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INDIANA ASSOCIATION OF PATHOLOGISTS


February 2020

A 67 y/o female with stage II pelvic organ prolapse

Contributors: 



Lan Zheng, MD, PhD

PGY2 

Department of Clinical Pathology & Laboratory Medicine

Indiana University School of Medicine




Sheila E. Segura, MD

Assistant Professor of Clinical Pathology & Laboratory Medicine

Indiana University School of Medicine


Clinical history: 

A 67 year-old female presented for surgery for stage II pelvic organ prolapse. She denied any symptoms including abdominal pain, dysuria or abnormal vaginal bleeding.

Gross Examination: The ectocervix is gray-tan, smooth, glistening to mostly granular. The os is slit like and probe patent with a length of 0.8 cm. The endocervix is gray-yellow, mucoid and glistening with the usual palmate folds.

Microscopic examination: 

Section from the cervix shows infiltrative nests of tumor cells arranged in a vague lobular configuration. Each nest is comprised of monomorphic, basaloid small cells with scant cytoplasm, round to oval nuclei and inconspicuous nucleoli. The cells palisade around the peripheral zones of the nests and occasional tubulo-glandular structures filled with eosinophilic secretions are identified. Focal squamous metaplasia and clear cell changes are present within the lesion. No desmoplastic stroma is seen.

For PC users, right click to open image in a new window, then zoom to enlarge.

Figure 1: Scanning magnification show infiltrative growth of haphazard cell nests without associated desmoplasia. (Hematoxylin & Eosin stain, original magnification X40) 

         Figure 1                

Figure 2: Small tubule-glandular structures with eosinophilic secretions in the lumen. The cells palisade around the peripheral zones of the nests. (Hematoxylin & Eosin stain, original magnification X100)


   Fig. 2

Figure 3: Cytologically, the tumor cells are small, monotonous with scant cytoplasm and regular, oval and basophilic nuclei without nucleoli or mitosis. (Hematoxylin & Eosin stain, original magnification X400)


 Fig. 3

February 2020 Final Diagnosis and Discussion


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