Pathology Laboratory

FGT & Breast (Doc Amata)

28 January 2008

DISEASES OF THE FGT

MATURE CYSTIC TERATOMA

CLINICAL
• G1P0 female- left lower quadrant pain
• Hx of a delay in menses for 1 month
• Ultrasound – no gestational sac in the uterus, rt
CLINICAL fallopian tube dilated
• Gradual abdominal enlargement w/ moderste pain • Pregnancy test – (+)
• PE- Right adnexal mass • Explaratory laparotomy – ruptured fallopian tube w/
• Ultrasound – solid cystic mass w/ teeth & bone-like hemoperitoneum amounting to 2 liters
structures GROSS
• Rt salpingo-oophorectomy • Left fallopian tube- edematous and hemorrhagic w/
GROSS adherent friable irregular blood clots
• Cyst is smooth grayish white and globular and • Cream white soft to spongy placental tissues
measures 10 X 10 X 5 cm MICROSCOPIC
• Cavuty filled w/ cream yellow amorphous greasy • Placental tissues implanted along the tubal mucosa
material admixed w/ hair partially obscured by blood clots
• Protuberant mass – along the inner wall w/ fat, teeth
and bone like structures
• Villi- immature w/ loose central stromal tissue
MICROSCOPIC containing a few blood vessels w/ trophoblast
• Cyst wall – ovarian stroma • Acute inflammatory cells
• Cyst lining – stratified squamous epithelium w/
 GIVE THE PREDISPOSING FACTORS IN THE
dermal appendages underneath
DEVELOPMENT OF ECTOPIC PREGNANCIES.
• Fat smooth ms, BVs, thyroid tissue, cartilage • Predisposing factors include PID w/ chronic salpingitis
& peritubular adhesions, but 50% occur in apparently
 WHAT ARE THE POSSIBLE COMPLICATIONS OF A normal tubes
MATURE CYSTIC TERATOMA?
• Torsion of a dermoid tumor on its pedicle HYDATIDIFORM MOLE
• Higher than usual rate of sterility
• Malignant transformation (SSCA, thyroid CA,
malignant melanoma, Sarcoma)

ECTOPIC TUBAL PREGANANCY

Brim, leu, virns 1 of 4

 Patholab – FGT & Breast by Doc Amata Page 2 of 4

MICROSCOPIC
• Lining epithelium – benign cuboidal to columnar
epithelium
• Some ciliated
• Cyst wall

 WHAT IS A KRUKENBERG TUMOR?

• Krukenberg tumor refers to metastatic ovarian cancer
(usually bilateral) composed of mucin- producing
CLINICAL signet cells that metastasize from the gastrointestinal
• G4P3-hx of abortion 5 months ago tract, mostly the stomach.
• Amenorrheic
• Enlarged abdomen about 5 months gestation size
• Profuse vaginal bleeding
• Mass of grape-like structures
• Enlarged fetus w/ no fetus
• ↑ HCG – blood and urine
• Suction curettage
GROSS
• Multiple vesicles admixed w/ soft and hemorrhagic
tissues – 5cm in dm
MICROSCOPIC
• Chorionic villi – large & distended w/o BVs
• Center of villi – loose, myxomatous stroma covered by
chorionic epithelium
• Cytotrophoblasts & synctial trophoblasts
• Trophoblasts & avascular stroma

 GIVE THE FEATURES OF COMPLETE VERSUS PARTIAL

HYDATIDIFORM MOLE.
Feature Complete mole Partial
Karyotype 46, XX (46, XY) Triploid
Villous edema All villi Some villi
Trophoblast Diffuse, Focal, slight
proliferation circumferential
Atypia Often present Absent
Serum HCG Elevated Less elevated
HCG in tissue ++++ +
Behavior 2% chorioCA Rare chorioCA

SEROUS CYSTADENOMA OVARY

CLINICAL
• Nulligravid F- vague abdominal apin
• Gradual enlargement 5 months ago
• Distended abdmen
• Palapabe rt adenxal mass
• US– cystically enlarged ovary w/ no solid areas
• Salpingo-oophorectomy
GROSS
• 5 X 5X 3 cm ovary – smooth, pinkidh cream w/
prominrt vascular markings
• Uniloculated and filled w/ serous fluid
• Cyst – smooth & glistening w/ no epithelial thickening
or papillary projections
 Patholab – FGT & Breast by Doc Amata
DISEASES OF THE BREAST
FIBROCYSTIC CHANGES OF THE BREAST
CLINICAL
• Enlarging left breast mass for 4 months
• 3cm dm mass, slightly tender, movable, firm w/
indistinct borders
GROSS
• Irregular w/ several brown to bluish colored cysts
• Semitranslucent turbid fluid
• Dense fibrous tissue
MICROSCOPIC
• Smaller cyst – lined by cuboidal to columnar
epithelium, multilayering
• Larger cysts – flattened lining, abundant granular
eosinophilic cytoplasm, small rounded deeply
chromatic nuclei
• Apocrine metaplasia
• Stroma- fibrous tissue infiltrated w/ lymphocytes
• Lining epithelium & cystic ducts
 GIVE THE ROLE OF ESTROGEN IN THE DEVELOPMENT
OF THIS CONDITION
• The excess of estrogens may represent an absolute
increase, as in the rarely associated functioning
ovarian tumors, or may be related to a deficiency of
progesterone, as seen in anovulatory women.
• Estrogen injections induce mammary cysts &
hyperplastic lesions experimentally.
• Hyperestrinism are considered to be basic to the
development of this multipatterned disorder.
FIBROADENOMA
Page 3 of 4
CLINICAL
• Movable left breast mass in a month
• Mass- firm, tender & movable
• Excision biopsy
GROSS
• Well circumscribed mass, lobulated w/ rubbery
consistency
• 3X 3X 2 cm
• Yellowish white, slightly bulging surfaces – w/ slit-like
spaces
MICROSCOPIC
• Large irregular loosely arranged spindle cells and fine
wavy connective tissue fibers enclosing glandular &
cystic spaces
• Lined by heaped-up and compressed cuboidal
epithelium
• Periphery – thin rim of fibroid connective tissue
separating the normal breast parenchyma
• Fibroblastic stroma
 WHAT ARE THE HISTOLOGIC TYPES OF
FIBROADENOMA?
• Pericanalicular fibroadenoma
o Intact, round-to-oval gland spaces may be
present, lined by single or multiple layers of cells
• Intracanalicular Fibroadenoma
o Glandular lumina are collapsed or compressed
into slitlike, irregular clefts & the epithelial
elements then appear as narrow strands or cords
of epithelium lying within the fibrous stroma
• Lactating adenoma
o Connective tissue element is scant in amount,
the entire tumor may be composed of fairly
densely packed glandular & acinar spaces lined
by a single or double layers of cells
o Most often encountered in the lactating breast
INVASIVE DUCTAL CARCINOMA
 Patholab – FGT & Breast by Doc Amata Page 4 of 4

Anyways, yung mga highlighted na red yung pinahanap

microscopically.

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Sma na ko sa nanlilimos ng ink..

O bsta ayun.. goodluck!

Namimiss ko ng gumawa ng detox..
Pero ala e,, tamad na ko.. knya kanya ng hanap ng detox.
Haha!
CLINICAL
• Non-healing ulcer in left breast
-brim
• 2 yrs ago -Small firm non tender nodule in upper
outer quadrant
• Mass excised – biopsy – severe epithelial hyperplasia
w/ atypia
• 3cm superficial ulcer w/ erythematous borders above
the nipple
• Firm palpable lymp nodes in left axilla
• Left modified radical mastectomy w/ lymph node
dissedtion
GROSS
• 8X6X4 cm breast tsissue w/ ulcerated skin flap &
attached axillary fat
• 2cm – circumscribed hard reddish cream mass
beneath ulcer
• Retracted below the cut surface & gritty
• Small pinpoint foci – chalky white necrotic areas
MICROSCOPICALLY
• Irregular nests & cords of polyhedral cells w/
hyperchromatic nuclei
• Prominent nucleoli
• Ample eosinophilic cytoplasm
• Tumor cells – dilated ducts containing central
necrosis
• Dense connective tissue – surround tumor nests
• Cribiform pattern 8/10- lymph nodes positive for
malignant cells
• Desmoplastic stroma & malignant glandular cells

 WHAT IS THE CLINICAL STAGE OF THIS TUMOR?

Stage CA Lymph Distant 5 Yr
Node Metastasi Survival
Metastatis s Rate
0 DCIS/ Absent Absent 92%
LCIS
I Invasive Abent Absent 87%
≤ 2cm <0.02cm
II Invasive ≤ 1-3 Absent 75%
5cm present
>5cm Absent
III Invasive ≤ ≥ 4 present Absent 46%
5 cm
> 5cm >1
present
Any size ≥ 10
present
Locally Present
Advanced Absent
IV Any size Present/ Present 13%
absent

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parehas lang naman,, o well, pra mareview din cguro ako..