—  SPECIALTY CONFERENCE HANDOUT  —

Gynecologic Pathology
 Sunday, March 18, 2012, 7:30 PM
Convention Centre Ballroom A/B




Clinical histories are printed below.
Click on the case numbers for text and references of each case.
Click on each slide thumbnail image for an enlarged view



Two Debates in Gynecologic Pathology
Moderator: RICHARD ZAINO
Hershey Medical Ctr
Hershey, PA
Disclosure: In accordance with ACCME guidelines regarding disclosure, the USCAP policy requires that faculty members who have a significant financial or other relationship with a commercial company, entity, or service (which will be discussed in this Symposium) must disclose this to attendees. The Academy also requires that speakers disclose any products that are not labeled for the use under discussion. The speakers listed below have indicated they have nothing to disclose.
Panelists:

Case #1 EIN is Superior to WHO in the Diagnosis and Management of Precursors of Endometrioid Adenocarcinoma
PRO: Marisa R. Nucci, Brigham & Women’s Hosp, Boston, MA
CON: Lora Hedrick Ellenson, New York Presbyterian Hosp, New York, NY

Case # 2 The Diagnosis of the Usual Complete or Partial Mole Requires an Immune and/or Molecular Workup Rather Than Just a Good H&E Stain and Some Experience
PRO: Brigitte M. Ronnett, Johns Hopkins Hospital, Baltimore, MD
CON: Janice M. Lage, Medical Univ of SC, Charleston, SC




Clinical histories are displayed below. For the fastest viewing of virtual slides, click:



under each thumbnail image below. You must have Aperio ImageScope installed on your PC.
If you do not already have Aperio ImageScope, Windows users with administrator privileges may download and install a free version in order to view USCAP Virtual Slides. Click the icon on the right to get your free copy:  
Or, click on slide thumbnail images to view each slide
in a Web-based slide viewer, which is somewhat slower.

If you have any difficulties viewing these slides, email or call George Clay at +1.724.449.1137.




Click here to download an introductory handout in 1-up pdf format

Click here to download an introductory handout in 6-up pdf format



Case 1 - Click here for Text and References

Submitted by: Marisa R. Nucci - Brigham & Women’s Hosp, Boston, MA

Clinical Summary:

59 year old with postmenopausal bleeding; endometrial sampling.


Case 1 - Figure 1
Case 1 - Figure 2
Case 1 - Figure 3

Case 1 - Figure 4
Case 1 - Figure 5
Case 1 - Figure 6




Case 2 - Click here for Text and References

Submitted by: Lora Hedrick Ellenson - New York Presbyterian Hosp, New York, NY

Clinical Summary:

Case A. 54 year old woman with postmenopausal bleeding

Case B. 34 year old woman with irregular bleeding

Case C. 40 year old woman with menometrorrhagia


Case 2A - Figure 1
Case 2A - Figure 2
Case 2A - Figure 3

Case 2B - Figure 1
Case 2B - Figure 2
Case 2B - Figure 3

Case 2C - Figure 1
Case 2C - Figure 2
Case 2C - Figure 3



Case 3 - Click here for Text and References


Submitted by: Brigitte M. Ronnett - Johns Hopkins Hospital, Baltimore, MD

Clinical Summary:

Case A: 34 year old; “R/O partial mole”.

Case B: 35 year old; Estimated gestational age = 6-7 weeks; β-HCG = 105,599 mIU/mL; Ultrasound: “multicystic mass filling endometrium, possible small abnormal gestational sac, suspicious for hydatidiform mole—could be partial”.

Case C: 49 year old; Incomplete abortion.

Case D: 19 year old; Recurrent missed abortions.

Case E: 41 year old; Rising quantitative β-HCG; Ultrasound: no evidence of fetal heart tones or definite fetal pole; R/O molar pregnancy.


Case 3A - Figure 1
Case 3A - Figure 2
Case 3A - Figure 3
Case 3B - Figure 1

Case 3B - Figure 2
Case 3B - Figure 3
Case 3C - Figure 1
Case 3C - Figure 2

Case 3C - Figure 3
Case 3D - Figure 1
Case 3D - Figure 2
Case 3D - Figure 3

Case 3E - Figure 1
Case 3E - Figure 2
Case 3E - Figure 3



Case 4 - Click here for Text and References


Submitted by: Janice M. Lage - Medical Univ of SC, Charleston, SC

Clinical Summary:

Case 1: 25-year-old woman presents with vaginal bleeding. Vaginal ultrasound of the uterine corpus shows intrauterine pregnancy with no fetal tissues. Uterine evacuation is performed.


Case 2: 32-year-old woman presents with vaginal bleeding. Vaginal ultrasound of the uterine corpus shows intrauterine pregnancy with no fetal tissues. Uterine evacuation is performed.

Pertinent Laboratory Data:

Case A: Pregnancy test is positive.

Case B: Pregnancy test is positive.


Case 4A - Figure 1
Case 4A - Figure 2
Case 4A - Figure 3
Case 4A - Figure 4

Case 4A - Figure 5
Case 4B - Figure 1
Case 4B - Figure 2
Case 4B - Figure 3

Complete hydatidiform mole Figure 1:
Cellular villous with trophoblast hyperplasia.
Complete hydatidiform mole Figure 2:
Stromal hypercellularity with karyorrhexsis
Complete hydatidiform mole Figure 3:
Cytotrophoblastic hyperplasia
Complete hydatidiform mole Figure 4:
Syncytio- and cytotrophoblastic hyperplasia

Complete hydatidiform mole Figure 5:
Syncytio- and cytotrophoblastic hyperplasia
Complete hydatidiform mole Figure 8:
Villous cavitation
Complete hydatidiform mole Figure 9:
Extravillous trophoblastic atypia
Complete hydatidiform mole Figure 10:
Extravilloous trophoblastic atypia, note size of red blood cell versus trophoblast nuclei.

Partial hydatidiform mole Figure 1:
Stromal trophoblastic inclusions
Partial hydatidiform mole Figure 2:
Stromal trophoblastic inclusion
Partial hydatidiform mole Figure 3:
Implantation site

Partial hydatidiform mole Figure 4:
Ki-67 immunohistochemical stain
Partial hydatidiform mole Figure 5:
Ki-67 immunohistochemical stain
Partial hydatidiform mole figure 6:
p57 immunostain positive in villous cytotrophoblast

Partial hydatidiform mole Figure 7:
Stromal trophoblastic inclusions
Partial hydatidiform mole Figure 9:
Two populations of villous sizes
Partial hydatidiform mole Figure 10:
Normal nonmolar implantation site


Handouts for all Specialty Conferences will be accessible via the "Educational Materials" section on the homepage the morning after each respective conference. Printed copies of the handout will not be available at the meeting.