Introduction Smooth muscle tumors of the uterus are very common and the vast majority are benign leiomyomas. In contrast, leiomyosarcomas are rare and constitute only 1.3% of uterine malignancies ( Figure 19.1 ). Nevertheless, leiomyosarcoma is the most frequent malignant…
Introduction Endometrial adenocarcinomas are a heterogeneous group of tumors derived from endometrial glandular epithelial cells. Most maintain a resemblance to endometrial glands (‘endometrioid’) but even in these cases mucinous or squamous differentiation occurs frequently. A much less common group of…
Introduction and Terminology The meaningful resolution of endometrial hyperplasias, a mixed group of diseases, has challenged pathologists for decades. Long envisioned as a continuous spectrum of morphologic changes of increasing severity, in reality they encompass only two discrete disease states,…
Inflammatory and Infectious Processes Infections of the gynecologic tract are relatively common, and cause an enormous health impact. It is estimated that there are 19 million cases of sexually transmitted diseases (STDs) in the United States, with a total healthcare…
Introduction Exogenous hormonal agents represent one of the most commonly prescribed medications in women. Hormonal therapies are used for a wide range of indications, including birth control, postmenopausal hormone replacement, dysfunctional uterine bleeding, endometriosis, infertility, and the treatment of malignant…
Components of the Normal Endometrium The mucosal lining of the uterus consists of glands, stroma, and blood vessels. The function of the endometrium is to form a receptive site for pregnancy. This is initially accomplished through a nutrient effect of…
Epithelial Tumors Adenoid Basal Carcinoma (Adenoid Basal Epithelioma) Definition Adenoid basal carcinoma (adenoid basal epithelioma) is composed of bland, uniform, basaloid cells arranged in nests with a variable amount of glandular and squamous differentiation. Based on their favorable outcome, there…
Preinvasive Glandular Lesions Terminology In keeping with the terminology used for squamous cervical intraepithelial neoplasia (CIN), earlier investigators recognized three grades of cervical glandular intraepithelial neoplasia (CGIN), but this has proven unrealistic. Three grades (glandular atypia, glandular dysplasia, and atypical…
Epidemiology and Staging Epidemiology Cancer of the cervix is the second most common cancer in women worldwide after cancer of the breast. Each year, approximately 529,828 new cases are diagnosed worldwide. In the United States in 2012, cervical cancer was…
Introduction Human papillomavirus (HPV) infection is now understood to be the underlying cause of squamous carcinogenesis in the cervix. Older diagnostic classifications of preinvasive disease based purely on descriptive correlation of histology with clinical behavior included dysplasia/carcinoma in situ (CIS;…