Transcript ppt - Stritch School of Medicine

Histology for Pathology
Female Genital Tract and Breast
Theresa Kristopaitis, MD
Associate Professor
Director of Mechanisms of Human Disease
Kelli A. Hutchens, MD, FCAP
Assistant Professor
Assistant Director of Mechanisms of Human Disease
Loyola Stritch School of Medicine
Objectives
• Ovary
– On a section of ovarian cortex identify stroma and follicles
– Define “Graafian follicle”
– Explain where “granulosa cells” are normally found in the
ovary
– Define “corpus luteum”
– Define corpus albicans and identify in a section of ovary
• Fallopian Tube
– List the 2 types of cells that line the fallopian tube and
their function
Objectives
• Uterus / Cervix
– On a low power section identify the endometrium and
myometrium
– Define endometrial “basalis” and “functionalis”
– Identify endometrial glands and stroma
– Describe the major changes of the endometrium through the
menstrual cycle (ie menstrual, proliferative and secretory
endometrium findings)
– Describe the epithelial lining of the endocervix and ectocervix
• Breast (Mammary Glands)
• List the flow of milk through the mammary glands
• Identify on histologic sections the major components of
breast tissue (lobules of glands, stroma, and adipose
tissue)
• Describe the epithelial lining of the intralobular ducts
Medulla
Cortex
Image from Harvard
University Medical
School Website
Follicles
Ovarian Cortex
Mesothelium
(also called germinal epithelium)
Ovarian follicle
• Primordial follicle: prior to
puberty
• Primary follicle: (after
puberty)
– Primary oocyte surrounded
by single layer of squamous
cells (granulosa cells)
embedded in ovarian stroma
• Secondary follicle:
Oocyte
– increased thickness of
Ovarian Stromal cells granulosa cells and formation
of the theca folliculi (stroma
Granulosa cells
cells around the follicle)
Primary Follicle
• Graafian (pre-ovulatory)
follicle: final stage
Oocyte
Mature Graafian Follicle
• Graafian (pre-ovulatory)
follicle: final stage
Granulosa Cells
Graafian (preovulatory) follicle
(up to 2.5 cm)
– Large antrum filled with
fluid (liquor folliculi)
– Ready to release oocyte in
response to LH surge
– Granulosa cells directly
around the oocyte =
corona radiata
– Just prior to release oocyte
resumes meiosis then
arrests as a secondary
oocyte
Site of follicular Rupture / Corpus
Luteum
A. Granulosa cells
B. Corpora albicans
Corpus Luteum
• After ovulation, the
remaining wall of the
graafian follicle
transforms into the
corpus luteum
• The wall of the corpus
luteum is folded and
contains granulosa lutein
cells derived from
granulosa cells which
secrete progesterone
Corpus Albicans
• In the absence of
fertilization the corpus
luteum degenerates,
decreases in size and
form the corpus
albicans which consists
of dense connective
tissue
Fallopian Tubes / Oviducts
• Two, open ended tubes that receive the ovum
• Provide the ideal environment for fertilization
– Most often occurs in ampulla
• The wall is composed of:
– Mucosa: ciliated cells, secretory (peg) cells, and
underlying lamina propria
– Muscularis layer
– Serosal layer
Fallopian Tube / Oviducts
• Mucosa – high power
Mucosa
Serosa
•
Muscularis
•
•
Lumen
Ciliated cells (arrows)
– Help sweep oocyte towards
uterus
Nonciliated Peg cells (arrowheads)
– Produce secretions to protect
oocyte and promote fertilization
Lamina propria (a)
Uterus
• Relative large organ between the fallopian
tubes and the vagina
• 3 anatomic regions: fundus, body, and cervix
• Site of implantation and placentation
• 3 layers
– Endometrium
– Myometrium
– Serosa
Uterus – low power
Endometrium
Myometrium
(smooth muscle)
Endometrium
Functionalis
Near the lumen
Hormonally responsive
Basalis
Produces new cells to
replace endometrium that
was shed during
menstruation
Endometrium – high power
Endometrial glands
Stroma
The endometrium undergoes morphologic and functional changes during
the menstrual cycle
Regressing
corpus luteum
Graafian
follicle
Corpus luteum
Proliferative Phase
Early post-menstrual
Sparse glands
Predominant basalis
Early proliferative
Endometrium thicker under
estrogen influence
Glands straight and thin
Later Proliferative
Darker more compact basal layer
Secretory Phase Endometrium
Mucoid
secretions
Early Secretory Phase Endometrium
Glands tortuous –progesterone effect, mucoid secretions
stored within the glands, pending a possible embryo
implantation
Cervix
• Lower part of uterus
• Bulges into vagina
• Two parts with different histology and a
transitional zone between them:
– Endocervix: Simple columnar glands
– Ectocervix: Stratified squamous epithelium
Cervix
Transition zone: simple columnar epithelium of the endocervix with
overlying non-cornified stratified squamous epithelium of the ectocervix
Endocervical
glands
Breast (Mammary Glands)
• Breasts are composed of two multilobed
mammary glands embedded in connective
and adipose tissue
– Glands are coumpound tubuloalveolar glands that
open into a lactiferous duct which express their
contents via the nipple
• Milk produced by the secretory alveoli first drains into
intralobular ducts and then interlobular ducts to
lactiferous sinus
• Intralobular ducts makes of the majority of the
glandular tissue
Breast Tissue
Breast Ducts
Myoepithelial cells
Cuboidal epithelial cells