Immature squamous metaplasia of endocervix

Mature squamous metaplasia of endocervix

The most common origin of cervical squamous cell carcinoma

Enlarged raisin-like nuclei + perinuclear halo

In any HPV lesion

nuclear enlargement, hyperchromasia (dark staining), coarse chromatin granules, and variation in nuclear size and shape (pleomorphism), loss of maturation and increased mitoses

This clearing is normal & it is due to glycogen

In lower third

In full thiscness but the BM is intact

In lower 2 thirds

= HSIL (high grade squamous intraepithelial lesion)

= LSIL (low grade squamous intraepithelial lesion)

= carcinoma in situ

These lesions are caused by HPV 16,18…etc.

= cervical smear cytology

Name for a stain that is good for nuclear details

Enlarged nucleus, irregular nuclear contours & abnormal chromatin

Changes worse than LSIL

Islands of atypical squamous cells are infiltrating the stroma

Keratin pearl

Invasive squamous cell carcinoma

Same notes as slide 5

Same notes as slide 5

Normal proliferative endometrium …the gland/stroma ratio is normal …the glands are regular and rounded

Surface epithelium

Simple cystic hyperplasia: The glands are cystically dilated and crowded with decreased stroma and increased gland/stroma ratio

Complex hyperplasia: The glands are branched, irregular and crowded with decreased stroma and increased gland/stroma ratio

Simple hyperplasia without atypia

Complex hyperplasia without atypia

Complex hyperplasia with atypia Complex hyperplasia with atypia…high power

Atypia here: enlarged vacuolated nucleus with prominent nucleolus

Cribriforming: 1 large structure with multiple glandular spaces inside

Endometrioid carcinoma

The glands are fused …marked architectural disturbance (most important) + atypia

Same notes as slide 11

Same notes as slide 11

Same notes as slide 11

Note that the malignant glands invade this stroma (feature of cancer)

Same notes as slide 11

This is high grade endometrioid carcinoma…sheets of cells (not forming glands)…poorly differentiated

few areas still contain glands

Main 2 types of endometrial cancer

Serous endometrial intraepithelial carcinoma

Papillae of serous endometrial carcinoma (it is commonly papillary and high grade by definition)

Endometrial glands & stroma that form a polyp in colon Colonic mucosa

Endometriosis (this example is in colon)

Endometriosis (this example is in colon) …high power

Endometrial glands & stroma

Colonic mucosa

Endometriosis

somewhere

A bisected uterus showing multiple well-circumscribed masses in its wall… The masses are white to yellow with hard whorly cut surface …multiplicity is toward benign more

Leiomyomata

Leiomyoma …smooth muscle cells …benign because the criteria that depend on tumor necrosis, atypia & mitotic rate are not matched here

Leiomyosarcoma …this is an area of a tumor the features of which matched the criteria of malignancy …note the marked atypia & high mitotic rate

Inside circles are mitoses