Gyneko

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Gyneko

  1. 1. Female genital tract
  2. 2. Infections <ul><li>Lower genital tract ( STD – HSV, molluscum contagiosum, HPV, trichomonas, chancroid, granuloma inguinale; endogenous – candida) </li></ul><ul><li>Entire genital tract ( STD – gonorrhea, chlamydia, mycoplasma, syphilis; endogenous – enteric bacteria), may end in PID </li></ul>
  3. 4. HSV
  4. 7. Syphilitic chancre
  5. 8. Syphilis <ul><li>secondary stage – early generalisation </li></ul>
  6. 9. Causes of female infertility
  7. 10. Acute salpingoophoritis
  8. 12. PID - torsion
  9. 14. Ovarian cysts <ul><li>non-neoplastic – inclusion c. (mesothelial, epithelial) </li></ul><ul><li>functional c. (follicular, luteal, polycystic ovary syndrome, ovarian hyperstimulation syndrome) </li></ul><ul><li>endometriosis </li></ul><ul><li>neoplastic ( surface epithelial tumors, germ cell tu, sex-cord stromal tu, metastatic tu, etc.) </li></ul>
  10. 28. Serous cystadenoma
  11. 29. Serous cystadenoma
  12. 30. Serous papillary cystadenoma
  13. 31. Serous papillary tumor of low malignant potential (papillary cystadenoma of borderline malignancy)
  14. 36. serous cystadenocarcinoma
  15. 38. ovarian adenocarcinoma – stromal invasion
  16. 40. Mucinous cystadenoma
  17. 50. Mucinous cystic tumor of low malignant potential
  18. 52. Germ cell tumors <ul><li>dysgerminoma (ovarian counterpart of seminoma) </li></ul><ul><li>embryonal carcinoma </li></ul><ul><li>yolk sac tumor (endodermal sinus tumor) </li></ul><ul><li>choriocarcinoma </li></ul><ul><li>teratoma (mature – benign: dermoid cyst, </li></ul><ul><li>immature – malignant, </li></ul><ul><li>malignisation in a mature teratoma) </li></ul>
  19. 56. Embryonal carcinoma
  20. 57. Choriocarcinoma
  21. 61. Dermoid cyst
  22. 67. Sex-cord stromal tumors <ul><li>Granulosa cell tumors (potentially malignant, possible estrogen production – risk of abnormal uterine bleeding, endometrial hyperplasia or ca) </li></ul><ul><li>Thecoma-fibroma (most common, usually benign, possible association with ascites, rarely estrogen production) </li></ul><ul><li>Sertoli-Leydig cell tumors (possible masculinisation) </li></ul>
  23. 68. Granulosa cell tumor
  24. 71. Ovarian fibroma
  25. 73. Sertoli-Leydig cell tumor
  26. 76. Metastatic tumors <ul><li>GIT (stomach, colorectal, commonly mucinous adenocarcinoma) </li></ul><ul><li>breast </li></ul><ul><li>! synchronnous primary endometrial ca + primary endometroid ovarian ca </li></ul>
  27. 78. Krukenberg tumor
  28. 80. Fallopian tubes diseases <ul><li>inflammation </li></ul><ul><li>cyst </li></ul><ul><li>tumors </li></ul><ul><li>GEU (ectopic pregnancy) </li></ul>
  29. 85. Chronic salpingitis
  30. 87. Hydrosalpinx
  31. 94. Pathology of uterine corpus <ul><li>congenital anomalies </li></ul><ul><li>inflammation </li></ul><ul><li>functional endometrial disorders </li></ul><ul><li>endometrial polyps </li></ul><ul><li>adenomyosis, endometriosis, </li></ul><ul><li>endometrial hyperplasia </li></ul><ul><li>tumors </li></ul>
  32. 95. Uterus bicornis
  33. 96. Uterus didelphys
  34. 97. Uterus unicornis with rudimentary horn
  35. 100. Acute endometritis
  36. 101. Chronic endometritis
  37. 105. Hypersecretion
  38. 106. Adenomyosis
  39. 107. Adenomyosis
  40. 109. Table 8. Classification of endometrial hyperplasis Simple Complex Atypical (specify architecture: simple or complex)
  41. 120. Carcinosarcoma = metaplastic carcinoma
  42. 131. Leiomyosarcoma
  43. 132. Pathology of the cervix <ul><li>cervicitis </li></ul><ul><li>polyps </li></ul><ul><li>physiological and pre-neoplastic epithelial changes – metaplasia, dysplasia (CIN) </li></ul><ul><li>tumors </li></ul>
  44. 134. Endocervical polyp with squamous metaplasia
  45. 137. Cervical intraepithelial neoplasia <ul><li>flat HPV condyloma (without dysplasia) </li></ul><ul><li>mild dysplasia (CIN I) </li></ul><ul><li>moderate dysplasia (CIN II) </li></ul><ul><li>severe dysplasia (CIN IIIa) </li></ul><ul><li>carcinoma in situ (CIS, CIN IIIb) </li></ul><ul><li>Cytology: </li></ul><ul><li>Low grade squamous intraepithelial lesion (LSIL): condyloma + CIN I </li></ul><ul><li>High grade SIL (HSIL): CIN II + CIN III </li></ul>
  46. 138. HPV – koilocytosis - LSIL
  47. 139. HPV - immunohistochemistry
  48. 145. Invasive squamous cell carcinoma
  49. 151. Endocervical (glandular) intraepithelial neoplasia – ECCIN
  50. 155. Adenosquamous carcinoma – alcian blue staining
  51. 159. Vaginal pathology <ul><li>inflammation </li></ul><ul><li>polyps, cysts </li></ul><ul><li>vaginal squamous intraepithelial neoplasia (VaIN) </li></ul><ul><li>vaginal adenosis (glands) </li></ul><ul><li>tumors </li></ul>
  52. 162. vaginal adenosis
  53. 165. Vulvar pathology <ul><li>inflammatory disorders (infectious, noninfectious) </li></ul><ul><li>cysts </li></ul><ul><li>vulvar intraepithelial neoplasia (VIN) </li></ul><ul><li>tumors </li></ul>
  54. 168. Extensive HPV condylomatosis
  55. 174. Lichen sclerosus
  56. 176. Vulvar squamous carcinoma

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