Female reproductive system
practical
Dr: Salah Ahmed
Endometriosis, Fibroids, PCOD
red-blue to yellow-brown nodules
Endometrial glands and stroma within the myometrium
Multiple fibroids (subserosal)
Multiple fibroids (submucosal, intramural)
interlacing smooth muscle fibers and spindle cells in swirling
pattern
Subcortical cysts
Hirsutism
Endometrial polyp, hyperplasia,
carcinoma
Dr: Salah Ahmed
Endometrial polyp ( fibrous stroma harboring dilated glands
lined by columnar epithelium
A) Simple hyperplasia
- crowding of glands without atypia some of them are dilated (cystic hyperplasia)
:Swiss cheese
- only 1% of cases progress to adenocarcinoma
B) Complex hyperplasia
- crowding and branching of glands without cellular atypia
- 3% of cases progress to adenocarcinoma
C) Atypical hyperplasia
- complex hyperplasia with atypia ( hyperchromatic nuclei, mitotic figures )
- commonly progresses to adenocarcinoma
- treated may be with Tamoxifen (antiestrogen) or hysterectomy
(A, B )Endometrioid carcinoma (C ) Serous carcinoma of the endometrium displaying
formation of papillae and marked cytologic atypia (D )Immunohistochemical stain for
p53 reveals accumulation of mutant p53 in serous carcinoma.
Cervical intraepithelial neoplasia (CIN)
• CIN is characterized by
– disordered growth of cervical epithelium.
– Most commonly involves squamo-columnar junction.
– Disordered growth manifests as loss of polarity of
cells and nuclear hyperchromatism.
– Changes begin at the basal layer and extend outward
– Peak incidence is 35 years of age
• Majority of cases are associated with HPV
– High risk – types 16 and 18, 31 and 33.
– HPV produces koilocytosis in squamous cells
• Clear halo containing a wrinkled and pyknotic
nucleus.
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koilocytosis in squamous cells
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Classification of CIN
• Classified into 3 types depending on extent of epithelial
involvement.
• CIN I:
– Mild dysplasia involving the lower third of the
epithelium.
• CIN II:
– Moderate dysplasia involving the lower two thirds of
the epithelium
• CIN III:
– Severe dysplasia to CIS (carcinoma in situ) involving
full thickness of epithelium.
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Carcinoma in situ: intact basement membrane
Screening of dysplasia : PAP
smear of the exfoliated cell
from the cervix
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Squamous cell carcinoma of cervix
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Squamous cell cancer of cervix
Exophytic, ulcerated
squamous cell carcinoma
“keratin pearls”
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