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E-Book - Pathology of the Female Reproductive Tract

E-Book - Pathology of the Female Reproductive Tract

Stanley J. Robboy | George L. Mutter | Jaime Prat | Rex C Bentley | Peter Russell | Malcolm C. Anderson

(2008)

Additional Information

Book Details

Abstract

This critically acclaimed book has been thoroughly revised and updated to bring you state-of-the-art assistance in diagnosing pathologies of the female reproductive tract. It covers more than 1100 common, rare, benign, and malignant lesions, and tackles the questions so often asked and not answered elsewhere. All entities are illustrated by well-chosen photographs of outstanding quality. The updated text provides the latest advances in immunohistochemistry, molecular biology, and cytogenetics, as well as the most current concepts, classification and staging systems for all diseases and disorders of the female genital tract. “Road maps” at the beginning of each chapter help you navigate the book more quickly. You’ll have everything you need to effectively diagnose and confidently sign out gynecologic and obstetric reports.

  • Covers all benign and malignant disorders of the female genital tract to provide you with a comprehensive resource for use in the reporting room or in formal study.
  • Offers a complete visual guide to each tumor or tumor-like lesion to assist you in the recognition and diagnosis of any tissue sample under the microscope with over 2500 high-quality, full-color illustrations.
  • Provides expert advice on how to avoid diagnostic errors with practical advice on pitfalls in differential diagnosis.
  • Integrates histopathologic features with data from ancillary techniques such as immunohistochemistry and cytogenetics and discussions of the relevant clinical manifestations of gynecological diseases to provide you with the necessary tools to make a comprehensive diagnostic workup.
  • Features summary tables, diagnostic flow charts, and analytic tables to facilitate rapid interpretation and accurate diagnosis.
  • Approaches definitions, clinical features, gross features, microscopic features, and differential diagnosis consistently and uniformly for quick and easy access to the information you need.
  • Readers praise its readability and practicality for both daily and reference use by both the novice and experienced pathologist.
  • Features a “Road map” at the beginning of each chapter to help you navigate and access the material more quickly.
  • Provides you with the latest advances in immunohistochemistry to reflect the development of reliable techniques.
  • Covers cytology more extensively, including cytologic/histologic correlations, additional cytologic images, and additional material on differential diagnosis to reflect modern diagnostic practice.
  • Includes the latest classification and staging systems for all diseases and disorders of the female genital tract, so you can provide the referring physicians with the most accurate and up-to-date diagnostic and prognostic indicators possible.
  • Uses more bullet points, diagnostic flowcharts, decision-making algorithms, and summary tables to make it even easier to find what you need.

Table of Contents

Section Title Page Action Price
Front cover Cover
Robboy's Pathology of the Female Reproductive Tract iii
Copyright page iv
Table of contents v
Contributors xxix
Foreword xxxiii
Preface xxxv
Dedication xxxvii
Acknowledgements xxxviii
CHAPTER 1: Embryology 1
INTRODUCTION 1
GONADAL DEVELOPMENT 1
MÜLLERIAN AND WOLFFIAN DUCT DEVELOPMENT 14
EXTERNAL GENITALIA 19
REFERENCES 20
CHAPTER 2: Vulvar dermatoses and infections 23
INTRODUCTION 23
COMMON DERMATOSES AFFECTING THE VULVA 23
LESS COMMON DERMATOSES THAT FREQUENTLY INVOLVE THE VULVA 31
REFERENCES 55
APPENDIX 2.1 COMMON CLINICAL DERMATOLOGIC TERMS 57
APPENDIX 2.2 COMMON DERMATOPATHOLOGIC TERMS 57
CHAPTER 3: Vulvar cysts, neoplasms, and related lesions 59
CYSTS 59
BENIGN KERATINOCYTIC NEOPLASMS 62
PREMALIGNANT KERATINOCYTIC NEOPLASMS 63
MALIGNANT KERATINOCYTIC NEOPLASMS 66
MELANOCYTIC LESIONS 76
SKIN APPENDAGE NEOPLASMS 81
VASCULAR LESIONS 83
MISCELLANEOUS LESIONS 84
MISCELLANEOUS LESIONS OF AFFILIATED STRUCTURES 89
REFERENCES 91
CHAPTER 4: Vulvar mesenchymal neoplasms and tumor-like conditions 95
TUMOR-LIKE CONDITIONS 95
BENIGN NEOPLASMS 96
LOCALLY RECURRENT NEOPLASMS 103
MALIGNANT NEOPLASMS 106
REFERENCES 108
CHAPTER 5: Vagina 111
NORMAL STRUCTURE 111
DEVELOPMENTAL DISORDERS 113
INFLAMMATORY DISORDERS 115
VAGINAL CYSTS 117
BENIGN EFFECTS OF DIETHYLSTILBESTROL ON THE VAGINA 117
TUMOR-LIKE CONDITIONS 120
BENIGN TUMORS 123
SQUAMOUS NEOPLASIA 125
GLANDULAR LESIONS 128
OTHER PRIMARY MALIGNANT TUMORS OF THE VAGINA 133
MALIGNANT VAGINAL TUMORS IN CHILDHOOD 134
LYMPHOMA 136
SECONDARY TUMORS OF THE VAGINA 136
REFERENCES 137
CHAPTER 6: Cervical benign and non-neoplastic conditions 141
NORMAL STRUCTURE 141
PHYSIOLOGIC CHANGES IN THE CERVIX AND THE FORMATION OF THE TRANSFORMATION ZONE 146
THE CONGENITAL TRANSFORMATION ZONE 150
INFLAMMATORY (CERVICITIS) TO REGENERATIVE CHANGES 152
EPITHELIAL INFLAMMATORY CHANGES 157
HEALING/REGENERATING EPITHELIUM 158
NON-NEOPLASTIC CHANGES 159
LESIONS OF THE ENDOCERVICAL GLANDULAR EPITHELIUM 161
LESIONS RELATED TO EXOGENOUS STIMULI 164
OTHER NON-NEOPLASTIC CONDITIONS 167
CERVICAL POLYP 169
BENIGN TUMORS 170
REFERENCES 171
CHAPTER 7: Cervix: epidemiology of squamous neoplasia 173
EPIDEMIOLOGY AND PUBLIC HEALTH SIGNIFICANCE 173
THE ETIOLOGIC AGENT: HUMAN PAPILLOMAVIRUS (HPV) 173
HPV: ROUTES OF TRANSMISSION 180
HPV COFACTORS 181
PREVENTION OF CERVICAL CANCER 184
CONCLUSION 185
ACKNOWLEDGMENT 185
REFERENCES 185
CHAPTER 8: Cervical precancer (intraepithelial neoplasia), including functional biomarkers and colposcopy 189
NTRODUCTION 189
CERVICAL INTRAEPITHELIAL NEOPLASIA (CIN): AN EVOLVING CONCEPT 189
COLPOSCOPY, A TECHNIQUE (SOMEWHAT) USEFUL FOR DETECTION OF CIN 218
COLPOSCOPIC APPEARANCES 219
REFERENCES 225
CHAPTER 9: Cervical squamous cell carcinoma 227
MICROINVASIVE CARCINOMA 227
INVASIVE CARCINOMA 234
REFERENCES 245
CHAPTER 10: Cervical glandular neoplasia 249
CERVICAL GLANDULAR INTRAEPITHELIAL NEOPLASIA 249
PRECLINICAL CARCINOMA 260
INVASIVE ADENOCARCINOMA 264
REFERENCES 274
CHAPTER 11: Miscellaneous cervical neoplasms 281
EPITHELIAL TUMORS 281
NEUROENDOCRINE TUMORS 286
SARCOMAS OR TUMORS WITH A SARCOMATOUS COMPONENT 288
MALIGNANT MELANOMA 291
METASTATIC TUMORS TO THE CERVIX 293
REFERENCES 293
CHAPTER 12: The normal endometrium 297
NORMAL STRUCTURE OF THE UTERUS 297
COMPONENTS OF THE NORMAL ENDOMETRIUM 297
ENDOMETRIUM DURING THE NORMAL MENSTRUAL CYCLE 304
ENDOMETRIUM AFTER THE MENOPAUSE 314
METHODS OF ENDOMETRIAL SAMPLING 316
PROBLEMS IN INTERPRETATION OF ENDOMETRIAL SPECIMENS 318
REFERENCES 322
CHAPTER 13: Exogenous hormones and their effects on the endometrium 325
INTRODUCTION 325
ESTROGENS 325
PROGESTINS 325
ORAL CONTRACEPTIVES 328
HORMONE-REPLACEMENT THERAPY (HRT) 331
OTHER HORMONAL AGENTS 333
TREATMENT OF HYPERPLASIA, EIN, AND CARCINOMA 337
REFERENCES 340
CHAPTER 14: Endometritis, metaplasias, polyps, and miscellaneous changes 343
INFLAMMATORY AND INFECTIOUS PROCESSES 343
ENDOMETRITIS 343
ENDOMETRIAL METAPLASIAS 348
ENDOMETRIAL POLYPS 361
MISCELLANEOUS CONDITIONS 364
REFERENCES 365
CHAPTER 15: Benign endometrial hyperplasia and EIN 367
INTRODUCTION AND TERMINOLOGY 367
DISORDERED PROLIFERATIVE TO BENIGN ENDOMETRIAL HYPERPLASIA SEQUENCE 367
ENDOMETRIAL INTRAEPITHELIAL NEOPLASIA (EIN) 376
PRIOR CLASSIFICATION 389
REFERENCES 390
CHAPTER 16: Endometrial adenocarcinoma 393
INTRODUCTION AND TERMINOLOGY 393
MAJOR TYPES OF ENDOMETRIAL ADENOCARCINOMA 393
RISK FACTORS IN ENDOMETRIAL CARCINOMA 394
ENDOMETRIOID ADENOCARCINOMA 396
MUCINOUS ADENOCARCINOMA 408
SQUAMOUS CELL CARCINOMA 409
SEROUS ADENOCARCINOMA 410
CLEAR CELL ADENOCARCINOMA 413
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
MOLECULAR PATHOLOGY 421
THE SPREAD OF ENDOMETRIAL CARCINOMA 422
REFERENCES 422
CHAPTER 17: Mesenchymal uterine tumors, other than pure smooth muscle neoplasms, and adenomyosis 427
INTRODUCTION 427
ENDOMETRIAL STROMAL TUMORS 427
MIXED MÜLLERIAN TUMORS 439
OTHER SARCOMAS 448
BENIGN OR BORDERLINE MESENCHYMAL TUMORS 448
REFERENCES 453
CHAPTER 18: Uterine smooth muscle tumors 457
INTRODUCTION 457
LEIOMYOMA 457
LEIOMYOSARCOMA 471
REFERENCES 481
CHAPTER 19: Fallopian tube 485
INTRODUCTION 485
INFLAMMATION OF THE FALLOPIAN TUBES 487
TUBAL STERILIZATION 493
TUBAL PREGNANCY 495
NON-NEOPLASTIC LESIONS 498
TUMORS OF THE FALLOPIAN TUBE 501
PARATUBAL TISSUES AND BROAD LIGAMENTS 509
REFERENCES 512
CHAPTER 20: Endometriosis 515
INTRODUCTION 515
CLINICAL FEATURES OF ENDOMETRIOSIS 515
DISTRIBUTION OF ENDOMETRIOSIS 515
EPIDEMIOLOGY OF ENDOMETRIOSIS 516
PATHOGENESIS OF ENDOMETRIOSIS 516
ETIOLOGIC FACTORS IN ENDOMETRIOSIS 519
MORPHOLOGIC FEATURES OF ENDOMETRIOSIS 521
CLASSIFICATION OF ENDOMETRIOSIS 533
INFERTILITY IN ENDOMETRIOSIS 533
MALIGNANCY IN ENDOMETRIOSIS 533
REFERENCES 538
CHAPTER 21: Normal ovaries, inflammatory and non-neoplastic conditions 543
ANATOMY, HISTOLOGY AND FUNCTION OF THE OVARIES 543
FOLLICULAR FAILURE 550
ANOMALIES OF OVARIAN DEVELOPMENT AND DESCENT 557
INFECTIOUS INFLAMMATORY DISEASES 558
NON-INFECTIOUS INFLAMMATORY DISEASES 564
REFERENCES 566
CHAPTER 22: Ovarian cysts, tumor-like, iatrogenic and miscellaneous conditions 569
DYSFUNCTIONAL CYSTS 569
TUMOR-LIKE LESIONS ASSOCIATED WITH PREGNANCY 575
REACTIVE STROMAL TUMOR-LIKE LESIONS 581
SEQUELAE OF SURGERY OR TRAUMA 594
IATROGENIC DISORDERS OF THE OVARIES 594
OVARIAN HEMORRHAGE AND ADNEXAL TORSION 597
MÜLLERIANOSIS AND REACTIVE MESOTHELIAL LESIONS 598
REFERENCES 599
CHAPTER 23: Ovarian neoplasia: epidemiology and etiology 601
DESCRIPTIVE EPIDEMIOLOGY 601
RISK AND PROTECTIVE FACTORS FOR SPORADIC OVARIAN CARCINOMA 601
ORIGINS OF OVARIAN CARCINOMA AND MODELS OF CARCINOGENESIS 606
CONCLUSION 607
REFERENCES 607
CHAPTER 24: Ovarian serous and mucinous epithelial–stromal tumors 611
SURFACE EPITHELIAL–STROMAL TUMORS 611
SEROUS TUMORS 611
MUCINOUS TUMORS 634
REFERENCES 651
CHAPTER 25: Ovarian endometrioid, clear cell, Brenner, and rare epithelial–stromal tumors 655
ENDOMETRIOID TUMORS 655
CLEAR CELL TUMORS 672
TRANSITIONAL CELL TUMORS 678
SQUAMOUS CELL LESIONS 683
MIXED EPITHELIAL TUMORS 684
UNDIFFERENTIATED CARCINOMAS 684
MISCELLANEOUS AND UNCLASSIFIED TUMORS 686
REFERENCES 690
CHAPTER 26: Ovarian sex cord-stromal and steroid cell tumors 693
GRANULOSA CELL TUMORS 693
THECOMA–FIBROMA GROUP OF TUMORS 701
ANDROBLASTOMAS (SERTOLI–LEYDIG CELL TUMORS) 708
GYNANDROBLASTOMAS 719
SEX-CORD TUMORS WITH ANNULAR TUBULES (SCTAT) 720
UNCLASSIFIED SEX CORD-STROMAL TUMORS 723
STEROID CELL TUMORS 723
REFERENCES 725
CHAPTER 27: Ovarian germ cell tumors 729
DYSGERMINOMAS 729
YOLK SAC TUMORS (ENDODERMAL SINUS TUMORS) 734
EMBRYONAL CARCINOMAS 740
POLYEMBRYOMAS (POLYEMBRYONIC EMBRYOMAS) 741
CHORIOCARCINOMAS 742
TERATOMAS 744
MALIGNANT MIXED GERM CELL TUMORS 768
MIXED GERM CELL AND SEX CORD-STROMAL TUMORS (GONADAL ANLAGE TUMORS) 770
REFERENCES 775
CHAPTER 28: Ovarian lymphoid and hematopoietic neoplasms 779
LYMPHOMA 779
LEUKEMIA 790
REFERENCES 793
CHAPTER 29: Ovarian tumors: miscellaneous and metastatic 795
UNCLASSIFIED AND MISCELLANEOUS ‘EPITHELIAL’ TUMORS 795
MISCELLANEOUS MESENCHYMAL TUMORS 797
MALIGNANT TUMORS METASTATIC TO THE OVARIES 801
REFERENCES 824
CHAPTER 30: Nidation and placenta 829
INTRODUCTION 829
ANATOMY AND EMBRYOLOGY 829
EXAMINATION OF THE PLACENTA 833
MICROSCOPIC LESIONS OF THE PLACENTA 849
REFERENCES 859
CHAPTER 31: Placenta – clinical scenarios 863
ECTOPIC PREGNANCY 863
EARLY PREGNANCY LOSS (SPONTANEOUS MISCARRIAGE) 864
MID TO LATE PREGNANCY LOSS 866
ABRUPTION 866
HYPERTENSIVE DISORDERS 868
OTHER PATHOLOGIC CONDITIONS EVALUATED IN THE CONTEXT OF IUGR 870
SICKLE CELL TRAIT AND DISEASE 873
TWIN PREGNANCY 873
PROLONGED PREGNANCY 873
MATERNAL INFECTIONS AND THE PLACENTA 874
REFERENCES 878
CHAPTER 32: Gestational trophoblastic disease 881
WHAT IS GESTATIONAL TROPHOBLASTIC DISEASE? 881
TROPHOBLAST TYPES 881
TROPHOBLAST MARKERS 881
FEATURES OF GESTATIONAL TROPHOBLASTIC DISEASES 884
TYPES OF GESTATIONAL TROPHOBLASTIC DISEASE 885
SUMMARY 904
REFERENCES 904
CHAPTER 33: The peritoneum 909
NORMAL PERITONEUM 909
INFLAMMATORY AND REACTIVE LESIONS 909
MÜLLERIANOSIS (MÜLLERIAN TUMOR-LIKE CONDITIONS) 915
TUMOR-LIKE CONDITIONS 920
MESOTHELIAL NEOPLASMS 923
SEROUS TUMORS (PRIMARY AND METASTATIC) 928
MISCELLANEOUS PRIMARY TUMORS 935
METASTATIC TUMORS 937
REFERENCES 940
CHAPTER 34: Disorders of sexual development 945
DISORDERS OF GENITAL DIFFERENTIATION (DISORDERS GENERALLY ASSOCIATED WITH A NORMAL CHROMOSOME CONSTITUTION AND NORMAL GONAD) 945
DISORDERS OF SEX DETERMINATION (DISORDERS GENERALLY ASSOCIATED WITH AN ABNORMAL SEX CHROMOSOME CONSTITUTION LEADING TO ABNORMAL GONADAL FORMATION) 958
REFERENCES 975
CHAPTER 35: Cutup – gross description and processing of specimens 979
GENERAL ASPECTS 979
VULVA 982
CERVIX 984
UTERINE CORPUS 987
FALLOPIAN TUBE 991
OVARY 992
FETUS AND PLACENTA 994
REFERENCES 997
CHAPTER 36: Immunohistochemical and functional biomarkers of value in female genital tract lesions 999
INTRODUCTION 999
BROAD SPECTRUM DIFFERENTIATION MARKERS 999
NARROW SPECTRUM DIFFERENTIATION MARKERS 1003
MARKERS OF ALTERED FUNCTION IN DISEASE STATES 1004
REFERENCES 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
INTRODUCTION 1033
SECTION ON STAGING IN THE REPORT 1033
VULVAR CARCINOMA 1033
VAGINAL CARCINOMA 1034
CERVICAL MICROINVASIVE AND CARCINOMA 1034
ENDOMETRIAL CANCER (EXCLUDES STROMAL TUMORS) 1035
FALLOPIAN TUBE CARCINOMA 1036
OVARIAN CARCINOMA (EXCLUDING GERM CELL TUMORS) 1036
GESTATIONAL TROPHOBLASTIC TUMOR 1036
REFERENCE 1036
Appendix D: Coding with SNOMED CT (Systematized Nomenclature of Medicine-Clinical Terminology) 1037
WHY CODE? WHY SNOMED? 1038
REFERENCE 1039
Appendix E: Abbreviations 1041
Index 1045