1. Histology for Pathology Female Genital Tract and Breast
Theresa Kristopaitis, MD
Associate Professor
Director of Mechanisms of Human Disease
Kelli A. Hutchens, MD, FCAP
Assistant Professor
Assistant Director of Mechanisms of Human Disease
Loyola Stritch School of Medicine
Welcome to basic histology of the skin

2. Objectives Fallopian Tube Ovary
On a section of ovarian cortex identify stroma and follicles
Define “Graafian follicle”
Explain where “granulosa cells” are normally found in the ovary
Define “corpus luteum”
Define corpus albicans and identify in a section of ovary
Fallopian Tube
List the 2 types of cells that line the fallopian tube and their function

3. Objectives List the flow of milk through the mammary glands
Uterus / Cervix
On a low power section identify the endometrium and myometrium
Define endometrial “basalis” and “functionalis”
Identify endometrial glands and stroma
Describe the major changes of the endometrium through the menstrual cycle (ie menstrual, proliferative and secretory endometrium findings)
Describe the epithelial lining of the endocervix and ectocervix
Breast (Mammary Glands)
List the flow of milk through the mammary glands
Identify on histologic sections the major components of breast tissue (lobules of glands, stroma, and adipose tissue)
Describe the epithelial lining of the intralobular ducts

4. Medulla
Cortex
Image from Harvard University Medical School Website

5. Ovarian Cortex
Follicles
Mesothelium
(also called germinal epithelium)

6. Ovarian follicle Primary Follicle
Primordial follicle: prior to puberty
Primary follicle: (after puberty)
Primary oocyte surrounded by single layer of squamous cells (granulosa cells) embedded in ovarian stroma
Secondary follicle:
increased thickness of granulosa cells and formation of the theca folliculi (stroma cells around the follicle)
Graafian (pre-ovulatory) follicle: final stage
Ovarian Stromal cells
Oocyte
Granulosa cells
Primary Follicle

7. Mature Graafian Follicle
Oocyte
Graafian (pre-ovulatory) follicle: final stage
Large antrum filled with fluid (liquor folliculi)
Ready to release oocyte in response to LH surge
Granulosa cells directly around the oocyte = corona radiata
Just prior to release oocyte resumes meiosis then arrests as a secondary oocyte
Granulosa Cells
Graafian (preovulatory) follicle
(up to 2.5 cm)

8. Site of follicular Rupture / Corpus Luteum
A. Granulosa cells
B. Corpora albicans

9. Corpus Luteum
After ovulation, the remaining wall of the graafian follicle transforms into the corpus luteum
The wall of the corpus luteum is folded and contains granulosa lutein cells derived from granulosa cells which secrete progesterone

10. Corpus Albicans
In the absence of fertilization the corpus luteum degenerates, decreases in size and form the corpus albicans which consists of dense connective tissue

11. Fallopian Tubes / Oviducts
Two, open ended tubes that receive the ovum
Provide the ideal environment for fertilization
Most often occurs in ampulla
The wall is composed of:
Mucosa: ciliated cells, secretory (peg) cells, and underlying lamina propria
Muscularis layer
Serosal layer

12. Fallopian Tube / Oviducts
Mucosa – high power
Ciliated cells (arrows)
Help sweep oocyte towards uterus
Nonciliated Peg cells (arrowheads)
Produce secretions to protect oocyte and promote fertilization
Lamina propria (a)
Mucosa
Serosa
Muscularis
Lumen

13. Uterus Relative large organ between the fallopian tubes and the vagina
3 anatomic regions: fundus, body, and cervix
Site of implantation and placentation
3 layers
Endometrium
Myometrium
Serosa

14. Uterus – low power
Endometrium
Myometrium
(smooth muscle)

15. Endometrium Functionalis Near the lumen Hormonally responsive Basalis
Produces new cells to replace endometrium that was shed during
menstruation

16. Endometrium – high power
Endometrial glands
Stroma

17. The endometrium undergoes morphologic and functional changes during the menstrual cycle
Corpus luteum
Regressing corpus luteum
Graafian
follicle

18. Proliferative Phase Early post-menstrual Sparse glands
Predominant basalis
Early proliferative
Endometrium thicker under
estrogen influence
Glands straight and thin
Later Proliferative
Darker more compact basal layer

19. Secretory Phase Endometrium
Mucoid secretions
Early Secretory Phase Endometrium
Glands tortuous –progesterone effect, mucoid secretions stored within the glands, pending a possible embryo implantation

20. Cervix Lower part of uterus Bulges into vagina
Two parts with different histology and a transitional zone between them:
Endocervix: Simple columnar glands
Ectocervix: Stratified squamous epithelium

21. Cervix
Transition zone: simple columnar epithelium of the endocervix with overlying non-cornified stratified squamous epithelium of the ectocervix
Endocervical glands

22. Breast (Mammary Glands)
Breasts are composed of two multilobed mammary glands embedded in connective and adipose tissue
Glands are coumpound tubuloalveolar glands that open into a lactiferous duct which express their contents via the nipple
Milk produced by the secretory alveoli first drains into intralobular ducts and then interlobular ducts to lactiferous sinus
Intralobular ducts makes of the majority of the glandular tissue

23. Breast Tissue

24. Breast Ducts
Myoepithelial cells
Cuboidal epithelial cells