Vulva
Non-neoplastic
– Lichen sclerosus
-Lichen simplex chronicus
– Fibroepithelial stromal polyp
Neoplastic
– Low-grade Squamous Intraepithelial Lesion (LSIL, VIN1, Condyloma)
– High-grade Squamous Intraepithelial Lesion (HSIL, VIN2)
– High-grade Squamous Intraepithelial Lesion (HSIL, VIN3)
– Differentiated (simplex) Vulvar Intraepithelial Neoplasia (dVIN)
COMMENT: Differentiated VIN occurs in the setting of inflammatory vulvar disease (lichen sclerosis or lichen simplex chronicus) and confers an increased risk of vulvar squamous carcinoma; conservative excision and follow-up advised.
– Superficially invasive squamous cell carcinoma
– Invasive squamous cell carcinoma, ****-differentiated
Vagina
Benign
– Squamous mucosa, Negative for dysplasia
Neoplastic
– Low-grade Squamous Intraepithelial Lesion (LSIL, VAIN 1)
– High-grade Squamous Intraepithelial Lesion (HSIL, VAIN 2)
– High-grade Squamous Intraepithelial Lesion (HSIL, VAIN 3)
– Superficially invasive squamous cell carcinoma
Cervix
Benign
– Transformation zone mucosa, Negative for dysplasia
– Squamous mucosa, Negative for dysplasia
– Benign endocervical mucosa
– fragments of Benign endocervix
– Follicular cervicitis
– Benign endocervical polyp
– Squamous mucosa with parakeratosis, consistent with prolapse
Neoplastic
– Low-grade Squamous Intraepithelial Lesion (LSIL, CIN 1)
– High-grade Squamous Intraepithelial Lesion (HSIL, CIN 2)
– High-grade Squamous Intraepithelial Lesion (HSIL, CIN 3)
– Superficially invasive squamous cell carcinoma
– Invasive squamous cell carcinoma, ***-differentiated
– Endocervical Adenocarcinoma In Situ (AIS), HPV-associated
– Stratified Mucin-producing Intraepithelial Lesion (SMILE)
– Invasive endocervical adenocarcinoma, HPV-mediated (Usual type)
– Invasive endocervical gastric adenocarcinoma (HPV-independent)
– Invasive endocervical mucinous adenocarcinoma (HPV-mediated)
– Invasive endocervical clear cell carcinoma (HPV-independent)
– Invasive endocervical mesonephric carcinoma (HPV-independent)
Uterus
Endometrium
Benign
– Proliferative endometrium
– Early secretory endometrium
– Late secretory endometrium
– Secretory endometrium
– Menstrual endometrium
– Benign endometrial fragments with stromal breakdown
– Chronic endometritis
– Benign endometrium with changes consistent with exogenous hormone effect
– Disordered proliferative endometrium
– Benign endometrial polyp
– Fragments of mostly superficial, inactive endometrium (see comment)
COMMENT: The sections demonstrate scant fragments of mostly surface, inactive endometrium. There is not sufficient intact endometrium showing endometrial glands with stroma to evaluate for hyperplasia or carcinoma. Additional sampling is suggested if clinical concern persists.
Neoplastic
– Complex endometrial hyperplasia without atypia
– Complex atypical endometrial hyperplasia (Endometrial Intraepithelial Neoplasia, EIN)
– Atypical Polypoid Adenomyoma
– Complex mucinous endometrial proliferation (see comment)
COMMENT: The endometrial biopsy shows a proliferation of mucinous glands with somewhat complex architecture. Such proliferations are sometimes associated with associated carcinoma on hysterectomy. Consideration should be given to additional sampling, if clinically indicated.
– Complex atypical endometrial hyperplasia with areas bordering on well-differentiated endometrioid carcinoma
– Endometrial adenocarcinoma, Endometrioid-type, FIGO ***
– Serous carcinoma
– Clear cell carcinoma
– Carcinosarcoma
– Dedifferentiated endometrial carcinoma
– Undifferentiated carcinoma
– Adenosarcoma
– Mesonephric-like Adenocarcinoma
Myometrium
Benign
– Leiomyoma
– Leiomyomata
– Adenomyosis
– Adenomyoma
– Adenomatoid tumor
Neoplastic
– Smooth Muscle Tumor of Uncertain Malignant Potential (STUMP)
– Inflammatory myofibroblastic tumor (IMT)
– Low-grade endometrial stromal sarcoma
– High-grade endometrial stromal sarcoma
– Leiomyosarcoma
– NTRK-Rearranged Spindle Cell Neoplasm
Fallopian Tube
Benign
– Chronic salpingitis
– Peritubal adhesions
– Hydrosalpinx
– Endometriosis
– Paratubal cysts
Neoplastic
– Serous Tubal Intraepithelial Carcinoma (STIC)
– Serous carcinoma
Ovary
Benign
– Follicle cyst
– Cortical inclusion cysts
– Corpus luteum
– Endometriosis
– Hemorrhagic cyst (see comment)
COMMENT: Sections of the ovary demonstrate a benign hemorrhagic cyst with a denuded lining. The differential diagnosis includes an endometrioma or a hemorrhagic corpus luteum/albicans; the precise nature of the cyst cannot be determined due to lack of lining cells.
– Serous cystadenoma
– Serous cystadenofibroma
– Mucinous cystadenoma
– Serous cystadenoma with focal epithelial proliferation
Neoplastic
– High-grade serous carcinoma
– Low-grade serous carcinoma
– Clear cell carcinoma
– Endometrioid adenocarcinoma, FIGO grade ***
– Mucinous adenocarcinoma
– Serous borderline tumor
– Mucinous borderline tumor