelium

Prostatic adnocarcinoma: GS 3 | Individual well-formed glands with no basal layer

Prostatic adenocarcinoma: GS 4 | Cribriform pattern (glands within glands)

Prostatic adenocarcinoma: GS 5 | Central necrosis

Prostatic adenocarcinoma: GS 5 | Individual cells

Prostatic adenocarcinoma: GS 5 | Solid sheet

Metastatic osteoblastic prostatic carcinoma

Cryptorchidism | Seminiferous tubule w/ Sertoli cells, no spermatogenesis

Testicular torsion | Hemorrhagic infarction of testis

Testicular torsion | Only ghostly outline of parenchyma visible; tissue is nonviable

Condyloma acuminata | Anogenital HPV; genital wart

Condylomata acuminata | Exophytic papillary architecture

Condylomata acuminata | Perinuclear cytoplasmic halo, multinucleation, nuclear enlargement

Condylomata acuminata | Nuclear enlargement, hyperchromasia, multinucleation, perinuclear halo

Classic VIN | Basaloid & warty carcinoma

Basaloid vulvar carcinoma | Basaloid & warty carcinoma

Differentiated VIN | Keratinized squamous carcinoma

Well-differentiated vulvar SCC | Keratinized squamous carcinoma; keratin pearls

Vulvar SCC

VAIN

Vaginal SCC | Atypical squamous cells in neoplastic islands invading into stroma

LSIL | Koilocytes

LSIL | Histology

LSIL | Cytology

HSIL | Abnormal nuclei; no cytoplasmic differentiation in upper & middle thirds

HSIL: increased N/C ratios | Cytology

HSIL: irregular nuclear membranes | Cytology

Normal cervical epithelium | Histology

LSIL (CIN 1): koilocytic atypia | Histology

HSIL (CIN 2): progressive atypia | Histology

HSIL (CIN 3): diffuse atypia; loss of maturation | Histology

Normal exfoliated superficial squamous cells | Cytology

LSIL (CIN 1): koilocytic atypia | Cytology

HSIL (CIN 2)

HSIL (CIN 3)

Invasive cervical SCC | Fungating mass

Invasive cervical SCC

Cervical adenocarcinoma, usual type

Cervical AIS | Maliginant epithelium within gland, no invasion into stroma

Cervical AIS | Crowded, atypical epithelial cells with hyperchromatic nuclei

Proliferative endometrium | Tubular shaped glands; pseudostratified nuclei; mitotic figures present

Secretory endometrium

Simple endometrial hyerplasia | Mild crowding of glands; "swiss cheese" appearance; no cytologic atypia

Simple endometrial hyperplasia | Correctly polarized nuclei; absence of eosinophilic macronucleoli

Complex endometrial hyperplasia | Moderate glandular crowding; branched glandular shapes; lack of atypia

Complex endometrial hyperplasia | Moderate-to-severe glandular crowding; no cytologic atypia

Complex endometrial hyperplasia | Moderate glandular crowding; no cytologic atypia

Atypical endometrial hyperplasia | Severe glandular crowding; nuclear atypia

Endometrial hyerplasia without atypia | Glandular crowding w/ areas of back-to-back glands; no cytologic atypia

Atypical endometrial hyperplasia | Severe glandular crowding & abnornal cytologic features

Atypical endometrial hyperplasia | Rounded, vesicular nuclei w/ prominent nucleoli

Endometrial carcinoma, type 1 | Fungating mass in the uterus

Well-differentiated (grade 1) endometrioid adenocarcioma | Preserved architecture but lack of intervening stroma; < 5% solid growth

Well-differentiated (grade 1) endometrioid adenocarcioma | Preserved glandular architecture but lack of intervening stroma

Moderately differentiated (grade 2) endometrioid adenocarcinoma | Glandular architecture admixed w/ solid areas; < 50% solid growth

Poorly differentiated (grade 3) endometrioid adenocarcinoma | Predominantly solid growth (> 50%)

Endometrial intraepithelial carcinoma (EIC) | Malignant cells with no stromal invasion

IHC: p53 in EIC | Strong, diffuse expression of p53

Serous endometrial carcinoma | Papillary growth composed of malignant cells w/ marked cytologic atypia

IHC: p53 in serous endometrial carcinoma | Accumulation of p53 in nuclei

Primordial & primary ovarian follicles | Primary follicles exhibit a single layer of granulosa cells

Secondary ovarian follicle | Demonstrates early perioocyte clearing caused by accumulation of fluid

Early antral (Graafian) ovarian follicle | Distinct zone of fluid accumulation & eccentrically placed oocyte

Luteinized follicle lining cells

Follicular cysts in ovarian cortex | Yellow corpus luteum & white corpora albicantia

Intratubular germ cell neoplasia

IHC: PLAP in intratubular GCT

Seminoma | Fleshy cream-to-tan lobulated mass

Seminoma, classic type | Large round cells with clear cytoplasm & large central nuclei

Seminoma, spermatocytic type | 3 cell sizes: small, medium, large; mitotic figures; no lymphocytes

Seminoma, spermatocytic type | Large tumor of myxoid apperance bulging from cut surface

Embryonal carcinoma | Solid nodular cut surface with numerous areas of necrosis & hemorrhage

Embryonal carcinoma | Solid sheets of tumor cells

Embryonal carcinoma | Glandular pattern of tumor cells; areas of necrosis

Teratoma | Red = hemorrhagic areas; white = cartilage

Teratoma | Black = cystic areas; yellow = adipose tissue; white = cartilage

Endodermal sinus tumor

Endodermal sinus tumor | Reticular growth pattern (lacelike network)

Endodermal sinus tumor | Schiller-Duval body = histological hallmark; pathognomonic

Endodermal sinus tumor | Eosinophilic hyalin globules

Choriocarcinoma (pure) | Strikingly hemorrhagic apeparance = characteristic

Choriocarcinoma | Necrosis, hemorrhage

Choriocarcinoma

Choriocarcinoma | Cytos: small, uninucleated; Syncytios: large, multinucleated; hemorrhage

Mixed testicular GCT | Seminoma: solid, homogenous gray areas; Other: variegated w/ hemorrhage

Leydig cell tumor | Granular, yellowish tumor replacing most of testis

Leydig cell tumor | Reinke crystals = histological hallmark

Sertoli cell tumor | Tan white firm or gelatinous cut surface

Sertoli cell tumor | Neoplastic Sertoli cells arranged in tubules

Ovarian serous cystadenoma | Large, translucent cyst filled with yellowish fluid

Ovarian serous cystadenoma | Simple columnar ciliated & non-cilated epithelium

Ovarian serous papillary cystadenoma | Multilobulated cystic tumor

Ovarian serous papillary cystadenoma | Stromal papillae with simple columar epithelium; benign

Ovarian serous papillary cystadenocarcinoma | Yellow irregular papillary growth within cyst

Ovarian papillary serous cystadenocarcinoma | Invasion of underlying stroma by malignant serous epithelial ells

Ovarian papillary serous cystadenocarcinoma | Invasion of underlying stroma

Ovarian serous adenocarcinoma | Ovary tissue replaced by large bilateral masses

Ovarian serous carcinoma | Omental caking: omentum studded with islands of ovarian serous carcinoma

Ovarian serous carcinoma | Omental caking; normal omentum = lobulated adipose tissue

High-grade ovarian serous carcinoma | Stroma invasion; cells grow in solid nests w/ slit-like spaces (arrow)

Low-grade ovarian serous carcinoma | Micropapillae; uniform round nuclei w/ evenly distributed chromatin

High-grade ovarian serous carcinoma | Complex macropapillae; pleomorphic nuclei, irregular chromatin

Ovarian mucinous cystadenoma | Mucinous cells w/ abundant gland-like or papillary growth

Ovarian mucinous cystadenocarcinoma | Complex architecture; nuclear atypia; stromal invasion

Ovarian endometrioid carcinoma

Ovarian endometrioid adenocarcinoma | Similar to uterine endometrioid carcinoma: glandular & squamoid features

Ovarian endometrioid adenocarcinoma | Nuclei are cleared out & pleomorphic; glandular spaces w/ necrosis

Ovarian clear cell carcinoma

Ovarian clear cell carcinoma | Hobnail cells = histological hallmark

Ovarian dysgerminoma

Ovarian dysgerminoma | Large cells in nests, trabeculae; septae infiltated by lymphocytes

Ovarian teratoma

Ovarian eratoma

Mature cystic teratoma (dermoid cyst) | Cyst containing teeth

Mature cystic teratoma (dermoid cyst) | Cartilage; granular epithelium; thyroid follicles

Mature cystic teratoma (dermoid cyst) | Cystic tumor filled with hair & sebaceous material

Mature cystic teratoma (dermoid cyst) | Skin & adnexal structures

Immature ovarian teratoma | Contains primitive neuroepithelium

Struma ovarii | Teratoma composed primarily of thyroid elements (follicles, colloid)

Carcinoid teratoma

Ovarian embryonal carcinoma

Endodermal sinus tumor | Reticular, myxoid, solid, glandular, polyvesicular patterns

Endodermal sinus tumor | Schiller-Duval body = histological hallmark

Endodermal sinus tumor | Hyalin PAS+ bodies: AFP

Ovarian fibroma | Firm, white whorled masses

Ovarian fibroma | Fasicles of closely packed spindle cells in storiform arrangement

Ovarian fibroma | Well-circumscribed w/ a smooth surface & homogenous white cut section

Ovarian fibroma | Short fascicles of bland spindle cells with a storiform arrangement

Ovarian thecoma | Yellow, lipid-rich

Ovarian thecoma

Ovarian thecoma | Fascicles of spindle cells w/ central nuclei & moderate pale cytoplasm

Thecoma | Tumor has a solid, glistening, homogenous, tan-yellow cut surface

| Tumor composed of spindle-to-plump cells w/ pale-to-vacuolated cytoplasm

Granulosa cell tumor

Granulosa cell tumor, microfollicular type | Call-Exner bodies: small follicles filled w/ eosinophic secretions

Granulosa cell tumor | Cells arranged in sheets punctuated by small follicle-like structures

IHC: inhibit in granulosa cell tumor | Strong IHC positivity w/ antibody to inhibin = characteristic

Ovarian Sertoli cell tumor | Hollow or solid tubules lined by cuboidal cells w/ vacuolated cytoplasm

Sertoli-Leydig cell tumor | Well-differentiated; open Sertoli cell tubules w/ round Leydig cells

Sertoli-Leydig cell tumor | Reinke crystals = histological hallmark

Metastatic ovarian cancer

Krukenberg tumor

Metastatic ovarian cancer

Images: GU / GYN Pathology Flashcards

(194 cards)