The most common origin of cervical squamous cell carcinoma Immature squamous metaplasia of endocervix Mature squamous metaplasia of endocervix

In any HPV lesion Enlarged raisin-like nuclei + perinuclear halo

These lesions are caused by HPV 16,18…etc. 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 lower 2 thirds In full thiscness but the BM is intact = carcinoma in situ = HSIL (high grade squamous intraepithelial lesion) = LSIL (low grade squamous intraepithelial lesion)

Name for a stain that is good for nuclear details = cervical smear cytology Enlarged nucleus, irregular nuclear contours & abnormal chromatin Changes worse than LSIL

Invasive squamous cell carcinoma Keratin pearl Islands of atypical squamous cells are infiltrating the stroma

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

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 Atypia here: enlarged vacuolated nucleus with prominent nucleolus Complex hyperplasia with atypia Complex hyperplasia with atypia…high power

…marked architectural disturbance (most important) + atypia Endometrioid carcinoma Cribriforming: 1 large structure with multiple glandular spaces inside 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

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

Main 2 types of endometrial cancer

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

Endometriosis (this example is in colon) Endometrial glands & stroma that form a polyp in colon Colonic mucosa

Endometriosis (this example is in colon) …high power Endometrial glands & stroma Colonic mucosa

Endometriosis somewhere

Leiomyomata 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

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

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