female reproductive lecture pptmedsci.indiana.edu/c602web/602/c602web/docs/fem_rep/gynslides.pdf ·...
TRANSCRIPT
2/6/2013
1
Vulva:Squamous epithelium
“skin”
Vagina:Squamous epithelium
“mucosa”
Cervix:Ectocervix: squamousEndocervix: glandular
Slide courtesy of Dr. Lodge‐Rigal
Bartholin Cyst
Slide courtesy of Dr. Lodge‐Rigal
Lichen sclerosus et atrophicus
Figure 18‐1
Lichen simplex chronicusSquamous epithelial hyperplasia
Figure 18‐1
2/6/2013
2
Condylomataacuminata
Figure 18‐2
Koilocytes
HPV 6, 11 low risk
DYSPLASIA (VIN3) VULVAR BASALOID SQUAMOUSCELL CARCINOMA
Slide courtesy of Dr. Lodge‐Rigal
Figure 18‐3
Extramammary Paget Disease
Sir James Paget
Embryology of female lower genital tract
Embryology of female lower genital tract
Arcuate Septate Didelphic
2/6/2013
3
Larry Cochard. Netter’s Atlas of Human Embryology1st ed. Saunders. 2012.
Candida albicans on Pap smear
Trichomonas vaginalis on wet mount slide
http://www.youtube.com/watch?v=UJ3yjJmBhY8
Gardnerella vaginalis“clue cell” on Pap test
VAGINOSIS/VAGINITIS PANELDNA‐hybridization
Molluscum contagiosum
2/6/2013
4
Embryonal rhabdomyosarcoma(Sarcoma botryoides)
Figure 18‐4
Figure 18‐5
PAP TESTS
Dr. George Papanicolaou
Conven onal smears → liquid basedmonolayer Thin Prep
Images courtesy of Dr. Lodge‐Rigal
Cervical cytology on Pap test
Cervical histology on biopsy/excision
Figure 18‐7
Figure 18‐6 Loop Electrosurgical Excision Procedure (LEEP)
2/6/2013
5
Cervical carcinoma
Microinvasive SCCa Invasive SCCa
Squamous cell carcinoma 80%
Invasive adenocarcinoma
Adenocarcinoma 15%
Adenocarcinoma in situSCCa in situ
Adenomyosis
Endometriosis
Images courtesy of Dr. Lodge‐Rigal
Histology of the endometrial cycle
Simple hyperplasia without atypia Complex hyperplasia without atypia
Complex hyperplasia with atypia
2/6/2013
6
Endometrial polyps Leiomyomata
Figure 18‐13
Endometrial carcinoma Type I Endometrial carcinoma type II(serous carcinoma)
Papillary serouscarcinoma
Malignant Mixed Müllerian Tumor(Triple MT, Carcinosarcoma)
Endometrial carcinoma + malignant mesenchymal elements (sarcoma)
SalpingitisPelvic inflammatory disease
GabrielloFallopio
2/6/2013
7
Larry Cochard. Netter’s Atlas of Human Embryology
1st ed. Saunders. 2012.
Corpus luteumLuteinized cells
Larry Cochard. Netter’s Atlas of Human Embryology1st ed. Saunders. 2012.
Polycystic ovaryStein‐Leventhal syndrome
Anovulatory hyperandrogenism
String of pearls
Torsion of ovary
Ovarian tumors
Figure 18‐5
2/6/2013
8
Ovarian serous cystadenoma
Serous cystadenocarcinomaSerous tumor of low malignant potential
Serous adenocarcinoma with psammoma bodies
Figure 18‐17
Ovarianmucinouscystadenoma
Figure 18‐17
2/6/2013
9
Pseudomyxoma peritonei
Omental “caking”
Endometrioid cystadenoma Brenner tumor
Ovarian benign (mature) cystic teratoma
Immature (malignant) teratoma with primitive neuroepithelium
Struma ovarii
Yolk sac (endodermal sinus) tumor
Schiller‐Duval bodyα‐fetoprotein
ChoriocarcinomaSyncytiotrophoblastsCytotrophoblastsβ‐hCG
Ovarian germ cell tumors
Figure 18‐21
Dysgerminoma
“Seminoma counterpart”
Ovarian sex cord‐stromal tumors
Granulosa cell tumor
EstrogenicCall‐Exner bodies
Fibroma‐thecoma
Meigs syndrome
Sertoli‐Leydig cell tumor
Androgenic
Leydig cells
Sertoli cells
Krukenberg tumor
2/6/2013
10
Before We Are Born : Essentials of Embryology and Birth Defects .Keith L. Moore, T.V.N. Persaud, Mark G. Torchia.—8th ed.Elsevier 2013. Figures 2‐8 and 2‐2
Day 6 post fertilization Day 7
Before We Are Born : Essentials of Embryology and Birth Defects .Keith L. Moore, T.V.N. Persaud, Mark G. Torchia.—8th ed.Elsevier 2013. Figure 3‐4
Before We Are Born : Essentials of Embryology and Birth Defects .Keith L. Moore, T.V.N. Persaud, Mark G. Torchia.—8th ed.Elsevier 2013.
Day 8 Day 14Day 21
Before We Are Born : Essentials of Embryology and Birth Defects .Keith L. Moore, T.V.N. Persaud, Mark G. Torchia.—8th ed.Elsevier 2013. Figure 5‐11
Before We Are Born : Essentials of Embryology and Birth Defects .Keith L. Moore, T.V.N. Persaud, Mark G. Torchia.—8th ed.Elsevier 2013. Figure 8‐6
Chorionic villusVillus cross sectionat 10 weeks
Villus cross sectionat term
Before We Are Born : Essentials of Embryology and Birth Defects .Keith L. Moore, T.V.N. Persaud, Mark G. Torchia.—8th ed.Elsevier 2013. Figure 8‐5
2/6/2013
11
Before We Are Born : Essentials of Embryology and Birth Defects .Keith L. Moore, T.V.N. Persaud, Mark G. Torchia.—8th ed.Elsevier 2013. Figure 8‐13
Before We Are Born : Essentials of Embryology and Birth Defects .Keith L. Moore, T.V.N. Persaud, Mark G. Torchia.—8th ed.Elsevier 2013. Figure 8‐6
Fetal aspect Maternal aspectSingle umbilical artery
Trivascular cord
Umbilical knot
Cord prolapse Nuchal cord
Amniotic band syndrome
Before We Are Born : Essentials of Embryology and Birth Defects .Keith L. Moore, T.V.N. Persaud, Mark G. Torchia.—8th ed.Elsevier 2013.
2/6/2013
12
Placental infarction Placental abruption
Before We Are Born : Essentials of Embryology and Birth Defects .Keith L. Moore, T.V.N. Persaud, Mark G. Torchia.—8th ed.Elsevier 2013. Figure 8‐11 Larry Cochard. Netter’s Atlas of Human Embryology
1st ed. Saunders. 2012. Figures 2‐17 and 2‐18
Monochorionic = MonozygosityAmnion
Chorion
Dividing membraneDiamnionic monochorionic
Dividing membraneDiamnionic dichorionic
MembraneTwin‐Twin Transfusion Syndrome
2/6/2013
13
Acute villitis
Chorioamnionitis
Congenital herpes infection
Larry Cochard. Netter’s Atlas of Human Embryology1st ed. Saunders. 2012.
Complete mole
Figures 18‐19, 18‐20
Table 18‐4
2/6/2013
14
Figure 18‐21
Gestational choriocarcinoma Altered uteroplacental blood flow in preeclampsia
Proteinuria
HELLP in Eclampsia
Hemolysis Elevated Liver enzymes
Low Platelets