Verfügbarkeit: Robboy's pathology of the female reproductive tract

Robboy's pathology of the female reproductive tract:

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Bibliographische Detailangaben
Format:	Buch
Sprache:	English
Veröffentlicht:	London [u.a.] Churchill Livingstone 2009
Ausgabe:	2. ed.
Schlagworte:	Enfermedades de los Genitales Femeninos Enfermedades Urogenitales Gynécologie Organes génitaux femelles - Histopathologie Organes génitaux femelles - Maladies Female Urogenital Diseases > pathology Generative organs, Female > Diseases Generative organs, Female > Histopathology Gynecology
Online-Zugang:	Inhaltsverzeichnis
Beschreibung:	An Expert Consult title
Beschreibung:	XXXVIII, 1066 S. zahlr. Ill. u. graph. Darst.
ISBN:	9780443074776

Internformat

MARC


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245	1	0	\|a Robboy's pathology of the female reproductive tract \|c ed. by Stanley J. Robboy ...
246	1	3	\|a Pathology of the female reproductive tract
250			\|a 2. ed.
264		1	\|a London [u.a.] \|b Churchill Livingstone \|c 2009
300			\|a XXXVIII, 1066 S. \|b zahlr. Ill. u. graph. Darst.
336			\|b txt \|2 rdacontent
337			\|b n \|2 rdamedia
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500			\|a An Expert Consult title
650		4	\|a Enfermedades de los Genitales Femeninos
650		4	\|a Enfermedades Urogenitales
650		4	\|a Gynécologie
650		4	\|a Organes génitaux femelles - Histopathologie
650		4	\|a Organes génitaux femelles - Maladies
650		4	\|a Female Urogenital Diseases \|x pathology
650		4	\|a Generative organs, Female \|x Diseases
650		4	\|a Generative organs, Female \|x Histopathology
650		4	\|a Gynecology
700	1		\|a Robboy, Stanley J. \|e Sonstige \|4 oth
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Datensatz im Suchindex

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adam_text	Contents Contributors xxix Foreword xxxiii Preface xxxv Dedication xxxvii Acknowledgements xxxiii CHAPTER 1 EMBRYOLOGY 1 Francis jaubert Stanley j. Robboy George L Mutter Marc Fellous Introduction 1 Gonadal development 1 Role of germ cells 13 Miillerian and wolffian duct development 14 The miillerian duct to week 8 14 External influence on the developing embryonic genital tract ducts 15 The miillerian duct after week 8 17 The miillerian duct during the second trimester 18 External genitalia 19 CHAPTER 2 VULVAR DERMATOSES AND INFECTIONS 23 Maria Angelica Selim Bruce R. Smoller Christopher R. Shea Stanley). Robboy Introduction 23 Common dermatoses affecting the vulva 23 Acute and chronic spongiotic dermatitis (eczemas) 23 General clinical and pathologic features of spongiotic dermatitis 23 Acute spongiotic dermatitis 23 Chronic spongiotic dermatitis 26 Clinical patterns of vulvar spongiotic dermatitis 27 Endogenous vulvar spongiotic dermatitis 27 Exogenous vulvar spongiotic dermatitis 28 Hints on histopathologic interpretation of vulvar spongiotic dermatitis 29 Chronic dermatidites 29 Lichen simplex chronicus 29 Clinical features 29 Microscopic features 30 Psoriasis 30 Clinical features 30 Microscopic features 31 Less common dermatoses that frequently involve the vulva 31 Lichenoid dermatoses 31 Lichen sclerosus 31 Clinical features 31 Microscopic features 32 Lichen planus 33 Clinical features 33 Cutaneous-pattern lichen planus 33 Mucosal lichen planus 34 Mixed cutaneous and mucosal pattern lichen planus 35 Pathology 35 Immunobullous disorders 35 Pemphigus vulgaris 36 Clinical features 36 Microscopic features 36 Pemphigus vegetans 36 Clinical features 36 Microscopic features 37 Bullous pemphigoid and cicatricial pemphigoid 37 Clinical features 38 Microscopic features 38 Chronic bullous dermatosis of childhood and adult linear IgA bullous dermatosis 38 Clinical features 38 Microscopic features 39 Inherited dermatoses 39 Hailey-Hailey disease 39 Clinical features 39 Microscopic features 39 Epidermolysis bullosa 39 Dariers disease 39 Clinical features 39 Microscopic features 40 Other inflammatory diseases affecting the vulva 40 Zoons vulvitis (plasmacytosis mucosae) 40 Clinical features 40 Microscopic features 41 Erythema multiforme 41 Microscopic features 41 Behcets disease 41 Clinical features 42 Microscopic features 42 Crohns disease 42 Clinical features 42 Microscopic features 41 Hidradenitis suppurativa 43 Vulvar pain syndromes 44 Vulvar vestibulitis 44 Clinical features 44 Microscopic features 44 Dysesthetic vulvodynia 44 Pigmentary alterations 44 Hyperpigmented vulva 44 Hyperpigmentation due to melanin in vulvar skin 44 Clinical features 44 Microscopic features 44 Hyperpigmentation due to increased keratin in stratum corneum 45 Clinical features 45 Microscopic features 45 Hypopigmentation 45 Postinflammatory hypopigmentation 45 Vitiligo 46 Clinical features 46 Microscopic features 46 Drugs 46 Stevens-Johnson syndrome variant of erythema multiforme 46 Fixed drug eruptions 46 Clinical features 46 Microscopic features 47 Vulvar infections and infestations 47 Bacterial infections 47 Bacterial vaginosis 47 Staphylococcal infections 47 Streptococcal infections 47 Clinical features 47 Microscopic features 48 Syphilis 48 Clinical features 48 Microscopic features 48 Gonorrhea 49 Chancroid 49 Chlamydial infection 49 Granuloma inguinale (donovanosis) 49 Fungal infections 49 Candidiasis 49 Clinical features 49 Microscopic features 49 Pityriasis versicolor 50 Tinea cruris 50 Clinical features 50 Microscopic features 50 Viral infections 50 Herpes virus infections 50 Clinical features 50 Microscopic features 51 Clinical features 52 Microscopic features 52 vi Other virus infections 52 Clinical features 52 Microscopic features 53 Clinical features 53 Microscopic features 54 Protozoal infections 54 Trichomoniasis 54 Infestations 55 Scabies 55 Clinical features 55 Microscopic features 55 Pubic (crab) lice (Phthirus pubis) 55 Appendix 2.1 Common clinical dermatologic terms 57 Appendix 2.2 Common dermatopathologic terms 57 Terms applied to the surface keratin layer 57 Terms applied to the epidermis 58 Terms applied to the dermis 58 CHAPTER 3 VULVAR CYSTS, NEOPLASMS, AND RELATED LESIONS 59 Christopher R. Shea Maria Angelica Selim Stanley j. Robboy Cysts 59 Follicular (epidermoid) cyst 59 Definition 59 Clinical features 59 Microscopic features 59 Steatocystoma multiplex 59 Definition 59 Clinical features 59 Microscopic features 59 Bartholin cyst 59 Definition 59 Clinical features 59 Microscopic features 60 Mucinous cyst 61 Definition 61 Clinical features 61 Microscopic features 61 Ciliated cyst 61 Definition 61 Paraurethral (Skene) gland cyst 61 Definition 61 Clinical features 61 Microscopic features 61 Mesonephric-like cyst 61 Definition 61 Clinical features 61 Cyst of the canal of nuck 61 Definition 61 Clinical features 61 Microscopic features 62 Benign keratlnocytic neoplasms 62 Seborrheic keratosis (verruca seborrheica, basal cell papilloma) 62 Definition 62 Clinical features 62 Microscopic features 62 Keratoacanthoma 62 Definition 62 Clinical features 63 Microscopic features 63 Premalignant keratinocytic neoplasms 63 Vulvar intraepithelial neoplasia (VIN) 63 Definition 63 Clinical features 63 Microscopic features 64 Bowenoid papulosis 66 Definition 66 Clinical features 66 Microscopic features 66 Malignant keratinocytic neoplasms 66 Microinvasive squamous cell carcinoma 66 Invasive squamous cell carcinoma 67 Definition 67 Clinical features 67 Microscopic features 69 Natural history 69 Verrucous carcinoma 70 Definition 70 Clinical features 70 Pathology 70 Differential diagnosis 71 Extramammary paget disease 72 Definition 72 Clinical features 72 Microscopic features 72 Basal cell carcinoma 74 Definition 74 Clinical features 74 Microscopic features 75 Basosquamous carcinoma 75 Definition 75 Clinical features 75 Microscopic features 75 Sebaceous carcinoma 76 Definition 76 Clinical features 76 Microscopic features 76 Melanocytic lesions 76 Lentigo 76 Definition 76 Clinical features 76 Microscopic features 76 Common acquired melanocytic nevus 76 Definition 76 Clinical features 77 Microscopic features 77 Atypical melanocytic nevus of the genital type 77 Definition 77 Clinical features 78 Microscopic features 78 Atypical (dysplastic, dark) nevus 78 Definition 78 Clinical features 78 Microscopic features 78 Blue nevus (dermal melanocytoma) 78 Definition 78 Clinical features 78 Microscopic features 78 Malignant melanoma 79 Definition 79 Clinical features 79 Microscopic features 80 Skin appendage neoplasms 81 Hidradenoma papilliferum (papillary hidradenoma) 81 Definition 81 Clinical features 81 Microscopic features 82 Syringoma 82 Definition 82 Clinical features 82 Microscopic features 82 Trichoepithelioma (epithelioma adenoides cysticum, superficial trichoblastoma) 82 Definition 82 Clinical features 83 Microscopic features 83 Vascular lesions 83 Infantile hemangioma (strawberry hemangioma, juvenile hemangioendothelioma) 83 Definition 83 Clinical features 83 Microscopic features 83 Venous malformation (cavernous hemangioma) 84 Definition 84 Clinical features 84 Microscopic features 84 Deep lymphatic malformation (cavernous lymphangioma) 84 Definition 84 Clinical features 84 Microscopic features 84 Miscellaneous lesions 84 Acrochordon (fibroepithelial polyp, skin tag, squamous papilloma) 84 Definition 84 Clinical features 84 Microscopic features 84 Endometriosis (endometrial implant) 85 Definition 85 Clinical features 85 Microscopic features 85 Heterotopic breast 85 Definition 85 Clinical features 85 Microscopic features 85 Rare tumors and tumor-like conditions 85 Langerhans cell histiocytosis (histiocytosis x) 86 Definition 86 Clinical features 86 Microscopic features 88 Merkel cell carcinoma (trabecular carcinoma, small cell carcinoma of the skin, primary cutaneous neuroendocrine carcinoma) 88 Definition 88 Clinical features 88 Microscopic features 88 Metastatic tumors 89 Miscellaneous lesions of affiliated structures 89 Bartholin gland 89 Paraurethral (skene) gland 90 Urethra 90 Urethral caruncle 90 Definition 90 Clinical features 91 Microscopic features 91 Urethral carcinoma 91 Definition 91 Clinical features 91 Microscopic features 91 CHAPTER 4 VULVAR MESENCHYMAL NEOPLASMS AND TUMOR-LIKE CONDITIONS 95 Mama R. Nucci Christopher D.M. Fletcher Tumor-like conditions 95 Fibroepithelial-stromal polyp (pseudosarcoma botryoides) 95 Definition 95 Clinical features 95 Pathology 95 Differential diagnosis 95 Nodular fasciitis 95 Definition 95 Clinical features 95 Pathology 95 Benign neoplasms 96 Angiomyofibroblastoma 96 Definition 96 Clinical features 97 Pathology 97 Differential diagnosis 97 Cellular angiofibroma 97 Definition 97 Clinical features 97 Pathology 98 Differential diagnosis 98 Prepubertal vulval fibroma 98 Definition 98 Clinical features 98 Pathology 98 Dermatofibroma (fibrous histiocytoma) 99 Definition 99 Clinical features 99 Pathology 99 Differential diagnosis 99 Granular cell tumor 100 — Definition 100 Clinical features 100 Pathology 100 Differential diagnosis 100 Leiomyoma 100 Definition 100 Clinical features 100 Pathology 100 Lymphangioma circumscriptum 101 Definition 101 Clinical features 101 Pathology 101 Angiokeratoma 101 Definition 101 Clinical features 101 Pathology 102 Other rare tumors 102 Locally recurrent neoplasms 103 Deep angiomyxoma (deep aggressive angiomyxoma) 103 Definition 103 Clinical features 103 Pathology 103 Differential diagnosis 104 Superficial angiomyxoma (cutaneous myxoma) 104 Definition 104 Clinical features 104 Pathology 105 Differential diagnosis 105 Dermatofibrosarcoma protuberans 105 Definition 105 Clinical features 105 Pathology 105 Differential diagnosis 106 Malignant neoplasms 106 Leiomyosarcoma 106 Definition 106 Clinical features 106 Pathology 106 Proximal-type epithelioid sarcoma 106 Definition 106 Clinical features 106 Pathology 106 Differential diagnosis 107 Liposarcoma 107 Definition 107 Clinical features 107 Pathology 107 Other rare sarcomas 107 CHAPTER 5 VAGINA 111 Stanley j. Robboy Peter Russell Normal structure 111 Mesonephric ducts 112 Developmental disorders 113 Imperforate hymen 114 Vaginal agenesis 114 Transverse vaginal septum 114 Miscellaneous congenital disorders 114 Inflammatory disorders 115 Vaginitis 115 Malacoplakia 116 Tampon-related lesions and toxic shock syndrome 117 Vaginal cysts 117 Cysts of the introitus 117 Benign effects of diethylstilbestrol on the vagina 117 Vaginal adenosis 118 Tumor-like conditions 120 Fibroepithelial polyps 120 Prolapsed fallopian tube 121 Granulation tissue nodule 122 Postoperative spindle cell nodule 122 Microglandular hyperplasia 122 Endometriosis 123 Benign tumors 123 Benign mixed tumor 123 Miillerian papilloma 123 Leiomyoma 124 Rhabdomyoma 124 Angiomyofibroblastoma 124 Miscellaneous benign tumors 125 Squamous neoplasia 125 Human papillomavirus (HPV) infection 125 Vaginal intraepithelial neoplasia (VaIN) 125 Definition 125 Clinical features 125 Pathology 126 Microinvasive squamous cell carcinoma 126 Invasive squamous cell carcinoma 126 Definition 126 Clinical features 126 Pathology 127 Spread and natural history 127 Squamous cell neoplasia and exposure to diethylstilbestrol 127 Verrucous carcinoma 127 Warty carcinoma 128 Small cell carcinoma 128 Glandular lesions 128 Atypical adenosis 128 Clear cell adenocarcinoma 129 Clinical features 129 Gross pathology 129 Microscopic pathology 130 Natural history 131 Pathogenesis 132 Differential diagnosis 132 Adenocarcinoma, non-clear cell 132 Other primary malignant tumors of the vagina 133 Malignant melanoma 133 Leiomyosarcoma 133 Miscellaneous tumors 133 Malignant vaginal tumors in childhood 134 Embryonal rhabdomyosarcoma 134 Pathology 134 Natural history 135 Yolk sac tumor 135 Lymphoma 136 Secondary tumors of the vagina 136 CHAPTER 6 CERVICAL BENIGN AND NON-NEOPLASTIC CONDITIONS 141 Anais Malpica Stanley /. Robboy Normal structure 141 Anatomy 141 Original (native) squamous epithelium 141 Terminology 141 Cytologic correlation 142 Hormonal influences on squamous epithelium 143 Cytologic correlation 143 Basal cell hyperplasia 144 Squamous cell hyperplasia 144 Cervical glandular epithelium 144 Cytologic correlation 145 Physiologic changes in the cervix and the formation of the transformation zone 146 Squamous metaplasia 148 Cytologic correlation 150 The congenital transformation zone 150 Definition 150 Histogenesis of the congenital transformation zone 151 Cytologic correlation 152 Inflammatory (cervicitis) to regenerative changes 152 Infective cervicitis 152 Cytologic correlation 153 Chlamydia trachomatis 154 Cytologic correlation 154 Tuberculosis 154 Cytologic correlation 155 Syphilis 155 Herpes simplex virus (HSV) 155 Cytologic correlation 156 Cytomegalovirus (CMV) 156 Human papillomavirus (HPV) 156 Schistosomiasis 157 Cytologic correlation 157 Epithelial inflammatory changes 157 Healing/regenerating epithelium 158 Cytologic correlation 159 Non-neoplastic changes 159 Miillerian metaplasias 159 Tubal, endometrioid, and tuboendometrioid metaplasia 159 Pathology 159 Differential diagnosis 160 Transitional cell metaplasia 160 Pathology 160 Differential diagnosis 161 Intestinal metaplasia 161 Lesions of the endocervical glandular epithelium 161 Endocervical tunnel clusters 161 Differential diagnosis 162 Deep nabothian cysts 162 Lobular endocervical glandular hyperplasia 163 Pathology 163 Pathogenesis 163 Diffuse laminar endocervical glandular hyperplasia 163 Lesions related to exogenous stimuli 164 Microglandular hyperplasia 164 Pathology 164 Differential diagnosis 164 Arias-Stella reaction 165 Pathology 165 Decidual change 165 Radiation changes 166 Differential diagnosis 166 Other non-neoplastic conditions 167 Endometriosis 167 Differential diagnosis 167 Mesonephric remnants and hyperplasia 168 Mesonephric duct remnants 168 Mesonephric duct hyperplasia 168 Differential diagnosis 169 Cervical polyp 169 Benign tumors 170 Squamous papilloma and condyloma acuminatum 170 Leiomyoma 170 Blue nevus 171 CHAPTER 7 CERVIX: EPIDEMIOLOGY OF SQUAMOUS NEOPLASIA 173 Sophia 5. Wang Mark E. Sherman Epidemiology and public health significance 173 The etiologic agent: human papillomavirus (HPV) 173 Evidence for causality 173 HPV classification and phytogeny 174 The HPV genome 176 Early genes 176 Late genes 176 HPV life cycle 177 HPV integration 178 HPV multiple infections 178 HPV viral load 178 Morphologic features of HPV infection 179 Immune response to HPV infection 179 Model of HPV-induced cervical pathogenesis 180 HPV: routes of transmission 180 Sexual behavior and HPV 180 Number of partners 180 Frequency of coitus 180 Prostitution 180 Male factors: condom use, promiscuity, and circumcision 181 Condom use 181 Circumcision 181 HPV cofactors 181 Smoking 181 Parity 182 Method of contraception: oral contraceptives and others 182 Racial and nationality factors/religion 182 Socioeconomic status 182 Age 183 Infectious agents: sexually transmitted infections and others 183 Nutrients, antioxidants 183 Immunosuppression (HIV/AIDS) 183 Familial aggregation and host genetics 183 Somatic events 184 Prevention of cervical cancer 184 Early detection of cervical cancer 184 Primary prevention: vaccines 184 Conclusion 185 CHAPTER 8 CERVICAL PRECANCER (INTRAEPITHEUAL NEOPLASIA), INCLUDING FUNCTIONAL BIOMARKERS AND COLPOSCOPY 189 Jan P.A. Baak Mark H. Staler Sarah M. Bean Malcolm C. Anderson Stanley J. Robboy Introduction 189 Cervical intraepithelial neoplasia (CIN): an evolving concept 189 Nomenclature 189 Features 192 Nuclear abnormalities 192 Mitotic activity 192 Differentiation, maturation, and stratification 193 Disease states 194 Condyloma acuminatum 196 CIN 1/LSIL/mild dysplasia/flat condyloma (subdinical papilloma infection) 198 CIN 2 including moderate dysplasia and part of HSIL 201 CIN 3 201 Areas of diagnostic difficulty 204 The scant endocervical curettage 204 Squamous epithelium with slightly enlarged nuclei and epithelial changes of uncertain significance 204 Basal cell hyperplasia 205 Immature squamous metaplasia and atypical squamous metaplasia 205 Repair (reactive epithelial changes) 206 Low estrogen states and atrophy 206 Thin epithelium 207 Invasive squamous cell carcinoma 207 Artifact 207 Miscellaneous conditions 207 Biomarkers 208 Why are deep epithelial layer biomarkers prognostic? 208 Ki-67 cell clusters 208 pi 6 209 Natural history of CIN, using molecular markers to assess risk 210 Biomarkers and biologic aggression of CIN lesions 211 CIN 3 with and without coexistent endocervical CCIN 211 Prognostic value of Ki-67 and other biomarkers in low-grade lesions 211 Prediction of CIN 2 and 3 behavior with biomarker patterns 211 Interpreting dynamic biomarker patterns 213 Analysis of early CIN lesions 213 Analysis of late CIN lesions 214 Other histologic findings affecting management and prognosis 214 Regression and progression to invasive carcinoma 216 Colposcopy, a technique (somewhat) useful for detection of CIN 218 Correlation between cytology and histology 218 Distribution and site of origin of CIN 219 Colposcopic appearances 219 Normal colposcopic findings 219 Original squamous epithelium 220 Columnar epithelium 220 Squamous metaplasia 220 Mature metaplasia 220 Immature metaplasia 221 Abnormal colposcopic findings 221 Mosaic and punctation 221 Acetowhite epithelium 222 Leukoplakia 222 Atypical vessels 223 Suspect frank invasive carcinoma 223 Congenital transformation zone 224 Other colposcopic findings 224 Wart virus infection 224 Glandular lesions 224 Vagina 224 CHAPTER 9 CERVICAL SQUAMOUS CELL CARCINOMA 227 Wenxin Zheng Stanley J. Robboy Microinvasive carcinoma 227 Staging 227 Definition 227 History and controversy 227 Morphologic features 228 Patterns of growth 228 Lymphovascular space involvement (LVSI) 231 Tumor dimensions 231 Extent of spread 231 Depth of invasion 232 Diagnosis 232 Cytologic findings 233 Invasive carcinoma 234 Squamous cell carcinoma 234 Definition 234 Gross features 234 Microscopic features used in classification 235 Clinicopathologic correlation 239 Clinical behavior 240 Prognostic features 240 Differential diagnosis 242 Special considerations 242 Pregnancy 242 Cervical stump carcinoma 242 Effects of radiotherapy on cervical carcinoma 243 Micrometastasis 243 Mucin-secreting carcinoma 243 Verrucous carcinoma 244 Lymphoepithelioma 244 Rapidly progressive carcinoma 245 Papillary squamotransitional cell carcinoma 245 CHAPTER 10 CERVICAL GLANDULAR NEOPLASIA 249 Richard C. jaworski Jennifer M. Roberts Stanley j. Robboy Peter Russell Cervical glandular intraepithelial neoplasia 249 Definition 249 Terminology 249 Clinical features 249 Pathogenesis/etiology 249 Diagnosis 249 HCCIN (high-grade cervical glandular intraepithelial neoplasia) 250 LCGIN (low-grade cervical glandular intraepithelial neoplasia) 253 Immunohistochemistry 254 Cytology and cytologic-pathologic correlations 255 Terminology 255 Cytologic morphology 256 Prediction of low-grade CGIN 258 Management of cytologic predictions 259 Differential diagnosis/problematic issues 259 Clinical behavior/management 260 Preclinical carcinoma 260 Microinvasive (early invasive) adenocarcinoma 260 Definition 260 Pathology 261 Cytologic correlation 263 Clinical behavior/management 263 Invasive adenocarcinoma 264 Endocervical-type adenocarcinoma (including features of adenocarcinoma in general) 264 ~ Definition 264 Clinical features 264 Pathogenesis/etiology 264 Classification and pathology 264 Immunohistochemistry 265 Cytology and cytologic correlation 266 Differential diagnosis 266 Clinical behavior/management 267 Villoglandular adenocarcinoma 267 Definition, clinical history and pathogenesis 267 Pathology 267 Clinical behavior/management 268 Adenoma malignum (minimal deviation adenocarcinoma, mucinous type) 269 Definition 269 Clinical features 269 Pathology 269 Differential diagnosis 270 Clinical behavior/management 271 Intestinal-type adenocarcinoma (including signet-ring cell and colloid adenocarcinoma) 271 Endometrioid adenocarcinoma 272 Minimal deviation adenocarcinoma, endometrioid type 272 Adenosquamous carcinoma 272 Definition 272 Clinical features 272 Pathology 272 Clinical behavior/management 273 Clear cell adenocarcinoma 273 Definition 273 Pathology 273 Differential diagnosis 273 Serous adenocarcinoma 274 Definition 274 Pathology 274 Clinical behavior/management 274 CHAPTER 11 MISCELLANEOUS CERVICAL NEOPLASMS 281 Anais Malpica Stanley /. Robboy Epithelial tumors 281 Glassy cell carcinoma 281 Definition 281 General features 281 Pathogenesis 281 Clinical features 281 Pathology 281 Ultrastructural features 281 Differential diagnosis 281 Prognosis 281 Malignant mesonephric tumor, including mesonephric adenocarcinoma 281 Definition 281 General features 281 Pathology 282 Immunohistochemical studies 283 Differential diagnosis 283 Prognosis 283 Adenoid basal carcinoma 283 Definition 283 General features 283 Pathology 284 Immunohistochemical features 285 Prognosis 285 Differential diagnosis 285 Adenoid cystic carcinoma 285 Definition 285 General features 285 Pathology 285 Immunohistochemical studies 285 Prognosis 285 Neuroendocrine tumors 286 Typical (classic) carcinoid tumor 286 Atypical carcinoid 286 Small cell neuroendocrine carcinoma 286 General features 286 Pathology 286 Immunohistochemical studies 287 Prognosis 287 Differential diagnosis 287 Large cell neuroendocrine carcinoma 288 Definition 288 Clinical features 288 Pathology 288 Immunohistochemical studies 288 Prognosis 288 Differential diagnosis 288 Sarcomas or tumors with a sarcomatous component 288 Embryonal rhabdomyosarcoma 289 Leiomyosarcoma 289 Pecoma 289 Adenosarcoma 289 Definition 289 General features 289 Pathology 289 Differential diagnosis 290 Prognosis 290 Carcinosarcoma (malignant mixed miillerian tumor) 290 Malignant melanoma 291 Pathology 291 Lymphoma and leukemia 291 Definition 291 General features 291 Macroscopic features 291 Microscopic features 292 Immunohistochemical studies 292 Prognosis 292 Differential diagnosis 293 Metastatic tumors to the cervix 293 CHAPTER 12 THE NORMAL ENDOMETRIUM 297 Rex C. Bentley George L Mutter Stanley j. Robboy Normal structure of the uterus 297 Components of the normal endometrium 297 Surface epithelium 299 Glandular cells 299 Stromal cells 301 Endometrial lymphocytes 302 Blood vessels 303 Endometrium during the normal menstrual cycle 304 Proliferative phase 304 Interval phase 305 Secretory phase 306 Early secretory phase 306 Mid-secretory phase 307 Late secretory phase 310 Menstrual phase 312 Endometrium after the menopause 314 Methods of endometrial sampling 316 Dilatation and curettage (D C) 316 Endometrial biopsy 316 Vabra aspirator 316 Pipelle biopsy 316 Cytologic evaluation of the endometrium 316 Direct endometrial cytologic sampling 316 Hysteroscopy 317 Endometrial resection (ablation) 317 Problems in interpretation of endometrial specimens 318 Adequacy 319 Dissociation artifact 319 Telescoping artifact 320 Fixation artifact 321 Legitimate tissue contaminants 322 CHAPTER 13 EXOGENOUS HORMONES AND THEIR EFFECTS ON THE ENDOMETRIUM 325 Rex C. Bentley Stanley /. Robboy Introduction 325 Estrogens 325 Progestins 325 Oral contraceptives 328 Combined oral contraceptives 328 Pure progestin oral contraceptives ( mini-pill ) 330 Long-term, progestin-only contraception 330 Hormone-replacement therapy (HRT) 331 Common types of HRT 331 Unopposed estrogen 331 Cyclic estrogen-progesterone 332 Combined estrogen-progesterone 333 Other hormonal agents 333 Tamoxifen 333 Raloxifene 335 Aromatase inhibitors 335 Phytoestrogens and other dietary agents 335 Clomiphene/ovulation induction therapy 335 Mifepristone ( morning-after pill) 336 Gonadotrophin-releasing hormone agonists 337 Conadotrophins 337 Corticosteroids 337 Danazol 337 Treatment of hyperplasia, EIN, and carcinoma 337 CHAPTER 14 ENDOMETRITIS, METAPLASIAS, POLYPS, AND MISCELLANEOUS CHANCES 343 George L Mutter Marisa R. Nucci Stanley /. Robboy Inflammatory and Infectious processes 343 Endometritis 343 Non-specific endometritis 343 Specific forms of endometritis 345 Chlamydia trachomatis and Neisseria gonorrhoeae 345 Mycoplasma 345 Cytomegalovirus 346 Herpes simplex virus 346 Tuberculous endometritis 346 Actinomyces israeli 347 Other forms of endometritis 347 Granulomatous endometritis 347 Histiocytic endometritis 347 Postpartum and postabortal endometritis 348 Pyometra 348 Endometrial metaplasias 348 Epithelial metaplasias 349 Etiology and natural history 349 Arias-Stella reaction 349 Pathology 349 Metaplasias to a tubal epithelium 351 Metaplasias to a squamous epithelium 352 Ichthyosis uteri 354 Isolated squamous morules 354 EIN with squamous morules 355 Metaplasias to a mucinous epithelium 356 Mucinous degenerative changes 356 Benign mucinous differentiation 356 EIN and adenocarcinoma with mucinous differentiation 357 Metaplasias to a secretory epithelium 358 Metaplasias to non-specific cell types 358 Eosinophilic metaplasia 358 Papillary metaplasia 359 Papillary syncytial metaplasia 360 Micropapillary hobnail metaplasia 360 Mesenchymal metaplasias 360 Will Osseous metaplasia 360 Endometrial extramedullary hemopoiesis 361 Endometrial polyps 361 Definition 361 Etiology and natural history 361 Clinical features 362 Gross features 362 Microscopic features 362 Atypical polypoid adenomyoma 364 Miscellaneous conditions 364 Ashermans syndrome 364 Radiation effect 364 The effects of the intrauterine contraceptive device on the endometrium 364 Endometrial ablation 365 CHAPTER 15 BENIGN ENDOMETRIAL HYPERPLASIA AND EIN 367 George L. Mutter Richard /. Zaino Jan P.A. Baak Rex. C. Bentley Stanley j. Robboy Introduction and terminology 367 Disordered prollferatlve to benign endometrial hyperplasia sequence 367 Definition 367 Clinical features 367 Etiology 368 Gross features 368 Microscopic features 368 Disordered proliferative endometrium (cysts and tubal metaplasia) 369 Benign endometrial hyperplasia (remodeling, fibrin thrombi, and microinfarcts) 371 Benign endometrial hyperplasia with superimposed progestin effect 373 Withdrawal shedding following benign hyperplasia 374 Differential diagnosis 374 Normal endometrium 374 Disordered proliferative endometrium 375 Endometrial polyps 375 Postmenopausal cystic atrophy 375 Endometrial intraepithelial neoplasia (EIN) 375 Treatment 375 Endometrial intraepithelial neoplasia (EIN) 376 Definition 376 Clinical features 376 Cancer outcomes in women with EIN 376 Molecular etiology and natural history 377 EIN is a monoclonal neoplasm 377 Genetic changes in EIN 377 The role of estrogens and progestins 378 Gross features 379 Microscopic features of EIN 379 EIN diagnostic criteria 379 1. Architecture: Area of glands exceeds that of stroma 379 2. Cytology: The cytology of EIN changes relative to the background endometrium from which it has arisen 380 3. Size: The lesion must be at least 1 mm in dimension 381 4. Exclusion of benign mimics 382 Normal tissues that can be mistaken for EIN 382 Benign processes that can be mistaken for EIN 382 5. Exclusion of carcinoma 383 Common EIN diagnostic problems 383 Non-localizing (widespread) EIN 384 EIN within an endometrial polyp 384 Localizing lesions subdiagnostic for EIN 384 Excessively fragmented tissue 385 Non-endometrioid EIN 385 Hormonally treated EIN 386 Biomarkers 388 PTEN immunohistochemistry 388 Quantitative histomorphometry 388 Treatment 388 Exclusion of coexisting adenocarcinoma 389 Hysterectomy 389 Hormonal therapy of EIN to reduce endometrial cancer risk 389 Prior classification 389 Where have all the hyperplasias gone? 390 CHAPTER 16 ENDOMETRIAL ADENOCARCINOMA 393 George L Mutter Xavier Matias-Cuiu Sigurd F. Lax Introduction and terminology 393 Major types of endometrial adenocarcinoma 393 Endometrial adenocarcinoma, endometrioid type (type I) 393 Endometrial adenocarcinoma, non-endometrioid type (type II) 393 Unique and hybrid types of carcinoma 393 Hereditary endometrial carcinoma 394 Risk factors in endometrial carcinoma 394 Estrogens 394 Tamoxifen 395 Endogenous risk factors 395 Polycystic ovary syndrome (PCOS) 395 Obesity 395 Diabetes 395 Ovarian lesions 395 Sex cord-stromal tumors 396 Non-neoplastic lesions 396 Reproductive factors 396 Cigarette smoking 396 Endometrioid adenocarcinoma 396 Definition 396 Clinical features 396 Gross features 397 Microscopic features 397 Cytologic correlation 400 Other variants of endometrioid adenocarcinoma 401 Differential diagnosis 405 Behavior and treatment 407 Appearances following radiation 407 Mucinous adenocarcinoma 408 Definition 408 Clinical features 408 Gross features 408 Microscopic features 408 Behavior and treatment 408 Squamous cell carcinoma 409 Definition 409 Clinical features 409 Gross features 409 Microscopic features 409 Behavior and treatment 410 Serous adenocarcinoma 410 Definition 410 Clinical features 410 Gross features 410 Microscopic features 410 Immunohistochemistry 411 Precursor lesions 411 Serous endometrial intraepithelial carcinoma (serous EIC) 411 Endometrial glandular dysplasia (EmGD) 412 Differential diagnosis 412 Behavior and treatment 413 Clear cell adenocarcinoma 413 Definition 413 Clinical features 413 Gross features 413 Microscopic features 413 Differential diagnosis 414 Behavior and treatment 415 Mixed carcinoma 415 Undifferentiated carcinoma 415 Carcinosarcoma 415 Other types of endometrial carcinoma 416 Synchronous endometrial and ovarian carcinoma 417 Tumors metastatic to the endometrium 418 Prognostic factors in endometrial carcinoma 418 Tumor type 418 Histologic grade 418 Stage and depth of myometrial invasion 420 Vascular invasion 420 Age 421 Steroid hormone receptors 421 Molecular pathology 421 The spread of endometrial carcinoma 422 CHAPTER 17 MESENCHYMAL UTERINE TUMORS, OTHER THAN PURE SMOOTH MUSCLE NEOPLASMS, AND ADENOMYOSIS 427 W. Glenn McCluggage Stanley J. Robboy Introduction 427 Endometrial stromal tumors 427 Definition 427 Classification 427 General features 427 Proliferating endometrial stroma in curettings 428 Endometrial stromal nodule 428 Definition 428 Clinical features 428 Gross features 428 Microscopic features 428 Treatment and prognosis 428 Differential diagnosis 429 Endometrial stromal sarcoma 431 Definition 431 Clinical features 431 Gross features 431 Microscopic features 432 Treatment and prognosis 434 Differential diagnosis 435 Endometrial stromal tumor variants 435 Endometrial stromal tumor with endometrioid glands 435 Definition 435 Pathology 435 Differential diagnosis 435 Mixed endometrial stromal and smooth muscle tumor 436 Definition 436 Pathology 436 Endometrial stromal tumor with sex cord-like elements 436 Definition 436 Pathology 436 Treatment and prognosis 436 Uterine tumor resembling ovarian sex-cord tumor 437 Definition 437 Gross features 437 Microscopic features 437 Histogenesis 437 Treatment and prognosis 438 Undifferentiated uterine or endometrial sarcoma 438 Definition 438 Pathology 438 Treatment and prognosis 438 Differential diagnosis 439 Mixed mullerian tumors 439 Adenofibroma 439 Definition 439 Clinical features 439 Pathology 439 Microscopic features 439 Treatment and prognosis 440 v%/ Differential diagnosis 440 Adenosarcoma 440 Definition 440 Clinical features 440 Gross features 440 Microscopic features 441 Treatment and prognosis 442 Differential diagnosis 442 Adenosarcoma with sarcomatous overgrowth 443 Carcinofibroma 443 Carcinosarcoma 443 Definition 443 Clinical features 443 Gross features 444 Microscopic features 444 Treatment and prognosis 446 Differential diagnosis 447 Histogenesis of carcinosarcomas 447 Other sarcomas 448 Benign or borderline mesenchymal tumors 448 Uterine perivascular epithelioid cell tumor (PEComa) 448 Atypical polypoid adenomyoma 449 Definition 449 Clinical features 449 Gross features 449 Microscopic features 449 Transition to adenocarcinoma 450 Treatment and prognosis 450 Differential diagnosis 450 Adenomyosis 450 Definition 450 Background 450 Clinical features 451 Pathogenesis 451 Gross features 451 Microscopic features 452 CHAPTER 18 UTERINE SMOOTH MUSCLE TUMORS 457 Bradley]. Quade Stanley). Robboy Introduction 457 Leiomyoma 457 Definition 457 Incidence 457 Etiology 457 Gross features 458 Microscopic features 460 Variants of leiomyoma 461 Degenerated leiomyoma 461 Leiomyoma treated with gonadotrophin-releasing hormone analogues 462 Gross features 462 Microscopic features 462 Leiomyoma treated by interventional radiology 463 Atypical leiomyoma 463 Definition 463 wi Gross features 463 Microscopic features 463 Cytogenetic and molecular features 464 Mitotically active leiomyoma 464 Definition 464 Microscopic features 465 Cellular leiomyoma 465 Definition 465 Gross features 465 Microscopic features 465 Differential diagnosis 465 Cytogenetic features 466 Hemorrhagic cellular leiomyoma 466 Definition 466 Pathology 466 Epithelioid leiomyoma 466 Definition 466 Gross features 466 Microscopic features 466 Myxoid leiomyoma 467 Definition 467 Microscopic features 467 Leiomyomas with heterologous elements 467 Unusual growth patterns of leiomyomas 468 Diffuse leiomyomatosis 468 Definition 468 Gross features 468 Microscopic features 468 Intravascular leiomyomatosis 468 Definition 468 Gross features 469 Microscopic features 469 Clinical features and treatment 469 Benign metastasizing leiomyoma 469 Definition 469 Disseminated peritoneal leiomyomatosis 470 Definition 470 Features 470 Leiomyosarcoma 471 Definition 471 Incidence 471 Gross features 471 Microscopic features 472 The approach to the histologic diagnosis of leiomyosarcoma 473 Diagnostic criteria 475 Mitotic activity 475 Atypia 476 Necrosis 477 Tumor invasiveness 478 Size 478 Age 478 Conclusions 478 Variants of leiomyosarcoma 478 Epithelioid leiomyosarcoma 478 Definition 478 Microscopic features 478 Myxoid leiomyosarcoma 479 Definition 479 Gross features 479 Microscopic features 479 Molecular biology of leiomyosarcoma 479 Gene expression 479 Proliferation markers 480 Flow cytometry, cytogenetics, and molecular genetics 480 Treatment and prognosis 480 Practical considerations 480 CHAPTER 19 FALLOPIAN TUBE 485 Wenxin Zheng Stanley j. Robboy Introduction 485 Anatomy, histology, and function of the fallopian tube 485 Anatomy 485 Histology 485 Function 486 Sperm transport 486 Ovum transport 486 Inflammation of the fallopian tubes 487 Infective salpingitis 487 Non-granulomatous salpingitis 487 Cross features 487 Microscopic features 487 Cranulomatous salpingitis 489 Gross features 490 Microscopic features 490 Pelvic inflammatory disease and intrauterine contraceptive device use 491 Intrauterine contraceptive device 491 Salpingitis isthmica nodosa 492 Definition 492 Pathology 492 Histogenesis 492 Differential diagnosis 493 Tubal sterilization 493 Pathology 493 Appearances following sterilization 494 Examination of the fallopian tube following failed sterilization 494 Tubal pregnancy 495 Etiology and pathogenesis 495 Natural history 496 Pathology 496 Non neoplastic lesions 498 Metaplasias 498 Mucinous metaplasia 498 Endometrial replacement and endometriosis 498 Transitional metaplasia 499 Other forms of metaplasia 499 Decidual change 499 Torsion of the fallopian tube 500 Prolapse of the fallopian tube 500 Mucosal epithelial proliferation 500 Definition 500 Microscopic features 500 Epithelial proliferation associated with salpingitis 500 Definition 500 Microscopic features 501 Tumors of the fallopian tube 501 Benign tumors 501 Adenomatoid tumor 501 Definition 501 Pathology 501 Metaplastic papillary tumor 502 Leiomyomas 503 Other benign tumors 503 Borderline tumors 503 Malignant tumors 504 Adenocarcinoma in situ (AIS) 504 Adenocarcinoma 504 Definition 504 General features 504 Tubal carcinogenesis and the putative precursor lesions of tubal carcinomas 504 Potential role of tubal epithelia contributing to ovarian serous carcinogenesis 505 Clinical features 505 Gross features 505 Microscopic features 506 Spread, treatment and prognosis of tubal carcinoma 508 Carcinosarcoma 508 Definition 508 Clinical features 508 Pathology 508 Treatment and prognosis 508 Other malignant tumors 508 Tumors metastatic to the fallopian tube 509 Paratubal tissues and broad ligaments 509 Cysts 509 Mesonephric cysts 509 Paramesonephric cysts 509 Adrenal rest 510 Female adnexal tumor of probable wolffian origin (FATWO) 511 Definition 511 Clinical features 511 Gross features 511 Microscopic features 511 Origin 512 Differential diagnosis 512 Prognosis 512 CHAPTER 20 ENDOMETRIOSIS 515 Stanley j. Robboy Arthur Haney Peter Russell Introduction 515 Clinical features of endometriosis 515 Distribution of endometriosis 515 Epidemiology of endometriosis 516 Pathogenesis of endometriosis 516 Transplantation 517 Metaplastic theory 518 Induction theory 519 Catamenial pneumothorax 519 Etiologic factors in endometriosis 519 Genetic factors 519 Hormonal aspects 519 Peritoneal environment 520 Other factors 520 Angiogenesis 520 Prostaglandins 521 Morphologic features of endometriosis 521 General 521 Gross features 521 Microscopic features 524 Differential diagnosis 528 Ovary 528 Fallopian tube 529 Cervix 530 Gastrointestinal tract 530 Urinary tract 531 Abdominal wall 532 Lymph nodes 532 Special considerations 532 Classification of endometriosis 533 Infertility in endometriosis 533 Malignancy in endometriosis 533 Pathogenesis of malignancy 537 CHAPTER 21 NORMAL OVARIES, INFLAMMATORY AND NON-NEOPLASTIC CONDITIONS 543 Peter Russell Stanley ]. Robboy Anatomy, histology and function of the ovaries 543 Anatomy 543 Histology 543 Physiologic function of the ovaries 543 Ovarian development 543 Folliculogenesis 544 Ripening of the follicles 544 Formation of the corpus luteum 545 Involution of the corpus luteum 546 Follicular atresia 547 The hormonal background of the ovarian cycle 547 The ovarian hilum and its vicinity 550 Follicular failure 550 Follicular dysgenesis (dysplasia) 550 Definition 550 Microscopic features 551 Ovarian failure 551 Definition 551 Clinical features 552 Afollicular ovarian failure (premature follicular depletion, true premature menopause) 552 h/A/iii Etiology 552 Microscopic features 553 Follicular ovarian failure 553 Resistant ovary syndrome (Savage syndrome, gonadotrophin-insensitivity syndrome) 553 Autoimmune oophoritis 554 Hypogonadotrophic hypogonadism 556 Etiology 556 Microscopic features 556 Anomalies of ovarian development and descent 557 Supernumerary and accessory ovaries 557 Dystopic ovaries 557 Ovarian agenesis 557 Ovarian hypoplasia 558 Splenogonadal fusion 558 Uterus-like mass replacing ovary 558 Infectious inflammatory diseases 558 Bacterial oophoritis 558 Pelvic inflammatory disease (PID) 558 Definition 558 Etiology 558 Gross features 559 Microscopic features 559 Xanthogranulomatous oophoritis (inflammatory pseudotumor) 560 Malacoplakia 560 Actinomycosis 560 Etiology 560 Gross features 560 Microscopic features 560 Tuberculosis 561 Etiology 561 Viral oophoritis 561 Mumps 561 Cytomegalovirus (CMV) 561 Parasitic oophoritis 562 Schistosomiasis (bilharziasis) 562 Etiology 562 Microscopic features 563 Enterobiasis 563 Etiology 563 Pathology 563 Echinococcosis 563 Fungal oophoritis 564 Coccidioidomycosis 564 Etiology 564 Pathology 564 Blastomycosis 564 Non-infectious inflammatory diseases 564 Sarcoidosis 564 Etiology 564 Microscopic features 564 Crohns disease 564 Cortical granulomas 565 Isolated non-infectious granulomas 565 Autoimmune oophoritis 565 Necrotizing arteritis 565 Etiology 565 Microscopic features 565 Giant cell arteritis 565 Microscopic features 565 Polyarteritis nodosa 565 Microscopic features 566 Puerperal ovarian vein thrombophlebitis 566 Etiology 566 Microscopic features 566 CHAPTER 22 OVARIAN CYSTS, TUMOR-LIKE, IATROGENIC AND MISCELLANEOUS CONDITIONS 569 Peter Russell Stanley j. Robboy Dysfunctional cysts 569 Definition 569 Cysts derived from preovulatory follicles (follicular cysts) 569 Etiology 569 Clinical features 569 Gross features 570 Microscopic features 570 Differential diagnosis 572 Corpus luteum cysts 572 Etiology 572 Clinical features 572 Gross features 572 Microscopic features 572 Differential diagnosis 573 Corpus albicans cysts 573 Simple (unclassified) cysts 574 Definition 574 Microscopic features 574 Tumor-like lesions associated with pregnancy 575 Luteomas of pregnancy (nodular theca-lutein hyperplasia) 575 Definition 575 Clinical features 575 Etiology 575 Gross features 575 Microscopic features 575 Differential diagnosis 576 Multiple theca-lutein cysts (hyperreactio luteinalis) 577 Etiology and clinical features 577 Gross and microscopic features 577 Differential diagnosis 577 Solitary luteinized follicular cysts of pregnancy and puerperium 577 Definition 577 Microscopic features 578 Leydig (hilus) cell hyperplasia 579 Deciduosis 579 Etiology 579 Gross and microscopic features 579 Ovarian granulosa cell proliferations of pregnancy 579 Definition 579 Microscopic features 580 Ovarian pregnancy 580 Definition 580 Etiology 580 Microscopic features 580 Primary ovarian trophoblastic disease 580 Other ovarian lesions 580 Torsion 580 Disseminated peritoneal leiomyomatosis 581 Ovarian neoplasms 581 Reactive stromal tumor-like lesions 581 Polycystic ovary syndrome 581 Definition 581 Etiology 582 Investigational profile 583 Gross features 583 Microscopic features 584 Differential diagnosis 584 Stromal hyperplasia and hyperthecosis 584 Definitions and clinical features 584 Gross features 585 Microscopic features 585 Differential diagnosis 586 Behavior and treatment 586 Leydig (hilus) cell hyperplasia 586 Definition 586 Etiology 586 Clinical features 587 Microscopic features 587 Massive ovarian edema and fibromatosis 588 Massive ovarian edema 588 Definition 588 Etiology 588 Clinical features 588 Gross and microscopic features 588 Differential diagnosis 589 Behavior and treatment 590 Fibromatosis 590 Definition 590 Etiology 590 Gross features 591 Microscopic features 591 Differential diagnosis 593 Sequelae of surgery or trauma 594 Ovarian remnant syndrome (residual ovary syndrome) 594 Definition 594 Etiology 594 Clinical features 594 Pathology 594 Ovarian drilling for polycystic ovary syndrome 594 Splenosis (autotransplantantion of splenic tissue) 594 Etiology 594 Microscopic features 594 latrogenic disorders of the ovaries 594 Radiotherapy damage 594 Etiology 594 Microscopic features 595 Chemotherapeutic and immunosuppressive drugs 596 Etiology 596 Microscopic features 596 Oral contraceptives 596 Etiology 596 Microscopic features 596 Differential diagnosis 596 Progesterone 596 Etiology 596 Microscopic features 596 Danazol 596 Etiology 596 Microscopic features 596 Gonadotrophin-releasing hormone (GnRH) analogues 597 Ovulation-induction agents 597 Pathology 597 Tamoxifen 597 Microscopic features 597 Ovarian hemorrhage and adnexal torsion 597 Ovarian hemorrhage 597 Etiology 597 Microscopic features 597 Adnexal torsion 598 Etiology 598 Microscopic features 598 Miillerianosis and reactive mesothelial lesions 598 CHAPTER 23 OVARIAN NEOPLASIA: EPIDEMIOLOGY AND ETIOLOGY 601 James V. Lacey jr. Mark E. Sherman Descriptive epidemiology 601 Risk and protective factors for sporadic ovarian carcinoma 601 Reproductive variables 602 Gynecologic surgery 602 Exogenous hormones 602 Endogenous hormones 603 Energy balance 603 Other risk factors 604 Host factors 604 Screening 605 Histology-specific associations 605 Origins of ovarian carcinoma and models of carcinogenesis 606 Conclusion 607 CHAPTER 24 OVARIAN SEROUS AND MUCINOUS EPITHELIAL-STROMAL TUMORS 611 Jaime Prat Surface epithelial-stromal tumors 611 Borderline tumors 611 Serous tumors 611 Definition 611 Epidemiology 612 Benign serous tumors 612 Clinical features 612 Macroscopic features 612 Microscopic features 612 Differential diagnosis 613 Serous borderline tumors 613 Clinical features 613 Macroscopic features 613 Primary tumors 614 Pseudoinvasion, autoimplants, and mesothelial cell hyperplasia 614 Micropapillary pattern 616 Microinvasion 618 Immunohistochemistry 620 Peritoneal implants 620 Somatic genetics 624 Differential diagnosis 625 Biologic behavior 626 Serous borderline tumors in lymph nodes 626 Serous borderline tumors of the peritoneum 628 Treatment 629 Prognosis 629 Serous carcinomas 629 Clinical features 629 Macroscopic features 629 Microscopic features 630 Immunohistochemistry 630 Histogenesis and somatic genetics 633 Differential diagnosis 633 Treatment and prognosis 634 Mucinous tumors 634 Definition and general features 634 Benign mucinous tumors 635 Clinical profile 635 Macroscopic features 635 Microscopic features 635 Mucinous borderline tumors 636 Mucinous borderline tumors endocervical-like 636 Macroscopic features 636 Microscopic features 636 Treatment and prognosis 639 Mucinous borderline tumors of intestinal type 639 Macroscopic features 639 Microscopic features 640 Immunohistochemistry 641 Treatment and prognosis 641 Mucinous cystic tumors associated with pseudomyxoma peritonei 642 Prognosis and treatment 644 Mucinous carcinomas 644 Macroscopic features 645 Microscopic features 645 Differential diagnosis 645 Immunohistochemistry 646 Somatic genetics 647 Treatment and prognosis 647 Mural nodules 649 CHAPTER 25 OVARIAN ENDOMETRIOID, CLEAR CELL, BRENNER, AND RARE EPITHELIAL- STROMAL TUMORS 655 Jaime Prat Endometrioid tumors 655 Definition 655 Epithelial tumors 655 Clinical features 655 Pathogenesis 655 Benign endometrioid tumors 656 Borderline endometrioid tumors 656 Pathology 656 Immunohistochemistry and somatic genetics 657 Endometrioid carcinomas 657 Macroscopic features 657 Microscopic features 657 Immunohistochemistry 660 Grading 661 Spread and metastasis 661 Genetic susceptibility 661 Somatic genetics 661 Differential diagnosis 662 Treatment and prognosis 663 Simultaneous endometrioid carcinomas of the ovary and endometrium 663 Application of molecular pathology 663 Tumors with a sarcomatous component 665 Malignant mesodermal mixed tumors (carcinosarcomas) 665 Definition 665 General features 665 Macroscopic features 666 Microscopic features 666 Immunohistochemistry 667 Somatic genetics 667 Differential diagnosis 667 Tumor spread and prognosis 667 Miillerian adenosarcomas 667 Endometrioid stromal sarcomas 667 Definition 667 Clinical features 667 Macroscopic features 668 Microscopic features 668 Immunohistochemistry 669 Differential diagnosis 669 Prognosis 670 Treatment 670 Tumors of smooth muscle 670 Leiomyomas 670 Leiomyosarcomas 671 Myxoid leiomyosarcoma 672 Clear cell tumors 672 General features 672 Macroscopic features 672 Benign clear cell tumors 673 Borderline clear cell tumors 673 Clear cell adenocarcinomas 673 Immunohistochemistry 677 Somatic genetics 677 Differential diagnosis 677 Tumor spread and staging 678 Treatment and prognosis 678 Transitional cell tumors 678 Definition 678 Pathogenesis 678 Benign brenner tumor 678 Clinical features 678 Macroscopic features 679 Microscopic features 679 Immunohistochemistry and somatic genetics 679 Borderline and malignant brenner tumors 680 Clinical features 680 Macroscopic features 680 Microscopic features 680 Immunohistochemistry 681 Differential diagnosis 681 Treatment and prognosis 682 Transitional cell carcinomas 682 Clinical features 682 Microscopic features 683 Immunohistochemistry 683 Differential diagnosis 683 Treatment and prognosis 683 Squamous cell lesions 683 Epidermoid (squamous cell) cysts 683 Squamous cell carcinomas 684 Mixed epithelial tumors 684 Definition 684 Undifferentiated carcinomas 684 Definition 684 Clinical features 684 Pathology 684 Immunohistochemistry 685 Differential diagnosis 685 Prognosis 686 Miscellaneous and unclassified tumors 686 Small cell undifferentiated carcinoma, hypercalcemic type 686 Clinical features 686 Pathology 686 Immunohistochemistry, DNA cytometry, and ultrastructure 688 Differential diagnosis 688 Prognosis 688 Small cell carcinoma, pulmonary type 688 Undifferentiated carcinoma of non-small cell (neuroendocrine) type 688 Cysts and adenomas of the rete ovarii 688 Adenomatoid tumors 688 Ovarian mesotheliomas 688 Hepatoid carcinomas 689 Desmoplastic small cell tumors of childhood 690 Female adnexal tumors of wolffian origin 690 CHAPTER 26 OVARIAN SEX CORD-STROMAL AND STEROID CELL TUMORS 693 Peter Russell Stanley j. Robboy Jaime Prat Cranulosa cell tumors 693 Definition and cell types 693 Granulosa cell tumor, adult type 693 Clinical profile 693 Macroscopic features 693 Microscopic features 694 Differential diagnosis 697 Prognosis and treatment 698 Granulosa cell tumor, juvenile type 699 Clinical profile 699 Pathology 700 Prognosis 700 Thecoma-fibroma group of tumors 701 Definition 701 Thecomas 701 Definition 701 Clinical profile 701 Macroscopic features 701 Microscopic features 701 Thecafibromas 703 Clinical profile 703 Pathology 703 Sclerosing stromal tumors 703 Clinical profile 703 Macroscopic features 704 Microscopic features 704 Differential diagnosis 705 Fibromas 705 Clinical profile 705 Macroscopic features 706 Microscopic features 706 Differential diagnosis 708 Androblastomas (sertoli-leydig cell tumors) 708 Definition and cell types 708 Clinical profile 709 Well-differentiated sertoli cell tumors 709 Clinical profile 709 Macroscopic features 710 Microscopic features 710 Well-differentiated sertoli-leydig cell tumors 710 Clinical profile 710 Macroscopic features 710 Microscopic features 710 Leydig (hilus) cell tumors 711 Macroscopic features 711 Microscopic features 711 Differential diagnosis 712 Moderately and poorly differentiated sertoli-leydig cell tumors 713 Macroscopic features 713 Microscopic features 714 Retiform variants of sertoli-leydig cell tumor 715 Differential diagnosis 716 Prognosis and treatment 717 Androblastomas with heterologous elements 717 Clinical profile 718 Macroscopic features 718 Microscopic features 718 Gynandroblastomas 719 Macroscopic features 719 Microscopic features 720 Sex-cord tumors with annular tubules (SCTAT) 720 Clinical profile 720 Macroscopic features 721 Microscopic features 721 Differential diagnosis 722 Unclassified sex cord-stromal tumors 723 Steroid cell tumors 723 Clinical profile 724 Macroscopic features 724 Microscopic features 724 Differential diagnosis 725 Prognosis and treatment 725 CHAPTER 27 OVARIAN GERM CELL TUMORS 729 Peter Russell Stanley j. Robboy Jaime Prat Dysgerminomas 729 Definition and cell types 729 Clinical profile 729 Macroscopic features 729 Microscopic features 729 Differential diagnosis 731 Treatment and prognosis 733 Yolk sac tumors (endodermal sinus tumors) 734 Definition 734 Clinical profile 734 Macroscopic features 735 Microscopic features 735 Differential diagnosis 737 Treatment and prognosis 739 Embryonal carcinomas 740 Definition 740 Clinical profile 740 Macroscopic features 740 Microscopic features 740 Differential diagnosis 741 Treatment and prognosis 741 Polyembryomas (polyembryonic entbryomas) 741 Definition 741 Clinical profile 741 Macroscopic features 741 Microscopic features 741 Treatment and prognosis 742 Choriocarcinomas 742 Definition 742 Clinical profile 743 Pathology 743 Differential diagnosis 744 Treatment and prognosis 744 Teratomas 744 Immature teratomas 744 Definition 744 Clinical profile 744 Macroscopic features 745 Microscopic features 745 Differential diagnosis 748 Treatment and prognosis 749 Mature teratomas 749 Mature solid teratomas 749 Definition 749 Pathology 749 Treatment and prognosis 749 Mature cystic teratomas 749 Definition 749 Clinical profile 749 Macroscopic features 750 Microscopic features 751 Differential diagnosis 753 Treatment and prognosis 753 Teratomas with secondary malignant transformation 754 Definition 754 Clinical profile 754 Macroscopic features 755 Microscopic features 755 Differential diagnosis 757 Treatment and prognosis 759 Monodermal and highly specialized teratomas 759 Struma ovarii 759 Clinical profile 759 Macroscopic features 759 Microscopic features 760 Differential diagnosis 760 Treatment and prognosis 761 Carcinoid and strumal carcinoid tumors 761 Clinical profile 762 Macroscopic features 762 Microscopic features 763 Differential diagnosis 765 Treatment and prognosis 765 Other (rare) monodermal and highly specialized teratomas 766 Pituitary adenomas 766 Epidermoid cysts 766 Endodermal variants of mature cystic teratomas 766 Giant sebaceous tumors 766 Salivary tumors 766 Neuroectodermal tumors and gliomas 766 Malignant mixed germ cell tumors 768 Definition 768 Clinical profile 768 Macroscopic features 768 Microscopic features 769 Treatment and prognosis 769 Mixed germ cell and sex cord-stromal tumors (gonadal anlage tumors) 770 Gonadoblastomas 770 Clinical profile 771 Macroscopic features 771 Microscopic features 771 Differential diagnosis 773 Treatment and prognosis 773 Unclassified mixed germ cell and sex cord-stromal tumors 774 Clinical profile 774 Macroscopic features 774 Microscopic features 774 Differential diagnosis 775 Treatment and prognosis 775 CHAPTER 28 OVARIAN LYMPHOID AND HEMATOPOIETIC NEOPLASMS 779 Anand 5. Lagoo Peter Russell Stanley j. Robboy Lymphoma 779 Classification 779 Incidence 781 Clinical features 782 Staging 782 Pathology 783 Differential diagnosis 789 Leukemia 790 Microscopic features 791 Differential diagnosis 792 Treatment and prognosis 792 CHAPTER 29 OVARIAN TUMORS: MISCELLANEOUS AND METASTATIC 795 Peter Russell Jennifer M. Roberts Stanley /. Robboy Unclassified and miscellaneous epithelial tumors 795 Ovarian mesotheliomas 795 Adenomatoid tumors 795 Microscopic features 795 Epidermoid cysts 795 Squamous cell carcinomas 795 Microscopic features 795 Hepatoid carcinomas 795 Ovarian tumors of probable mesonephric (wolffian) origin 796 Cysts and adenomas of the rete ovarii 796 Miscellaneous mesenchymal tumors 797 Vascular and related tumors 797 Hemangiomas 797 Hemangioendotheliomas (angiosarcomas) 798 Hemangiopericytomas 798 Glomus tumors 798 Lymphangiomas 798 Tumors of musculoskeletal type supportive tissue 798 Tumors of striated muscle origin 798 Chondrogenic tumors 799 Bone tumors 799 Giant cell tumors 799 Synovial sarcoma 799 Neural and related tumors 799 Neurofibromas, neurofibrosarcomas 799 Neurilemmomas (schwannomas) 799 Canglioneuromas 799 Pheochromocytomas 800 Miscellaneous soft tissue tumors 800 Myxomas 800 Lipogenic tumors 800 Myofibroblastoma 801 Sarcomas not otherwise differentiated 801 Malignant tumors metastatic to the ovaries 801 Mechanisms of spread 801 Clinical profile 802 Macroscopic features 803 Microscopic features 804 Metastases from the female genital tract 807 Metastases from cervix 807 Metastases from fallopian tubes 807 Metastases from endometrium and myometrium 807 Metastatic trophoblastic disease 808 Metastases from breast 808 Diagnosis 808 Differential diagnosis 808 Metastases from gastrointestinal tract 809 Krukenberg tumors 810 Clinical profile 810 Macroscopic features 810 Microscopic features 810 Differential diagnosis 812 Prognosis 813 Metastases from colon and rectum 813 Clinical profile 813 Macroscopic features 813 Microscopic features 813 Differential diagnosis 815 Metastatic carcinoid tumors 816 Clinical profile 816 Diagnosis 816 Differential diagnosis 817 Treatment and prognosis 818 Metastases from small intestine 818 Metastases from the appendix 819 Metastases from pancreas 819 Differential diagnosis 819 Metastases from gall bladder and bile ducts 820 Metastases from liver 820 Metastatic hepatocellular carcinoma 820 Metastatic hepatoblastoma 820 Metastatic malignant melanoma 820 Pathology 821 Differential diagnosis 821 Metastatic non-genital carcinomas and sarcomas 822 Metastases from kidneys 822 _ Differential diagnosis 822 Metastases from bladder 822 Metastases from other urinary tract tumors 822 Metastases from lungs and mediastinum 823 Metastases from endocrine tumors 823 Metastases from extragenital sarcomas 823 CHAPTER 30 NIDATION AND PLACENTA 829 Eoghan E. Mooney Stanley j. Robboy Introduction 829 Anatomy and embryology 829 Early pregnancy 829 Placental morphology 831 Intervillous (maternal) circulation 832 Development of the uteroplacental vessels 832 Functional unit of the placenta 833 Examination of the placenta 833 Umbilical cord 833 Membranes 836 Meconium on cord and membranes 838 Architectural and developmental abnormalities 840 Placental weight 841 Fetal surface of placenta 841 Maternal surface of the placenta 842 Cut surface 842 Infarction 842 Perivillous fibrin deposition and maternal floor infarction 843 Hematoma 844 Subchorial thrombosis (breus mole) 845 Intervillous thrombosis 845 Other conditions 845 Multiple gestation 845 Microscopic lesions of the placenta 849 Placental inflammation and infection 849 Villitis 849 Deciduitis 851 Chronic intervillositis 851 Vascular lesions 851 Fetal vessel thrombi 851 Chorangiosis 853 Abnormalities of the uteroplacental vessels 854 Villous lesions 854 Villous maturity 854 Villous edema 855 Miscellaneous villous changes 855 Non-trophoblastic tumors of the placenta 856 Chorangioma 856 Chorangiocarcinoma (chorangiomas with trophoblastic proliferation) 857 Intraplacental choriocarcinoma 857 Teratomas 857 Metastatic tumor 858 CHAPTER 31 PLACENTA - CLINICAL SCENARIOS 863 Eoghan E. Mooney Emma Doyle Peter Cearhart Stanley I. Robboy Ectopic pregnancy 863 Early pregnancy loss (spontaneous miscarriage) 864 Mid to late pregnancy loss 866 Abruption 866 Hypertensive disorders 868 Pre-eclampsia 868 Pathology 869 Intrauterine growth restriction (IUGR) 869 Other pathologic conditions evaluated in the context of IUCR 870 Confined placental mosaicism 870 Absence or reversal of end-diastolic flow (ARED flow) 870 Adverse neurologic outcome: neonatal encephalopathy and cerebral palsy 870 Diabetes mellitus 871 Hydrops fetalis (maternal rhesus isoimmunization) 871 Placenta accreta (including increta and percreta) 871 Thrombophilia 872 Sickle cell trait and disease 873 Twin pregnancy 873 Prolonged pregnancy 873 Maternal infections and the placenta 874 Toxoplasmosis 874 Rubella 874 Cytomegalovirus 875 Herpes simplex 876 Varicella zoster 876 HIV 876 Human papillomavirus (HPV) 876 Parvovirus B19 876 Malaria 877 Syphilis 877 Listeria monocytogenes 878 Other organisms 878 CHAPTER 32 GESTATIONAL TROPHOBLASTIC DISEASE 881 Annie N-Y Cheung What is gestational trophoblastic disease? 881 Trophoblast types 881 Trophoblast markers 881 Importance of identifying trophoblast in histology sections 881 Examples of trophoblast markers 882 Features of gestational trophoblastic diseases 884 Epidemiology 884 Risk factors 884 Types of gestational trophoblastic disease 885 Hydatidiform mole 885 Pathogenesis and genetic basis 885 Karyotyping of hydatidiform mole 885 Genetic origin of hydatidiform mole 885 Genetic aberrations in hydatidiform mole 885 Clinicopathologic features 886 Complete hydatidiform mole 886 Partial hydatidiform mole 888 Problems in diagnosis of hydatidiform mole 890 Ancillary techniques to assist histologic diagnosis and classification 894 Progress of hydatidiform mole 895 Ancillary techniques to assist prediction of clinical outcome 896 Invasive mole 896 Clinicopathologic features 896 Diagnostic problems 896 Choriocarcinoma 897 Clinical presentation 897 Pathology 897 Pathogenesis 897 Diagnostic problems 898 Placental site trophoblastic tumor 899 Clinical presentation 899 Macroscopic features 899 Microscopic features 899 Clinical behavior 901 Pathogenesis 901 Diagnostic problems 901 Epithelioid trophoblastic tumor 902 Definition 902 Clinical presentation 902 Macroscopic features 902 Microscopic features 902 Diagnostic problems 902 Clinical behavior 903 Trophoblastic lesions, miscellaneous 903 Exaggerated placental site 903 Placental site nodules or plaques 903 Differential diagnosis of lesions derived from intermediate trophoblast 903 Unclassified trophoblastic lesions 904 Diagnostic problems 904 Summary 904 CHAPTER 33 THE PERITONEUM 909 John H. Eichhorn Stanley j. Robboy Rex C. Bentley Maria Merino Peter Russell Normal peritoneum 909 Inflammatory and reactive lesions 909 Granulomatous peritonitis 909 Suture materials 909 Surgical glove powder 910 Contrast media 910 Intestinal contents 910 Cystic teratoma (dermoid cyst) rupture 911 Keratin 911 Cauterized tissue 911 Cesarean delivery 911 Tuberculosis 911 Histiocytic, non-granulomatous peritoneal lesions 911 Fibrosing lesions 912 Reactive mesothelial proliferations 912 Mesothelial hyperplasia 912 Peritoneal mesothelial inclusion cysts and cystic proliferation 914 Miillerianosis (miillerian tumor-like conditions) 915 Endosalpingiosis (serous change) 916 Endocervicosis (mucinous change) 917 Endometrioid, clear cell, and transitional cell changes 918 Mullerian inclusion cysts 918 Pathology 918 Pathogenesis 918 Differential diagnosis 919 Tumor-like conditions 920 Endometriosis 920 Ovarian remnant syndrome 920 Supernumerary or accessory ovaries 920 Splenosis (autotransplantation of splenic tissue) 921 Trophoblastic implants 921 Infarcted appendix epiploica 921 Deciduosis 921 Disseminated peritoneal leiomyomatosis 922 Pathology 923 Pathogenesis 923 Mesothelial neoplasms 923 Adenomatoid tumor 923 Well-differentiated papillary mesothelioma 924 Multicystic mesothelioma 924 Diffuse malignant mesothelioma 924 Pathology 925 Differential diagnosis 926 Serous tumors (primary and metastatic) 928 Serous tumor of borderline malignancy (proliferating tumors, tumors of low malignant potential) 928 Pathology 928 Types of implant 930 Prognostic features 934 Serous carcinoma (of peritoneal origin) 934 Definition of primary disease 934 Pathology 935 Pathogenesis 935 Clinicopathoiogic correlation 935 Psammocarcinoma 935 Miscellaneous primary tumors 935 Intra-abdominal desmoplastic small round cell tumor 935 Solitary fibrous tumor of peritoneum ( fibrous mesothelioma ) 936 Other tumors 936 Metastatic tumors 937 Pseudomyxoma peritonei 937 Pathology 937 Pathogenesis 937 Treatment and prognosis 938 Gliomatosis peritonei 938 Strumosis peritonei 939 CHAPTER 34 DISORDERS OF SEXUAL DEVELOPMENT 945 Stanley . Robboy Francis Jaubert Disorders of genital differentiation (disorders generally associated with a normal chromosome constitution and normal gonad) 945 Female pseudohermaphroditism (female intersex) 945 Fetal defects 945 Adrenogenital syndrome 945 Placental aromatase defect 949 Maternal influence 949 Maternal ingestion of progestins or androgens 949 Maternal virilizing lesions 949 Male pseudohermaphroditism (male intersex) 950 Primary gonadal defects 950 Testicular regression syndrome 950 Leydig cell deficiency 951 Defects in testosterone synthesis 951 Defect in mullerian inhibiting system 952 End-organ defects 953 Androgen receptor disorders (androgen insensitivity syndromes) 953 5a-Reductase type 2 deficiency 958 Disorders of sex determination (disorders generally associated with an abnormal sex chromosome constitution leading to abnormal gonadal formation) 958 Sexual ambiguity infrequent 959 Klinefelter syndrome 959 Turner syndrome 961 XX male (sex reversal) 963 Pure gonadal dysgenesis 964 Usual form 964 Defect in the wilms tumor suppressor (WT1) gene 964 Denys-Drash syndrome 964 Frasier syndrome 964 Sexual ambiguity frequent 965 46,XY disorders of sex development (mixed gonadal dysgenesis) 965 Gonadoblastoma 969 Definition 969 Clinical features 970 Genetic changes 970 Pathology 970 XY female (sex reversal) 972 True hermaphroditism 972 CHAPTER 35 CUTUP - CROSS DESCRIPTION AND PROCESSING OF SPECIMENS 979 Stanley j. Robboy George L. Mutter Ruthy Shako-Levy Sarah M. Bean Jaime Prat Rex C. Bentley Peter Russell General aspects 979 Section codes and the report 980 Types of section code 980 Location of section codes in the report 980 Specimen and site identification 980 Gross description 981 Inking 981 Drawings and photographs 982 Fixatives 982 Number of sections required 982 Synoptic checklists 982 Vulva 982 Excisional biopsies 982 Wide local excision 982 Skinning vulvectomy 983 Simple (or total) vulvectomy 983 Radical vulvectomy 984 Cervix 984 Punch biopsies 984 Endocervical curettage 984 Cone biopsy 985 Malignant cervical disease 986 Uterine corpus 987 Endometrial biopsies and curettings 987 Sampling considerations 987 Uterus removed for benign functional disease 988 Uterus removed during obstetric procedures 990 Malignant uterine disease 990 Fallopian tube 991 Sterilization 991 Tubal ectopic pregnancy 992 Neoplasm 992 Ovary 992 General rules 992 Large cystic or neoplastic ovaries 992 Microscopic sections 993 Staging operations 994 Fetus and placenta 994 Second trimester fetus 994 Placenta 994 Twins 996 CHAPTER 36 IMMUNOHISTOCHEMICAL AND FUNCTIONAL BIOMARKERS OF VALUE IN FEMALE GENITAL TRACT LESIONS 999 W. Glenn McCluggage Introduction 999 Broad spectrum differentiation markers 999 Epithelial markers 999 Cytokeratins 999 Broad spectrum CKs 999 CAM 5.2 999 Cytokeratins 7 and 20 999 Cytokeratin 5/6 1000 Other cytokeratins 1000 Epithelial membrane antigen (EMA) and ber-EP4 1001 Mesenchymal cell markers 1001 Vimentin 1001 Smooth muscle markers 1001 Skeletal muscle markers 1002 Endometrial stromal markers 1002 CD10 1002 Mesothelial markers 1002 Calretinin 1002 Blood vessel markers 1002 CD34 1002 Narrow spectrum differentiation markers 1003 Trophoblastic markers 1003 Beta-human chorionic gonadotrophin ((3-HCC) 1003 Placental-like alkaline phosphatase (PLAP) 1003 Human placental lactogen (HPL) 1003 Mel-CAM (CD146) 1003 HLA-G (human leukocyte antigen) (cytotrophoblast) 1003 Melanocytic markers 1003 HMB45 1003 Melan-A(MART-I) 1004 S-100 protein 1004 Neuroendocrine markers 1004 Lymphoid antibodies 1004 Markers of altered function in disease states 1004 Tumor markers 1004 CA19.9 1004 Carcinoembryonic antigen (CEA) 1004 CA125(OCI25) 1004 Inhibin 1005 OCR 1005 HIK1083 1005 CDx2 1005 Alpha-fetoprotein (AFP) 1006 Hep Par 1 1006 MUC antibodies 1006 CD99 1006 Tumor suppressor genes 1006 WT1 1006 DPC4 1007 p53 1007 p63 1007 PTEN 1007 Proto-oncogenes 1008 bcl-2 1008 CD117(C-KIT) 1008 Cell cycle and nuclear proliferation 1008 KI-67(MIB1) 1008 pi 6 1009 p57 1009 Hormone receptors 1009 Estrogen receptor (ER) and progesterone receptor (PR) 1009 Androgen receptor 1010 Oxytocin receptor 1010 Cell adhesion markers 1010 Beta-eaten in 1010 Appendix A: FIGO staging rules of cancers of the female genital tract 1015 Appendix A1: carcinoma of the vulva 1015 Appendix A2: carcinoma of the vagina 1016 Appendix A3: carcinoma of the cervix 1017 Appendix A4: carcinoma of the endometrium 1018 Appendix A5: carcinoma of the fallopian tube 1020 Appendix A6: carcinoma of the ovary 1021 Appendix A7: carcinoma of the gestational trophoblastic diseases (GTD) 1022 Appendix B: Histologic classification of tumors and precursor conditions of the female genital tract 1023 Appendix C: Synoptic reports/checklists 1033 Appendix D: Coding with SNOMED CT 1037 Appendix E: Abbreviations 1041 Index 1045
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dewey-tens	610 - Medicine and health
discipline	Medizin
edition	2. ed.
format	Book
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id	DE-604.BV035244200
illustrated	Illustrated
indexdate	2024-07-09T21:29:27Z
institution	BVB
isbn	9780443074776
language	English
oai_aleph_id	oai:aleph.bib-bvb.de:BVB01-017049945
oclc_num	213447761
open_access_boolean
owner	DE-29 DE-20
owner_facet	DE-29 DE-20
physical	XXXVIII, 1066 S. zahlr. Ill. u. graph. Darst.
publishDate	2009
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publisher	Churchill Livingstone
record_format	marc
spelling	Robboy's pathology of the female reproductive tract ed. by Stanley J. Robboy ... Pathology of the female reproductive tract 2. ed. London [u.a.] Churchill Livingstone 2009 XXXVIII, 1066 S. zahlr. Ill. u. graph. Darst. txt rdacontent n rdamedia nc rdacarrier An Expert Consult title Enfermedades de los Genitales Femeninos Enfermedades Urogenitales Gynécologie Organes génitaux femelles - Histopathologie Organes génitaux femelles - Maladies Female Urogenital Diseases pathology Generative organs, Female Diseases Generative organs, Female Histopathology Gynecology Robboy, Stanley J. Sonstige oth HBZ Datenaustausch application/pdf http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=017049945&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA Inhaltsverzeichnis
spellingShingle	Robboy's pathology of the female reproductive tract Enfermedades de los Genitales Femeninos Enfermedades Urogenitales Gynécologie Organes génitaux femelles - Histopathologie Organes génitaux femelles - Maladies Female Urogenital Diseases pathology Generative organs, Female Diseases Generative organs, Female Histopathology Gynecology
title	Robboy's pathology of the female reproductive tract
title_alt	Pathology of the female reproductive tract
title_auth	Robboy's pathology of the female reproductive tract
title_exact_search	Robboy's pathology of the female reproductive tract
title_full	Robboy's pathology of the female reproductive tract ed. by Stanley J. Robboy ...
title_fullStr	Robboy's pathology of the female reproductive tract ed. by Stanley J. Robboy ...
title_full_unstemmed	Robboy's pathology of the female reproductive tract ed. by Stanley J. Robboy ...
title_short	Robboy's pathology of the female reproductive tract
title_sort	robboy s pathology of the female reproductive tract
topic	Enfermedades de los Genitales Femeninos Enfermedades Urogenitales Gynécologie Organes génitaux femelles - Histopathologie Organes génitaux femelles - Maladies Female Urogenital Diseases pathology Generative organs, Female Diseases Generative organs, Female Histopathology Gynecology
topic_facet	Enfermedades de los Genitales Femeninos Enfermedades Urogenitales Gynécologie Organes génitaux femelles - Histopathologie Organes génitaux femelles - Maladies Female Urogenital Diseases pathology Generative organs, Female Diseases Generative organs, Female Histopathology Gynecology
url	http://bvbr.bib-bvb.de:8991/F?func=service&doc_library=BVB01&local_base=BVB01&doc_number=017049945&sequence=000002&line_number=0001&func_code=DB_RECORDS&service_type=MEDIA
work_keys_str_mv	AT robboystanleyj robboyspathologyofthefemalereproductivetract AT robboystanleyj pathologyofthefemalereproductivetract

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