Note:
- Each of the following three kodachromes is from a hysterectomy specimen. Below are three fictitious case histories. Describe how the history and the histologic findings are correlated.
History A:
- A 30 year-old woman had an abnormal Pap smear, followed by colposcopy and cervical biopsy showing invasive squamous cell carcinoma. A hysterectomy was performed.
- Image 1.1: The image shows a proliferative endometrium. Notice the pseudostratified nuclei in the glandular epithelial cells and the occasional mitotic figures. This is the functionalis portion of the endometrium responding to normal hormonal cycles. If her cervical carcinoma is confined to the uterus, her prognosis is still quite good.
History B:
- A 32 year-old woman desired sterilization. She had complained of irregular periods during the last 6 months. During laparoscopic tubal ligation, a bulging, 2 cm diameter mass was noted on the left ovary. A depression lined by yellow tissue was present on the surface of this mass. A D&C was performed.
- Image 1.2: The image shows an early secretory endometrium. Notice the tortuous glands and epithelial cells containing subnuclear vacuoles. What is the main content of the vacuoles? The 2 cm diameter ovarian mass with the central yellow depression is a corpus luteum.
History C:
- A 52 year-old woman, who had had no periods for three years, began to experience intermittent vaginal bleeding. On pelvic exam, a small endocervical polyp protruded from the external os. A D&C was performed.
- Image 1.3: The image shows an atrophic, postmenopausal endometrium. Some of the glands are cystically dilated, but they are lined by flat, atrophic-appearing epithelial cells. There is no evidence of hyperplasia or
malignancy.
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