Professional Documents
Culture Documents
reproductive
organs and
breast
Budiningsih S
Department of Anatomic
Pathology FMUI
Indonesia (BRK,2000)
cervix
3277
payudara 2398
ovarium 878
prostat
392
Tumors of female
reproductive
organs
Benign tumor
Leiomyoma/uterine fibroid
Commonest benign tumor
Commonly present in later repro
ductive life & around menopause
Associated with infertility
precise aetiology is unknown
clinically may present with
- abdominal mass
- urinary problems
- abnormal uterine bleeding
MACROSCOPIC
Multiple, round 5 200 mm
well circumscribed
cut section white,whorled
MICROSCOPIC
Complex interlacing
bundles of smooth muscle
fibers
Ovarian tum
Ovarian tumors
Solid / cystic
Benign / malignant
Borderline lesions have low risk of
malignant
behaviour
Nomenclature based on cellular origin
Commonest fatal gynaecological
malignancy in
many countries
Malignant tumor
Cervical cancer
Cervical cancer
Risk factors
Early age at first intercourse
Frequency of i c
Number of partners
HPV postulated as main causative
factor
Precancer can be detected by
cytology
(Paps smear)
CIN 2
CIN I
CIN 3
Cervical carcinoma
Tumor
of the
breast
Diagnostic methods
Immagingmammography &
ultrasound
Fine needle aspiration cytology
Core biopsy
Benign tumor
Fibroadenoma
Duct papilloma
Adenoma
Connective tissue tumor
fibroadenoma
Commonest type
Clinically mobile on palpation
Mainly in young woman
Arises from connective tissue &
epithelium
fibroadenoma
Macroscopic
Well circumscribed & lobulated
1 4 cm in diameter
Cut surface: solid, firm
Microscopic
Admixture of stromal &
glandular epithelial pro
liferation
Breast cancer
20% of all cancers in woman (Ind : 2
nd rank)
Occur in pre & post menopausal
woman
Commonest cause of death in 35
55
age group
Prognosis is good if detected at
early stage
Breast cancer
Aetiological mechanism
Overexposure to estrogens &
underexposure
to progesterone important
Some tumors contain ER & PR &
respond to hormone
manipulation
No good evidence for viral
involvement
Peau dorange
Nipple retraction
Nipple eczema
Histologic subtype
Tumor grade
Estrogen & progesterone receptor
HER 2/neu
Lymphovascular invasion
Proliferative rate
DNA content
Frequency (%)
55
25
10
Medulary carcinoma
<5
Mucinous carcinoma
Ductal invasive
carcinoma
Macroscopic
irregular/stellate
outline/nodular
Ill defined edge
Cut surface : gray
white+yellow streaks
Microscopic
Tumor cells aranged in
cords,cluster,trabeculae
cytoplasm often
abundant
&
eosinophilic
nuclei regular /pleomor
phic
Predictive marker
ER
HER 2
HER 2
Tumor of male
reproductive
organs
Prostate cancer
Commonest
malignant tumor
second leading cause of male deaths
from ca
peak incidence is 60 85 years
unknown aetiology hormonal?
two clinicopathological types
clinical (symptomatic)
latent (incidental)
Clinical features
Urinary symptoms difficulty
/increase frequency micturition,
urinary retention
Rectal examination revealing hard
craggy
Bone metastases presenting with
pain,pathological fracture,anaemia
Lymph node metastases
Clinical / symptomatic
cancer
Arises in posterior subcapsular area
Adenocarcinoma
Invasion of stroma and perineural
spaces
Asymmetric firm enlargement may
palpable
per rectum
Metastasises especially to bone
Latent (incidental) ca
Microscopic focus of tumor found
incidentally
Common, incidence high in old
age
Dormant lesions
Metastases in 30% after 10 years
diagnosis
Digital rectal examination
Imaging ultrasound(TRUS), skeletal x
rays, isotop
bone scan
Cystoscopy including transurethral
resection
serologicserum acid & alkaline
phosphatase & Prostate Spesific Antigen
Haematologyleukoerythroblastic anemia
Biopsytransurethral
resection,needle,fine needle aspiration
cytology
Mode of spread
Direct stromal invasion,
capsule,urethra,
bladder base, seminal
vesicle
Via lymphatic to sacral,
iliac,paraaortic nodes
Via blood bone
(pelvis,lumbosacral spine,
femur), lungs, liver
Testis tumor
Disease of
pregnancy
Ectopic pregnancy
endometriosis
endometriosis
Pathology
of the Male
Reproductiv
e organs
Condyloma acuminatum
Condyloma accuminata