fibrous, glandular tissue

well-circumscribed, lobulated rubbery

stroma proliferation

Fibroadenoma

-most common benign breast tumor

-peaks in 20s

-no precursor to breast cancer

-Mixture of glands and stroma w/ increased stroma cellularity

-Bulky leaf-like clefts/projections 

Phyllodes Tumor

-presents in 60s

- some can become malignant

-Early malignancy w/out basement membrane penetration

-mammography: abnormal calcifications

Ductal Carcinoma in situ (DCIS)

-High nuclear grade & central necrosis

-subtype of DCIS

Comedocarcinoma

-Malignant acinar cells confined to BM

- bilateral, multicentric

-premenopausal women

-pre-invasive lesion 

Lobular Carcinoma in Situ (LCIS)

-hard, white mass /w yellow streaks 

-dense fibrous tissue

-cords, solid nests, or tubes of malignant cells invading fibrous stroma

Invasive ductal Carcinoma

*most common type of breast Cancer

-embedded in fibrous stroma

- "peas in pod" configuration

-often bilateral

- metastases to CSF, BM, ovary & uterus 

Invasive lobular Carcinoma 

-well-circumscribed grey fleshy mass

-lymphoplasmacytic cells

-BRCA 1 carriers

Medullary Carcinoma 

-Peau d'orange look, no palpable mass

-dermal lymphatic invasion 

Inflammatory Breast Cancer 

-endometrial gland proliferation

-excess estrogen stimulation

-postmenopausal bleeding

-RFs: low fertility, obesity, HTN, Diabetes...

Endometrial Hyperplasia 

-55-65yr ladies

-<40 usually obese

-Risks: delayed menopause, diabetes, HTN, obesity, nulliparity, unopposed estrogen

-has a precursor

Endometrial Carcinoma 

-well, circumscribed benign smooth muscle tumors

-whorled pattern of smooth muscle bundles 

Leiomyoma 

-Pelvic fullness, pain, bleeding, pregnancy complications

-1/4 of women have them during reproductive yrs

-estrogen sensitive & regress after menopause

Leiomyomas

-increased mitoses, nuclear atypia, coagulation necrosis

- arise de novo 

-Stain: desmin 

Leiomyosarcoma 

-endometrial glands within myometrium

-sx: pelvic pain, dyspareunia, colicky dysmenorrhea & enlarge uterus 

Adenomyosis 

-tubal regurgitaiton

-chocolate cysts

-pelvic pain during menses

-infertility 

Endometriosis 

Condyloma Acuminatum

HPV

Condyloma Latum

Syphilis 

Malignant Embryonal Rhabdomyosarcoma 

Sarcoma botryoides 

Clear Cell Carcinoma risk factor (in daughter)

Exposure to DES in utero 

-epithelial dysplasia in vulva

- 1/3 have CIN cervical intraepithelial neoplasia 

Vulvar Intraepithelial Neoplasia (VIN) 

-adenocarcinoma in situ of vulva & perianal skin

-eczema-like lesion (similar in nipple)

- malignant cells in epidermis 

Extramammary Paget's disease

Risk factors: early age @ first intercourse, multiple sex partners, high-risk male partner, smoking

Sx: vaginal bleeding, post-coital spotting 

Invasive Cervical Carcinoma 

HPV most common strains 

HPV 16 & 18

They have E6 bind to p53 & E7 bind to pRb 

-tubal fibrosis

-cause of infertility

-ectopic pregnancy

Salpingitis (sometimes used synonymously w/ PID)

-Abdominal pain

- high hCG

-endometrial sampling: only decidual tissue found 

Ectopic Pregnancy 

-anovulatory

-obese

-hirsute

- assoc. w/ insulin resistance

-high androgen levels 

PCOS 

-Unilocular cysts w/ clear fluid

-Papillary projections

-Psammoma bodies 

-bilateral

-Risk: BRCA 1

Serous Cystadenocarcinoma 

-poorly differentiated

-large atypical cells

-lymphocytic infiltrate

-analogous to seminoma in testes

Dysgerminoma 

Schiller-Duval bodies (resemble glomeruli) 

Yolk Sac Tumor 

(Endodermal Sinus Tumor)

Three germ cell layers

Single mural cyst/mass covered w/ hair, teeth

Teratoma

-mature: benign

-immature: aggressive, malignant 

Struma Ovarii 

Specialized teratoma produces thyroid 

-Call-Exner rosettes/bodies

-uniform nuclei w/ nuclear grooves

-produce abundant estrogen 

Granulosa-Theca cell Tumors