2009-03-27 Reproductive Images

Front 1

Back 1

Vulva – Condyloma acuminatum
The white “cauliflower” papillomatous lesions (arrow) are condyloma acuminata.

Front 2

Back 2

Vulva – Condyloma acuminatum
The white “cauliflower” papillomatous lesions (arrow) are condyloma acuminata.

Front 3

Back 3

Condyloma acuminatum
Papillomatous lesion represented by finger like projections lined by squamous epithelium with koilocytosis (koilocytosis can not be appreciated in this image, see next image).

Front 4

Back 4

Condyloma acuminatum
Papillomatous lesion represented by finger like projections lined by squamous epithelium with koilocytosis (koilocytosis can not be appreciated in this image, see next image).

Front 5

Back 5

Vulva-Squamous cell carcinoma
Exophytic white mass having gross features similar to a condyloma acuminatum in this case. This case would require microscopic evaluation to make the diagnosis.

Front 6

Back 6

Vulva-Squamous cell carcinoma
An exophytic mass has been sectioned. The tan fleshy tissue represents invasive carcinoma.

Front 7

Back 7

Paget’s disease of vulva (Extramammary Paget’s Disease)
The epidermis contains nests of larger epithelial cells with clear cytoplasm and pleomorphic hyperchromatic nuclei (arrows). The clear cells contain intracytoplasmic mucin.

Front 8

Back 8

Cervix – Squamous cell carcinoma
Large exophytic, tan-brown, ulcerated mass grossly representing invasive squamous cell carcinoma.

Front 9

Back 9

Cervix – Squamous cell carcinoma
Cervix has been opened longitudinally. It contains a tan-fleshy mass with a tumor epicenter at the squamocolumnar junction. Tumor extends to ectocervix and into the endocervical canal (arrow).

Front 10

Back 10

Cervix – Squamous cell carcinoma
Slightly exophytic, ulcerated, tan-brown mass of ectocervix (arrow). Grossly represents a cervical squamous cell carcinoma.

Front 11

Back 11

Cervix – Mild dysplasia (low grade dysplasia)
This patient had a pap smear interpreted as mild dysplasia and this represents a cervical biopsy. The lower one-third thickness of the squamous epithelium exhibits increased cellularity with nuclear hyperchromasia and occasional mitosis (arrow).

Front 12

Back 12

Cervix – High grade dysplasia
The lower one-half thickness of the epithelium exhibits increased cellularity, abnormal maturation of squamous cells, nuclear pleomorphism, hyperchromasia, and mitotic activity. This is an example of high grade dysplasia which incorporates moderate dysplasia and severe dysplasia. Koilocytotic features representing HPV effect are present.

Front 13

Back 13

Cervix – High grade dysplasia
The lower one-half and lower two-thirds (focally) thickness of the epithelium exhibits increased cellularity, abnormal maturation of squamous cells, nuclear pleomorphism and hyperchromasia, and mitotic activity. This is an example of high grade dysplasia which incorporates moderate dysplasia, and severe dysplasia, koilocytotic features representing HPV effect are present.

Front 14

Back 14

Cervix - CIS
Full thickness abnormal maturation is present. Cellularity is increased with nuclear hyperchromasia and pleomorphism. Mitoses extend toward the surface (arrow).

Front 15

Back 15

Cervix – Microinvasive squamous cell carcinoma
Nests of invasive squamous cells are invading superficially (less than 5 mm) into the submucosa (arrows). Horizontal dimension must be less than 7mm.

Front 16

Back 16

Squamous cell carcinoma
Nests of malignant squamous cells are invading into an inflamed reactive fibrous stroma. The nests contain squamous cells with cytologically malignant nuclei (hyperchromatic and pleomorphic). Some cells contain eosinophilic cytoplasm and there is keratin pearl formation (arrows).

Front 17

Back 17

Squamous cell carcinoma
Nests of malignant squamous cells are infiltrating reactive fibrous stroma.

Front 18

Back 18

Peritoneum: Endometriosis
Nests of endometrial stroma and glands (arrow) are present within the fibrous stroma.

Front 19

Back 19

Uterus – Adenomyosis (gross)
Myometrium contains a tan fleshy tissue nodule representing adenomyosis (arrow). The remainder of the myometrium is trabeculated (irregular) appearing. Slit-like spaces may be seen in a trabeculated myometrium in adenomyosis.

Front 20

Back 20

Uterus - Adenomyosis
Myometrium has a trabeculated appearance with slit-like spaces which are hemorrhagic appearing (arrows).

Front 21

Back 21

Uterus – Adenomyosis
An arrowhead points to the endometrial cavity surface. The long arrow points to the nests of endometrial glands and stroma within the myometrium.

Front 22

Back 22

Uterus - Adenomyoma
Uterus contains a nodular, trabeculated mass with slit-like spaces (arrowhead). There is a larger hemorrhagic area (large arrow) also present. This and the slit-like spaces represent endometrial stroma and glands. The remainder of the nodule is represented by proliferating smooth muscle.

Front 23

Back 23

Uterus - Leiomyomata
Cut section of gray-white whorled intra-mural masses which would be firm to rubbery on palpation.

Front 24

Back 24

Uterus - Leiomyomata
Multiple sub-serosal, irregular shaped masses representing leiomyomas (fibroids).

Front 25

Back 25

Uterus - Leiomyoma
A submucosal nodular mass (arrow) fills the endometrial cavity representing a leiomyoma.

Front 26

Back 26

Uterus - Leiomyoma
Leiomyomas sometimes undergo degenerative changes including infarction. This is represented grossly as softening with brown or red discoloration known as brown degeneration (arrow head). The long arrow represents an undected intrauterine pregancy.

Front 27

Back 27

Uterus – Leiomyoma (micro)
Myometrium containing an ill-defined mass of benign smooth muscle cells which intertwine with one another (arrows around leiomyoma – fibroid).

Front 28

Back 28

Uterus – Leiomyoma (micro)
The cellularity on the left is higher than on the right. Smooth muscle cells contain “cigar” shaped nuclei (arrow) which are cytologically benign and exhibit no mitotic activity.

Front 29

Back 29

Uterus - Leiomyoma (micro)
High power view of smooth muscle cells forming fascicles and bundles which intertwine with each other. Nuclei have benign cytologic features without atypia or mitotic activity.

Front 30

Back 30

Uterus - Leiomyosarcoma
Uterus and cervix have been opened. The uterus contains a gray-white fleshy mass (arrow) representing a leiomyosarcoma.

Front 31

Back 31

Uterus – Leiomyosarcoma (micro)
Spindle shaped smooth muscle cells exhibit slightly pleomorphic nuclei which are hyperchromatic. There is abundant mitotic activity present (arrows). Mitotic activity is the most important feature used to distinguish a leiomyoma from a leiomyosarcoma.

Front 32

Back 32

Uterus – Endometrial adenocarcinoma
(Adnexa – short arrow, endocervical canal – long arrow, tumor – bold arrow). The endometrial canal contains a fungating, cauliflower, tan, fleshy mass representing endometrial adenocarcinoma.

Front 33

Back 33

Uterus – Endometrial adenocarcinoma
A tan-red fleshy mass (short arrow), fills the endometrial cavity representing endometrial adenocarcinoma. Leiomyomas are also present (long arrows).

Front 34

Back 34

Uterus – Endometrial adenocarcinoma
(Ovary – short arrow, cervix – long arrow, tumor – bold long arrow, tumor invading myometrium – bold short arrow). The endometrial cavity is dilated and contains a large tan-brown to gray mass which can be seen focally invading myometrium (bold short arrow).

Front 35

Back 35

Uterus – Endometrial adenocarcinoma
(Cervix – short arrow, endometrial adenocarcinoma – long arrow). This is a longitudinal section of cervix and uterus. The endometrium has been replaced with lush, white fleshy tissue (long arrow) representing endometrial adenocarcinoma.

Front 36

Back 36

Endometrium – Atypical complex (adenomatous) hyperplasia
The gland to stroma ratio is increased and the glands exhibit complex architecture represented by micro-villous and papillary projections into the lumen of the glands.
This is from a 65-year-old obese, diabetic women with post-menopausal bleeding.

Front 37

Back 37

Uterus-cervix-Sarcoma botryoides (rhabdomyosarcoma)
Endocervix and uterus contain an irregular mass containing “grape-like” appearance (top of specimen).

Front 38

Back 38

Uterus – cervix – Sarcoma botryoides (rhabdomyosarcoma)
High power view revealing grape-like architecture (arrow) of the tumor.

Front 39

Back 39

Ovary – Serous cystic tumor (cystadenoma)
A large gray-white and gray-blue mass has replaced the ovary on the left (arrows). It would be soft to palpation and filled with yellow-clear non-viscous fluid. Microscopic studies would be necessary to differentiate a benign form from “undetermined malignant potential” type from a malignant form.

Front 40

Back 40

Ovary – Serous cystic tumor (cystadenoma)
The ovarian tumor on the left has been opened. It was filled with yellow-clear non-viscous fluid. The majority of the inner surface of the cyst is smooth (small arrows). Note the more solid papillomatous area (large arrow). This is the area which needs to be evaluated histologically to differentiate a benign, malignant and borderline (undetermined malignant potential) form from each other.

Front 41

Back 41

Ovary – Serous cystic tumor (cystadenocarcinoma)
This serous tumor exhibits a more extensive thickened papillae inner surface (arrows). Histologically, it proved to be adenocarcinoma.

Front 42

Back 42

Ovary – Serous cystadenoma (micro)
The cyst is lined by a single layer of serous cells columnar, non-mucin producing cells with cilia (arrow).

Front 43

Back 43

Ovary – Serous cystadenocarcinoma (micro)
The serous type epithelium is more complex architecturally and invades into the stroma of the ovary (arrow). Definitive ovarian stromal invasion distinguishes a borderline tumor from an adenocarcinoma.

Front 44

Back 44

Ovary – Mucinous cystadenocarcinoma
This is a cut section of an ovarian cystic neoplasm. The cysts contain tan to gray-white gelatinous mucoid material. Histologically, the tumor was malignant.

Front 45

Back 45

Ovary – Mucinous cystic neoplasm (micro)
Mucinous neoplasms of the ovary are lined by cells which exhibit mucinous differentiation. These cystic structures are lined by columnar cells, which contain clear cytoplasm representing mucin. In benign mucinous tumors, the cysts are lined by a single layer of epithelial cells, in a borderline tumor (undetermined malignant potential), they are lined by multiple layers of epithelium with complex architecture (papillae, cribriform pattern, microvillous structures). In a carcinoma there is ovarian stromal invasion and cytologically the epithelial cells exhibit malignant features.

Front 46

Back 46

Ovary – Clear cell carcinoma
This is a high grade adenocarcinoma of the ovary (it may also occur in the endometrium, cervix and vagina). The tumor cells are large due to abundant optically clear cytoplasm. Nuclei exhibit hyperchromasia and pleomorphism, and are usually eccentric in location.

Front 47

Back 47

Ovary – Krukenberg tumors
Bilateral ovarian tumors (arrows) represented by tan, fleshy cerebriform masses which histologically are represented by signet ring carcinoma. These represent ovarian metastases from a ****gastric primary adenocarcinoma****.

Front 48

Back 48

Ovary – Krukenberg tumor (micro)
Sheets of signet rings are present (arrows). Signet rings are represented by large polyhedral cells with abundant mucinous to clear cytoplasm containing a peripherally displaced crescent-shaped, hyperchromatic nucleus. The cells contain intracytoplasmic mucin.

Front 49

Back 49

Ovary - Fibroma
A large chalky-white fibrous mass. This fibroma would be firm to rubbery on palpation.

Front 50

Back 50

Ovary – Fibroma
Endometrium – Endometrial polyp
The adnexal mass on the right (long arrows) represent a fibroma. It is a circumscribed white trabeculated mass reminiscent of a leiomyoma. The short arrow is pointing to an endometrial polyp which is a tan-velvety polypoid structure filling the endometrial cavity.

Front 51

Back 51

Ovary – Cystic teratoma (mature)
This sectioned cystic ovarian mass is filled with whitish greasy gruminous material containing hairs. Prior to sectioning, it would be doughy feeling when palpated.

Front 52

Back 52

Ovary – Cystic teratoma (mature)
This is a cystic mass containing numerous hairs and teeth (small arrow). The large arrow points to a nodule in the mass called Rokitansky’s nodule which contains all of the teratomatous elements.

Front 53

Back 53

Ovary – Mature cystic teratoma (dermoid cyst) - micro
This section of a cystic teratoma contains skin represented by epidermis (long arrow), sweat glands (short arrow), and sebaceous glands (bold arrow). There is also adipose tissue present. All elements are mature.

Front 54

Back 54

Ovary – Mature cystic teratoma
This section contains respiratory epithelium, mucinous and serous acini, and cartilage. All elements have mature features (non-fetal appearing tissue seen normally in adults).

Front 55

Back 55

Ovary – Mature cystic teratoma
This teratoma contained thyroid tissue. Tumors composed only of thyroid tissue are also known as struma ovarii.

Front 56

Back 56

Ovary – Mature cystic teratoma
This portion of Rokitansky’s nodule contains gastric type mucosa.

Front 57

Back 57

Ovary – Endometriotic cyst (chocolate cyst)
The ovary on your left has a large cystic mass filled with long standing blood clot which as the appearance of melted chocolate (arrow). This represents an area of cycling endometriosis, which repeatedly bleeds creating a “chocolate cyst”.

Front 58

Back 58

Ovary – Endometriotic cyst
This cyst has a green to brown colored appearance of the inner wall. This represents old hemorrhage and hemosiderin (iron) deposits in the wall of the cyst.

Front 59

Back 59

Ovary – Hemorrhagic corpus luteum cyst
Normally a corpus luteum develops after ovulation. Sometimes it can become large and cystic to the degree it may presently clinically as an ovarian mass. The center of the cyst is represented by blood clot (short arrow). The outer wall of the cyst in some areas (long arrow) contains a thin yellow ribbon of tissue which is sometimes convoluted appearing representing luteinized granulosa cells and thecal cells.

Front 60

Back 60

Ovarian Dermoid Cyst - CT image at level of mid pelvis demonstrates a rounded mass on the right. There is a fat-fluid level within this mass with a mixed density structure floating at the fat-fluid interface (“dermoid plug” or Rokitansky nodule). The wall of this mass is partially calcified.

Front 61

Back 61

Cystadenoma - Transvaginal ultrasound image demonstrates a multiseptated cystic mass within the pelvis.

Front 62

Back 62

Cystadenoma - CT image at the level of the lower pelvis demonstrates a multiseptated cystic mass posterior and to the left of the uterus displacing the uterus anteriorly and to the right.

Front 63

Back 63

Simple Ovarian Cyst - Transabdominal ultrasound image of the uterus and ovaries demonstrating a cyst of the right ovary..

Front 64

Back 64

Simple Ovarian Cyst - Transabdominal ultrasound of the right ovary demonstrates the ovarian mass to be well circumscribed and anechoic.

Front 65

Back 65

Ovary – Tubo-ovarian abscess
This is a large adnexal cystic mass filled white-creamy purulent material (pus) forming an abscess.

Front 66

Back 66

Fallopian tube - Hydrosalpinx
Sausage-shaped dilation of fallopian tube seen in chronic salpingitis. This structure has gross features of a benign peri-tubal cyst, however, it communicated with the lumen of the fallopian tube in a patient with chronic salpingitis.

Front 67

Back 67

Fallopian tube – chronic salpingitis
Numerous plasma cells (arrow) and lymphocytes are present within plicae of the fallopian tube. Plasma cells must be present before the diagnosis of chronic salpingitis can be made.

Front 68

Back 68

Fallopian tube: Ectopic pregnancy
This fallopian tube exhibits a red or hyperemic sausage shaped region of dilation representing a non-ruptured ectopic pregnancy.

Front 69

Back 69

Fallopian tube: Ectopic pregnancy
The fallopian tube has been opened. It is cystic and contains an inner shaggy-spongy, red to brown wall representing placental tissue surrounding a small fetus with umbilical cord. Finding an intact fetus in an ectopic pregnancy is unusual.

Front 70

Back 70

Fallopian tube: Ruptured ectopic pregnancy
Note the rupture site of this ectopic pregnancy. Rupture is the most serious complication of an ectopic pregnancy, which can result in life-threatening hemorrhage.

Front 71

Back 71

Fallopian tube - Endometriosis
The wall of the fallopian tube containing nest of endometrial stroma and glands (arrow).

Front 72

Back 72

Tubo-ovarian abcess - Irregularly shaped multilocular complex mass abutting uterus on left.

Front 73

Back 73

Tubo-ovarian abcess - Multilocular complex mass.

Front 74

Back 74

Tubo-ovarian abcess - Multilocular cystic mass abutting uterus on left with air-fluid levels within the mass.

Front 75

Back 75

Hydatidiform mole
This is tissue expelled from a women representing a hydatidiform mole. It is represented by a mass having the appearance of a “bunch of grapes”.

Front 76

Back 76

Transabdominal US demonstrating absence of intrauterine pregnancy.

Front 77

Back 77

Heterogeneous echogenic mass in right adnexal region.

Front 78

Back 78

Color Doppler image demonstrating high velocity flow around the adnexal mass reflecting the increased peritrophoblastic blood flow at the implantation site.

Front 79

Back 79

(Choriocarcinoma) - Transabdominal ultrasound demonstrates a very subtle area of decreased echogenicity in the fundus of uterus.

Front 80

Back 80

(Choriocarcinoma) - Color Doppler evaluation of uterus demonstrates a focal area of markedly increased blood flow reflecting increased peritrophoblastic flow in this patient with myometrial invasion by the choriocarcinoma.

Front 81

Back 81

(Choriocarcinoma) - Hypodense mass is present in the fundus of the uterus.

Front 82

Back 82

Lung Metastases from Choriocarcinoma - Multiple rounded masses are present within both lungs consistent with hematogenous spread of the choriocarcinoma.

Front 83

Back 83

Breast – Fibrocystic disease
This breast tissue contains increased white-gray fibrous tissue (short arrow) and
multiple small cysts, some of which have blue-gray color representing “blue-domed
cyst” (long arrow).

Front 84

Back 84

Breast – Fibrocystic disease
Ducts are cystically ectatic or dilated (small arrow) and they are separated by fibrous stroma (long arrow).

Front 85

Back 85

Breast – Intraductal papilloma
This breast biopsy contains a dilated duct (small arrow) which is filled with a light brown-gray papillomatous mass (long arrow). These usually presents clinically with a bloody nipple discharge.

Front 86

Back 86

Breast - Fibroadenoma
This is a spherical nodule which is circumscribed appearing. They are tan to gray in color and usually rubbery to soft when palpated.

Front 87

Back 87

Breast - Fibroadenoma
Round, circumscribed appearing nodular mass containing slit-like spaces which represent ductular structures in the tumor. The left side represents the cut surface, the right side represents the outer surface which appears circumscribed.

Front 88

Back 88

Breast – Infiltrating carcinoma
The tumor is represented by a stellate white hard mass (arrow). Sometimes pinpoint areas of yellow color representing necrosis of tumor (comedonecrosis) can be seen.

Front 89

Back 89

Breast – Infiltrating carcinoma
The tumor is represented by a light-gray to white irregular firm mass (small arrow). There are pinpoint areas of yellow discoloration representing comedonecrosis (long arrow).

Front 90

Back 90

Breast – Infiltrating carcinoma
This section contains skin and nipple. Deep to the nipple is a gray to light tan mass (long arrows) with pinpoint yellow colored areas (short arrow).

Front 91

Back 91

Breast – Paget’s disease of nipple and infiltrating carcinoma
The nipple on the left is centrally ulcerated. The breast tissue on the right contains an irregular gray-white mass (arrows) representing infiltrating carcinoma.

Front 92

Back 92

Breast – Paget’s disease of nipple
The epidermis contains numerous large pale cells containing cytologically malignant nuclei (arrows). The pale cytoplasm represents intracytoplasmic mucin.

Front 93

Back 93

Breast – Paget’s disease of nipple
The epidermis contains numerous large pale cells containing cytologically malignant nuclei (arrow). The pale cytoplasm represents intracytoplasmic mucin.

Front 94

Back 94

Breast – Ductal carcinoma in situ (CIS)
Dilated ducts (arrows) contain ductal cellular proliferations creating a cribriform pattern. The cribriform spaces or clear spaces have the appearance of being made with a cookie-puncher, creating round symmetrical clear spaces like cookies were removed. No invasive tumor is present.

Front 95

Back 95

Breast – Ductal carcinoma in situ (CIS)
This duct exhibits a cribriform pattern but it also contains a central area of necrosis (arrow) representing comedonecrosis. No invasive component is present.

Front 96

Back 96

Breast – Lobular carcinoma in situ (CIS)
Lobules are dilated and filled with a proliferation of bland monotonous appearing cells (arrows).

Front 97

Back 97

Breast – Infiltrating mammary carcinoma
Nests of small malignant epithelial cells infiltrating a dense desmoplastic stroma (the dense stroma is responding to the tumor).

Front 98

Back 98

Mammogram of Cyst - Rounded mass with well circumscribed borders.

Front 99

Back 99

Simple Cyst of Breast - Ovoid mass which is anechoic, has well circumscribed margin, and demonstrates increased through transmission of sound deep to the mass (tissue is brighter deep to the mass).

Front 100

Back 100

Infiltrating ductal carcinoma - Cranio-caudal view of right breast with BB marking a palpable lump (a second BB marks the nipple). Mammogram demonstrates an area of increased density with fine spiculations radiating from this mass at a corresponding location with subtle skin thickening also present.

Front 101

Back 101

Infiltrating ductal carcinoma - Medial-Lateral Oblique view of right breast demonstrating similar findings.

Front 102

Back 102

Ductal carcinoma in situ - Cranio-caudal view of right breast demonstrationg clustered microcalcifications of varying sizes and shapes.

Front 103

Back 103

Ductal carcinoma in situ - Medial-lateral view of right breast demonstrating similar findings.

Front 104

Back 104

Ductal carcinoma in situ - Magnification view of microcalcifications suggests that some of these may be vascular in origin but others appear to be nonvascular and following a linear course (within the ductal system).

Front 105

Back 105

Papilloma - Craniocaudal view of left breast demonstrates several coarse calcifications in a focal area of increased density.

Front 106

Back 106

Fibroadenoma - Cranio-caudal view of the right breast demonstrates a round mass with well circumscribed borders.

Front 107

Back 107

Acute and chronic prostatitis - Prostatic gland contains intralumenal neutrophils, leukocytes, plasma cells, and histiocytes. Perglandular stoma contains chronic inflammatory cells.

Front 108

Back 108

Prostate – Benign Prostatic Hyperplasia (BPH)
An enlarged prostate, which on cut section, is represented by gray-white fibrous nodules. The nodules tend to protrude on cut section. Cancer is usually represented by soft nodules, which may shrink and appear umbilicated on cut section. Cancer may also be yellow in color.

Front 109

Back 109

Prostate – Benign Prostatic Hyperplasia (BPH)
An enlarged prostate which on cut section, is represented by gray-white fibrous nodules. The nodules tend to protrude on cut section. Cancer is usually represented by soft nodules, which may shrink and appear umbilicated on cut section. Cancer may also be yellow in color.

Front 110

Back 110

Prostate – BPH (micro)
Arrows surround a hyperplastic stromal nodule. This nodule is represented by hyperplastic fibroblasts and/or smooth muscle.

Front 111

Back 111

Prostate – BPH (micro)
Hyperplastic glands in BPH. The glands are lined by hyperplastic epithelial cells forming papillary aggregates (arrow) which grow into the lumen of the gland.

Front 112

Back 112

Prostate - Adenocarcinoma
The prostate exhibits vague nodularity containing areas which are yellow in color (arrows).

Front 113

Back 113

Prostate – Adenocarcinoma and BPH
Prostatic tissue on the right has nodularity (short arrows) representing BPH. The tissue on the left also exhibits multiple microcystic areas (small arrows) representing BPH. Long arrows point to more solid white tissue within the capsule representing adenocarcinoma.

Front 114

Back 114

Prostate - Adenocarcinoma
Gray to white peripheral vague nodularity (arrows) represent adenocarcinoma. Note the central space representing the urethra and that the tumor is peripherally placed near the capsule. Most adenocarcinomas are peripherally located in the prostate.

Front 115

Back 115

Prostate - Adenocarcinoma
Benign glands are present on top (short arrows). The small glandular structure
contains nuclei with prominent nucleoli represent adenocarcinoma (long arrows). Adenocarcinoma of the prostate usually have prominent nucleoli.

Front 116

Back 116

Prostate – Well differentiated adenocarcinoma
This tumor is low grade (Gleason’s-2) and is represented by well formed glands separated by fibrous stroma. The glands have pushing non-infiltrating margins. It is easy to see evidence of glandular differentiation in well differentiated adenocarcinoma.

Front 117

Back 117

Prostate – Poorly differentiated adenocarcinoma
This tumor is high grade and is represented by small infiltrating malignant cells with little evidence of glandular differentiation (arrows). You do not see definitive glands here as you saw in the previous image representing well differentiated adenocarcinoma.

Front 118

Back 118

Prostate - Adenocarcinoma
Prostate adenocarcinoma tends to invade nerves. This is an example of prostatic adenocarcinoma (long arrow) invading a nerve (short arrow).

Front 119

Back 119

Prostate - Adenocarcinoma
Adenocarcinoma of the prostate tends to contain malignant glands which produce “blue mucin”. This is represented by intraluminal blue wispy amorphus material (arrow).

Front 120

Back 120

Prostate – High molecular weight cytokeratin
Benign and malignant glands
Benign glands have a 2-cell layer lining. Malignant glands lack the second cell lining benign glands. This second cell lining benign glands expresses high molecular weight cytokeratin. The brown staining glands in this image are benign glands containing the second cell, which expresses high molecular weight cytokeratin (long arrows). The malignant glands do not express high molecular weight cytokeratin (short arrows).

Front 121

Back 121

Prostate – High grade prostatic intraepithelial neoplasia (PIN)
High grade PIN has been associated with prostate adenocarcinoma. These ductular structures are lined by hyperplastic epithelial cells. Nuclei are hyperchromatic and contain prominent nucleoli, which are stratified. The basement membrane is intact.
This could also be called severe dysplasia of this ductular structure. It is considered
pre-malignant.

Front 122

Back 122

Scrotum – Condyloma acuminatum
The scrotal skin contains multiple tan to pigmented sessile, cauliflower, papillomatous lesions representing condyloma acuminata. Histologically, these condyloma are similar to the ones seen in females.

Front 123

Back 123

Testis - Seminoma
Nests of large polyhedral to round seminoma cells (short arrows), separated by delicate septa containing lymphocytic stroma (long arrows).

Front 124

Back 124

Testis – Embryonal carcinoma
Testicular mass with central areas of necrosis and hemorrhage (arrow). Seminoma tends to be solid, fleshy, gray-white and without large areas of hemorrhage and necrosis.

Front 125

Back 125

Hydrocele - transilluminated
This hydrocele sac has been trans-illuminated. The outer wall is thin and contains several dilated blood vessels. It would be fluctuant to palpation and when sectioned, it would reveal contents of straw to clear colored non-viscous fluid.

Front 126

Back 126

Hydrocele
This hydrocele sae has been sectioned. It contains a smooth inner glistening surface (arrow).

Front 127

Back 127

Spermatocele
Convoluted light gray glistening myxoid appearing cystic mass. Histologically spermatozoa would be found within this cyst.

Front 128

Back 128

Penis – Giant condyloma
Cut section of penis containing a large tan cauliflower mass.

Front 129

Back 129

Penis – Squamous cell carcinoma
This penis has been bisected longitudinally. It contains a white mass (arrow) which is arising in the distal urethra and is invading into the penis. Histologically it had features of a squamous cell carcinoma.