2/9/2015. Bartholin Cyst. Vulva: Squamous epithelium skin. Vagina: Squamous epithelium mucosa. Cervix: Ectocervix: squamous Endocervix: glandular

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1 Vulva: Squamous epithelium skin Bartholin Cyst Vagina: Squamous epithelium mucosa Cervix: Ectocervix: squamous Endocervix: glandular Slide courtesy of Dr. Lodge Rigal Slide courtesy of Dr. Lodge Rigal Lichen sclerosus et atrophicus Lichen simplex chronicus Squamous epithelial hyperplasia Figure 18 1 Figure

2 Condylomata lata Secondary syphilis Condylomata acuminata HPV 6, 11 low risk Figure 18 2 Koilocytes Extramammary Paget Disease Sir James Paget DYSPLASIA (VIN3) Slide courtesy of Dr. Lodge Rigal VULVAR BASALOID SQUAMOUS CELL CARCINOMA Figure 18 3 Vulvar melanoma Embryology of female lower genital tract 2

3 Embryology of female lower genital tract Arcuate Septate Didelphic Candida albicans on Pap smear Larry Cochard. Netter s Atlas of Human Embryology 1 st ed. Saunders Strawberry cervix Trichomonas cervicitis Trichomonas vaginalis on wet mount slide 3

4 Gardnerella vaginalis clue cell on Pap test VAGINOSIS/VAGINITIS PANEL DNA hybridization Molluscum contagiosum Vaginal clear cell adenocarcinoma Embryonal rhabdomyosarcoma (Sarcoma botryoides) Cervical/endocervical polyp 4

5 Nabothian cysts Cervical dilated mucinous glands Figure 18 4 Dr. George Papanicolaou PAP TESTS Figure 18 5 Conven onal smears liquid based monolayer Thin Prep Cervical cytology on Pap test Figure 18 7 Cervical histology on biopsy/excision Figure

6 Squamous cell carcinoma 80% SCCa in situ Cervical carcinoma Adenocarcinoma 15% Adenocarcinoma in situ Microinvasive SCCa Invasive SCCa Invasive adenocarcinoma Loop Electrosurgical Excision Procedure (LEEP) Endometritis Retained POC IUD STDs Adenomyosis Endometriosis Histology of the endometrial cycle Chocolate cyst Images courtesy of Dr. Lodge Rigal 6

7 Larry Cochard. Netter s Atlas of Human Embryology 1 st ed. Saunders Simple hyperplasia without atypia Complex hyperplasia without atypia Endometrial polyps Complex hyperplasia with atypia Leiomyomata Endometrial carcinoma Type I Figure

8 Endometrial carcinoma type II (serous carcinoma) Malignant Mixed Müllerian Tumor (Triple MT, Carcinosarcoma) Endometrial carcinoma + malignant mesenchymal elements (sarcoma) Papillary serous carcinoma Gabriello Fallopio Hydrosalpinx Salpingitis Tubo ovarian abscess Cervical motion tenderness Larry Cochard. Netter s Atlas of Human Embryology 1 st ed. Saunders Luteinized cells Corpus luteum Larry Cochard. Netter s Atlas of Human Embryology 1 st ed. Saunders

9 Polycystic ovary Stein Leventhal syndrome Anovulatory hyperandrogenism Torsion of ovary String of pearls Ovarian tumors Figure 18 5 Ovarian serous cystadenoma 9

10 Serous tumor of low malignant potential Serous cystadenocarcinoma Serous adenocarcinoma with psammoma bodies Ovarian mucinous cystadenoma Figure Figure Pseudomyxoma peritonei Krukenberg tumor Omental caking 10

11 Ovarian benign (mature) cystic teratoma Endometrioid cystadenoma Brenner tumor Malignant (immature) teratoma Struma ovarii Ovarian germ cell tumors Dysgerminoma Seminoma counterpart Yolk sac (endodermal sinus) tumor Schiller Duval body α fetoprotein Choriocarcinoma Syncytiotrophoblasts Cytotrophoblasts β hcg Figure Ovarian sex cord stromal tumors Granulosa cell tumor Estrogenic Call Exner bodies Fibroma thecoma Meigs syndrome Sertoli cells Sertoli Leydig cell tumor Androgenic Leydig cells 11

12 Day 8 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 Figures 2 2 Before We Are Born : Essentials of Embryology and Birth Defects. Keith L. Moore, T.V.N. Persaud, Mark G. Torchia. 8th ed. Elsevier 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 Day 21 Chorionic villus Villus cross section at 10 weeks Before We Are Born : Essentials of Embryology and Birth Defects. Keith L. Moore, T.V.N. Persaud, Mark G. Torchia. 8th ed. Elsevier 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 Figure 8 6 Villus cross section at term Fetal aspect Maternal aspect Before We Are Born : Essentials of Embryology and Birth Defects. Keith L. Moore, T.V.N. Persaud, Mark G. Torchia. 8th ed. Elsevier Figure

13 Trivascular cord Single umbilical artery Cord prolapse Nuchal cord Umbilical knot Amniotic band syndrome Placental infarction Before We Are Born : Essentials of Embryology and Birth Defects. Keith L. Moore, T.V.N. Persaud, Mark G. Torchia. 8th ed. Elsevier Placental abruption Placenta accreta/increta/percreta 13

14 Membrane Amnion Chorion Dividing membrane Diamnionic monochorionic Dividing membrane Diamnionic dichorionic Monochorionic = Monozygosity Larry Cochard. Netter s Atlas of Human Embryology 1 st ed. Saunders Figures 2 17 and 2 18 Twin Twin Transfusion Syndrome Acute villitis Chorioamnionitis T O R H C Larry Cochard. Netter s Atlas of Human Embryology 1 st ed. Saunders

15 Complete mole Ultrasound snowstorm of molar pregnancy Figures 18 19, Gestational (non gonadal) choriocarcinoma Table 18 4 Figure Altered uteroplacental blood flow in preeclampsia Proteinuria 15

16 HELLP in Eclampsia Hemolysis with schistocytes Elevated Liver enzymes Low Platelets 16