Gross Unknowns

Audrea Williams, MDDepartment of Pathology

Howard University Hospital

A. Mammograms of young women are typically "dense" or white in appearance; difficult to detect lesionsB. Young woman's breast: predominance of fibrous interlobular stroma and the paucity of adipose tissueC. Pregnancy, branching of terminal ducts results in more numerous TDLUs, and the number of acini per TDLU increases. D. Increasing age: TDLUs decrease in size and number, and the interlobular stroma is replaced by adipose tissueE. Mammograms become more radiolucent (darker) with age secondary to small ducts and atrophic lobules in adipose tissue.

Robbins and Cotran p.1120

Robbins and Cotran p.1120

Multiple masses in the breast of a 40-year-old woman. Excision was performed, what is the best diagnosis?A. Fibrocystic changesB. Ductal carcinoma in situ with apocrine changeC. Apocrine carcinomaE. None of the above

Multiple masses in the breast of a 40-year-old female. Excision was performed, what is the best diagnosis?A. Fibrocystic changesB. Ductal carcinoma in situ with apocrine changeC. Apocrine carcinomaE. None of the above

Multiple masses in the breast of a 40-year-old female. Excision was performed, what is the best diagnosis?A. Fibrocystic changesB. Ductal carcinoma in situ with apocrine changeC. Apocrine carcinomaE. None of the above

Fibrocystic changes

64F bilateral skin/breast changes secondary to implants

Left breast: lobular carcinoma insitu (E-cadherin negative)

Rigt breast : Invasive moderately differentiated ductal carcinoma

Histology of the menstrual cycle

Robbins and Cotran p.1120

Uterus is hollow, pear shaped, 40-80 g, 7-8 cm

early proliferative (days 4-7) post-ovulatory day 2 days 20-21: maximal secretion

24 year old woman with polycystic ovarian syndrome (prolonged estrogenic stimulation with reduced progestational activity) and abnormal uterine bleeding

Endometrial hyperplasia

47 year old woman with abnormal uterine bleeding

DDx: Endometrial Carcinoma Endometrial polyps Leiomyomas(Fibroids)

47 year old woman with abnormal uterine bleeding

DDx: Endometrial Carcinoma Endometrial polyps Leiomyomas(Fibroids)

47 year old woman with abnormal uterine bleeding

DDx: Endometrial Carcinoma Endometrial polyps Leiomyomas(Fibroids)

Robbins and Cotran p.1094

Endometriosis of OvaryDx 2 of 3 are required:endometrial glands, stroma hemosiderin-laden macrophages

27 year old woman with severe abdominal pain; this is the ovary

Hint: endometrial glands and stroma outside the uterus

Endometriosis of OvaryDx: 2 of 3 are required:endometrial glands, stroma hemosiderin-laden macrophages

27 year old woman with severe abdominal pain this is the ovary

Hint: endometrial glands and stroma outside the uterus

benign serous cystadenoma

29 year old woman with a cystic ovarian mass

Papillary serous cystadenocarcinoma

49 year old woman with a cystic ovarian mass

30 cm retroperitoneal cystic mass in 55 year old woman mucinous cystadenomafluid to viscous material of mucoid nature in lumen

mucinous ovarian neoplasm that had borderline features at the microscopic level

mucinous cystadenocarcinoma

65 year old lady with stage IV malignancyuterus700grams

A07-25

epithelial component

necrosis