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Repro Path Lab 1

UTERINE LAB:
Vulvar, Cervical,
and Uterine Pathology


Vulvar Biopsy

Clinical Photo of Leukoplakia
Histology of Leukoplakia [WebScope] [ImageScope]

Case History:
60-year-old post-menopausal patient presents to her gynecologist relating that she has noticed a white patch (leukoplakia) that “recently” appeared in her genital area. It itches constantly. A biopsy is performed.

  1. What is the differential diagnosis based upon her history?

  2. After reviewing the slides, what do you think this lesion represents?



Cervix, Cone Biopsy

HPV-Related Squamous Neoplasia [WebScope] [ImageScope]
Normal Histology for Comparison [WebScope] [ImageScope]

Case History:
36-year-old with a PAP smear report of HSIL. She relates a history of “dysplasia” which was treated by cryotherapy (freezing the cervix). Attempts at colposcopy are deemed “inadequate” as the clinician is unable to see the transformation zone (T-Z) in its entirety. A cone biopsy was performed.

  1. In the slides you should see areas of normal and abnormal epithelial growth. Determine the grade of dysplasia (cervical intraepithelial neoplasia - CIN) present. Look at the endocervical canal; describe the process within the glands.

  2. What HPV sub-types might be responsible for these lesions?



Uterus, Endometrial Curettage

Hyperplasia [WebScope] [ImageScope]

Case History:
50-year-old with an ultrasound demonstrating thickening of the endometrial stripe.

  1. Locate:

    (a) proliferative or “disordered” proliferative endometrium
    (b) simple & complex hyperplasia
    (c) atypical hyperplasia
    (d) Is carcinoma present?



Uterus, Hysterectomy

Gross Photo
Carcinoma [WebScope] [ImageScope]

Case History:
The patient from the previous case undergoes a hysterectomy.

  1. Describe the process observed in both ovaries in the gross photo. What relationship does this have to the uterine pathology?

  2. Provided there is no carcinoma in the cervix or outside of the uterus, assess the surgical stage of this patient based upon your histologic section. Use the ScanScope measuring tool to determine the depth of myometrial invasion.



Uterus, Myomectomy

Gross Photo
Fibroids [WebScope] [ImageScope]

Case History:
28-year-old with a history of infertility and an enlarged uterus. The patient underwent myomectomy in an effort to preserve fertility.

  1. What are possible clinical presentations of patients with this condition?

  2. What would you expect these tumors to do in response to:

    Pregnancy?
    Menopause?
    Gonadotropin-releasing hormone (GNRH) agonists-antagonists?


The answers to the path lab questions will be posted approximately 48-72 hours after the lab sessions. These are abbreviated answers, not a full discussion of the topics. You can find them in the M2 CTools site resources. In the folder for each sequence the will be a folder called 'Path Lab Resources'


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