Index

Abortion, 785-789 Adenocarcinoma-Cant. gross examination of tissue from, 885-888 of vagina habitual, 788 clear cell, and prenatal exposure to DES, 99-105 induced, 788-789 relation to adenosis, 70, 71 missed, 788 of vulva, 50 spontaneous, 785-787 Adenofibroma in endometritis, 281 of cervix uteri, papillary, 151-152 threatened, 788 of ovary . Abruptio placentae, 779 benign, 523-525 Abscess malignant, 525 Bartholin, 26 of uterus, 371-373 ovarian, 442-443 Adenohypophysial-ovarian axis, 229-230 tubovarian, 442-443 Adenomatoid tumors mesothelioma of uterus, 385-386 Acatalasemia, prenatal diagnosis of, 807 of ovary, 553-554, 572 Acid phosphatase deficiency, lysosomal, prenatal diagnosis tubal, 407 of, 810 of cervix uteri, 152 Acrochordon of vulva, 30 Adenomyosis, 297-299 Actinomycosis, genital, 141 and carcinoma, 299 in IUD users, 293-294 Adenosarcoma oophoritis in, 445 of ovary, 538-539 salpingitis in, 402 of uterus, 373-376 Adenoacanthoma of ovary, 536 Adenosis, vaginal Adenocarcinoma atypical, from prenatal exposure to DES, 109-111 cervical, 200-207 from prenatal exposure to DES, 69-71, 105-108 cytologic diagnosis of, 854-855 Adenovirus infection, cytologic findings in, 849 in cervical polyp, 143-144 Adolescence, ovarian in, 665-700 clear cell, cytologic diagnosis of, 861 Adrenogenital syndrome, 10 in endometriosis of rectovaginal septum, 474-475 and female pseudohermaphroditism, 504-505 of endometrium, 330-333 and male pseudohermaphroditism, 504 of ovary, 532-538, 554 prenatal diagnosis of, 807 cytologic diagnosis of, 860 Age tubal and endometrial secretions, 247 cytologic diagnosis of, 860 ovarian changes with, 437-440 invasive, 409-410 Albinism, vulva in, 34

917 918 Index

Alkylating agents, cytologic changes from, 858-859 Animal tumor models-Cant. Amebiasis, ulceronecrotic, cervical, 140 induction of, 902-905 Amenorrhea, 232 from intrauterine devices, 904 secondary, from oral contraceptives, 291 from radiation, 905 in Stein-Leventhal syndrome, 460 spontaneous, 901-902 vaginal smears in, 865 from viruses, 905 Amniocentesis, 806 vaginal, 905-908 early, 807 vulval, 905-908 time-dependent factors in, 805 Anomalies Amnion, 769 of uterus, 10-11 meconium-stained,769-770 of vagina, 71-72 nodosum, 770 of vulva, 15-16 rupture of, 769 arAntitrypsin, in endodermal sinus tumor of ovary, 621 Amnionitis, 770 Apocrine glands of vulva, 14 Amniotic fluid, 769 Arborization of cervical mucus, 124 biochemical assays of, 804-816 Arcuate arteries, 237 creatine phosphokinase levels in fetal death, 806-807 Argininosuccinic aciduria, prenatal diagnosis of, 807 in erythroblastosis fetalis, 812 Argyrophil cell carcinoma of endometrium, 335-336 for fetal lung maturity, 813-816 Arias-Stella phenomenon, 112-114 and fetal maturity estimation, 812-813 differential diagnosis of, 206, 283 a-fetoprotein levels in neural tube defects, 811 in ectopic pregnancy, 767 indications for, 804-805 Arrhenoblastoma of ovary, in childhood, 693 lecithin: sphingomyelin ratio in, 813-815 Arteritis of cervix, 142 obtaining specimens for, 806 Ascariasis, gynecologic smears in, 849 predelivery, 812-813 Asherman syndrome, 294-295 and prenatal diagnosis of fetal disorders, 807-811 infertility in, 832-833 time-dependent factors in, 805-806 Aspiration embolism of, 773 endometrial, 866 Anaplasia, pink cell, endometrial, 264 for ovarian cytology, 716-739 Androblastomas of ovary, 590-597 accuracy of, 747-750 Androgens in benign cystomas, 743-744 actions during menstrual cycle, 227 in carcinomas, 744-745 ovarian synthesis of, 226 and cells from normal organs, 742-743 and tumor induction in animals, 896-897, 906 corpus luteum in, 724-725, 726-729 Anemia, hemolytic, and of ovary, 635 diagnosis with, 747-749 of vulva, 28 in endometriosis, 725, 730-732, 743 follicle in, 716-724 of ovary, 565 in germ cell tumors, 745-746 of vulva, 50 in metastatic tumors, 746-747 Animal tumor models, 891-909 in sex cord-stromal tumors, 745 and animals as hosts for human tumors, 908 in soft tissue tumors, 746 cervical, 905-908 stroma in, 725, 738-739 , 900-901 surface epithelium in, 725, 733-737 ovarian, 891-901 technique of, 741-742 from bright illumination, 896 in , 746 from chemical carcinogens, 898-899 in tumors, 741-750 from genetic selection, 894 typing of tumors with, 749-750 from hormone exposure, 896-897 of posterior fornix, 866 induction of, 894-899 Auspitz sign, in psoriasis, 25 from intrasplenic grafting to castrates, 895-896 Autosomal chromosomal aberrations, 498-499 from mutant genes, 894-895 from radiation, 897-898 spontaneous, 891-893 Barr bodies, 484 from transplantation, 895 Bartholin glands, 13, 14 from vasoligation, 895 cysts of, 26 relevance to human disease, 908-909 malignancies of, 50 teratomas and yolk-sac tumors, 899-900 Basal cell(s), in gynecologic smears, 839-840 uterine, 901-905 Basal cell nevus syndrome, in, 589 from chemical carcinogens, 903-904 Behc;et's syndrome, genital ulcers in, 24 from hormone imbalance, 902-903 Benzo[a]pyrene, and tumor induction in animals, 904, 906 Index 919

Berger's tumor of ovary, in childhood, 691-693 Carcinoma-Cant. Bilharziasis. See Schistosomiasis embryonal, 612, 618, 622-624, 670-672 Biopsy endometrioid, 532-538 and aspiration cytology of ovaries. See Aspiration, for of low malignant potential, 515-517, 528-529 ovarian cytology vitalline, 672 cervical, 182-183 yolk-sac, 672-673 of vulva, 52 and Paget's disease of vulva, 44-45 Blastomycosis, endometritis in, 283 transformation from genital condylomata, 17 Bleeding tubal, in situ, 408-409 dysfunctional uterine, 285-288 urethral, 51 in normal menstrual cycle, 286 of vagina vaginal, in , 192-193, 200 basal cell-like, 84 Bone, in endometrial stromal cells, 268, 305 in infancy, 84-85 Botryoid sarcoma. See Sarcoma, botryoid in situ, and dysplasia, 81-84 Breast squamous cell, 78-80 accessory tissue in vulva, 30 of vulva cancer metastasis to ovaries, 710 in situ, 40-42 Brenner tumors squamous cell, invasive, 45-48 of ovary, 547-553 Carcinosarcoma benign, 547-551 of ovary, 539-540 malignant, 552-553 tubal,410 proliferating, 551-552 Cartilage, in endometrial stromal cells, 268, 305 of uterus, 303 Caruncles, urethral, 51 Broad ligament Cervical mucus, 124 adrenal rests in, 411 abnormalities in secretion of, and infertility, 834 embryology of, 6-7 ferning of, 124 wolffian adenoma of, 411 in pregnancy, 133 Bromocriptine, and tumor induction in animals, 903 Cervicitis Buccal smear, for sex chromatin determination, 484 acute, nonspecific, 136-137 Burkitt's lymphoma of ovary, 573, 695 chronic, nonspecific, 137 Busulfan, cytologic changes from, 858 tuberculous, 140 Cervicovaginitis, emphysematous, 141 Cervix uteri Call-Exner bodies, 433, 583, 716 abnormalities of, and infertility, 834-835 Call-Exner-like bodies, in gonadoblastoma, 649-650 actinomycosis of, 141 Calymmatobacterium granulomatis infection, 21-22 adenocarcinoma of, 200-207 Candida infection clear cell, and prenatal exposure to DES, 99-105 cervical, 136 cytologic diagnosis of, 854-855 endometritis in, 283 diagnosis of, 200 gynecologic smears in, 846 differential diagnosis of, 206 of vagina, 66-67 etiology and pathogenesis of, 200-201 of vulva, 23 gross morphology of, 201 Carbo wax 1000, and tumor induction in animals, 907 incidence of, 200 Carcinoembryonic antigen microscopic morphology and ultrastructure of, 201- in cervical adenocarcinoma, 206 206 in endodernal sinus tumor of ovary, 621 modes of spread, 206 in endometrial carcinoma, 341 prognosis of, 206 Carcinogens, chemical, and tumor induction in animals, symptoms and signs of, 200 898-899, 903-904, 906-907 treatment of, 207 Carcinoid tumors adenofibroma of, papillary, 151-152 of cervix, 210 adenoid cystic carcinoma of, 210 of ovary, 639-643 adenomyoma of, 152 Carcinoma adenosquamous carcinoma of, 208 cervical. See Cervix uteri argyrophil cell carcinoma of, 213 endometrial, 311-347 atypia of repair, 137-138 cytologic diagnosis of, 859-860 biopsy specimens, processing of, 869 metastatic to ovary, 705-715 carcinoid tumors of, 210 of ovary carcinoma in situ, 156-175 aspiration cytology of, 744-745 cytologic diagnosis of, 851-852 clear cell, 542-547 cervicovaginitis emphysematosa, 141 920 Index

Cervix uteri-Cont. Cervix uteri-Cont. colposcopy of, 178-179 metastatic disease of, 218-219 columnar epithelium of, 123-126 micro glandular hyperplasia of, 144-146 condylomatous lesions of, 148-151 in pregnancy, 133 cytologic findings in, 848-849 from prenatal exposure to DES, 111-112 giant condylomata acuminata of Bushke and Lowen­ microinvasive carcinoma of, 184-190 stein, 150, 200 characteristics of, 184-186 conization biopsy of, 183, 869-871 diagnosis of, 186 curettage, endocervical, 183 histology of, 187-189 processing of curettings from, 869 incidence of, 186 cytologic examination of, 182 symptoms and signs of, 186 dysplasia of, 156-175 treatment of, 189-190 ectropion of, 126 morphology and physiology of, 120-126 from prenatal exposure to DES, 108 mucoepidermoid carcinoma of, 210 endometriosis of, 152-154 multiple carcinoma of, 213-214 entropion of, 127 neural tissue in, 146-147 fibroadenoma of, 152 occult invasive carcinoma of, 190-191 glassy cell carcinoma of, 208-210 papilloma of children, mesonephric, 152 gross anatomy of, 119-120 parasitic infections of, 140-141 changes from prenatal exposure to DES, 106 polyps of, 142-144 of, 147-148 adenocarcinomatous changes in, 143-144 herpeslike lesions of, 141-142 decidual, 143 in herpesvirus infection, 139 fibrous, 142 heterotopic structures of, 134 mixed, 143 hyperkeratosis or parakeratosis of, 138 mucosal, 142 inclusion cysts of, epithelial, 146 vascular, 142 inflammatory diseases of, 136-142 in pregnancy and puerperium, 132-134 intraepithelial neoplasia of, 156-175 pseudotumors of, 142-147 characteristics of, 156-162 punch biopsy of, 182 cryocautery in, 173 radiation affecting, 214-216 cytologic diagnosis of, 849-852 sarcomas of, 217-218 differential diagnosis of, 168 distribution of, 171-172 Schiller test of, 179-181 epidemiology of, 162-163 schistosomiasis of, 141 etiology of, 163-165 smears from, 865 laser therapy in, 174 squamocolumnar junction of, 125, 132 management of, 172-175 pregnancy affecting, 134 microscopic morphology of, 165-168 squamous epithelium of, 120-123 origin of, 168-171 squamous metaplasia from prenatal exposure to DES, invasive of, 191-199 108 of cervical stump, 199 subcolumnar reserve cells of, 130-131 clinical stages of, 193 in carcinoma, 207-213 cytologic diagnosis of, 852-854 transformation zone of, 126-132 diagnosis of, 178-183, 193 histogenetic mechanisms in development of, 129-130 differential diagnosis of, 196 and origin of subcolumnar reserve cells, 130-131 gross morphology of, 193 tumors of incidence of, 191-192 animal models for, 905-908 microscopic morphology of, 194-195 benign, 147-154 modes of spread, 196-197 gross examination of, 872-873 pathogenesis of, 192 malignant, 184-219 precursors of, 156-175 verrucous carcinoma of, 200 in pregnancy, 199-200 differential diagnosis of, 200 prognosis of, 198-199 vestigial structures of, 134 symptoms and signs of, 192-193 Chancre, syphilitic, 19 treatment of, 197-198 cervix in, 140 ultrastructure of, 195-196 Chancroid, 22-23 leiomyoma of, 147 cervix in, 140 vascular, 147 Chediak-Higashi syndrome, prenatal diagnosis of, 807 lymphomas of, 217-218 Chemical carcinogens, and tumor induction in animals, of, 216-217 898-899, 903-904, 906-907 Index 921

Chemotherapy, cytologic changes from, 858-859 Clitoris, 13, 14 Chiari-Frommel syndrome, vaginal smears in, 865 developmental defects in, 15 Childhood. See also Neonates embryology of, 9 ovarian neoplasms in, 665-700 lymphatic drainage from, 15 vaginal smears in, 863 Cloacal folds, 8 Chlamydia infections Clomiphene citrate, endometrial pathology from, 291-292 cervical, 136-137 Clostridium welchii infections, endometritis in, 280 lymphogranuloma venereum, 22 Coccidioidomycosis, endometritis in, 283 salpingitis, 398 Coelomic epithelium, 2-3 Chocolate cysts of ovary, 531 metaplasia of, and ovarian endometriosis, 531 Chondroma of ovary, 569 ovarian neoplasms of, in childhood, 684-688 Chondrosarcoma of ovary, 569-570 Colposcopy, 178-179 Chorangioma,780-781 correlation with histology, 181 Chorangiosis, 781 normal and abnormal findings in, 180 Chorioadenoma destruens, 796 Condylomata Choriocarcinoma, 797-802 acuminata, 16-18 animal models of, 900-901 and carcinoma development, 17 behavior of, 799 giant, of Bushke and Lowenstein, 150, 200 disseminated, 799-800 and podophyllin effect, 17-18, 150 of endometrium, 336 of cervix uteri, 148-151 focal, 800 cytologic findings in, 848-849 and hydatidiform mole, 791, 799 lata, 19 metastasis to vagina, 94 Conization biopsy, cervical, 183, 869-871 of ovary, 625-627 Contraception treatment of, 802 intrauterine devices in, 292-294 tubal, 411 endometritis from, 282 Chorioepithelioma, atypical, 299 pathology from, 292-294 Chorion frondosum, 756 pelvic infections from, 293 Chorionic gonadotropin. See Gonadotropin, chorionic salpingitis from, 398 Chorionic villi and tumor induction in animals, 904 hydropic, 786 oral agents in sclerotic, 786 breakthrough bleeding from, 291 Chorionitis, 770 carcinogenic effect of, 291, 339 Chromatin endometrial pathology from, 288-291 in endometrial cells, 255 and tumor induction in animals, 896, 903 euchromatin, 255 tubal procedures in, 406 heterochromatin, 255 Corona radiata, ovarian, 433 sex, 484-487 Corpora albicantia, 426, 437 Chromosomes. See also Karyotypes cyst of, 454, 698 autosomal abnormalities, 498-499 in polycystic ovary, 459 deletions in, 484, 496-498 Corpora cavernosa, 14 isochromosome, 484, 496 Corpus fibrosum, 434 mosaicism of, 483-484, 494-496 Corpus luteum, 224-225, 434-437 sex chromosome disorders, 480-488 aspiration cytology of, 724-725, 726-729 and sex differentiation, 4, 479 cysts of, 451-454 and sexual abnormalities, 10 in childhood, 698 translocations of, 498 inadequate luteal phase, 287 Ciliated cells and infertility, 833 in endometrium, 257, 314 in luteinized unruptured follicle syndrome, 831 hyperplasia of, 263 Cotyledons, placental, 756 in fallopian tubes, 394, 396 Creatine phosphokinase in amniotic fluid, in fetal death, Citrulline mia, prenatal diagnosis of, 807 806-807 Clear cell metaplasia, endometrial, 265-266 Crohn's disease Clear cell tumors genital ulcers in, 25 adenocarcinoma salpingitis in, 402 cytologic diagnosis of, 861 Cryosurgery of endometrium, 335 in cervical intraepithelial neoplasia, 173 of ovary, 542-547 cytologic changes from, 858 leiomyoma of uterus, 358 Cryptococcosis, endometritis in, 283 922 Index

Curettage Cytology of female genital tract-Cant. and Asherman syndrome, 294-295 erythrocytes in, 841 endocervical, 183, 869 in folic acid or vitamin B12 deficiency, 858 endometrial, 868-869 in herpes simplex infections, 847-848 Cylindroma of cervix, 210 histiocytes in, 840-841 Cyst hormonal, 861-866 corpus albicans, 454, 698 in amenorrheas, 865 corpus luteum, 451-454 at birth and in childhood, 863 in childhood, 698 in endocrinopathies, 865 dermoid, of ovary, 632-636 in menopause, 864-865 aspiration cytology of, 746 in menstrual cycle, 864 in childhood, 678-684 numerical indices in, 862-863 of ovary, 449-462 in pregnancy, 865 chocolate, 531 premenarchial, 863 dermoid, 632-636 progestogens affecting, 865 epidermoid, 645 inflammatory exudate in, 842 follicular, 697-698, 718 intermediate cells in, 838 theca-lutein, 718, 723-724 changes in, 843 tubal, 412 laser therapy affecting, 859 inclusion, 406 leukocytes in, 841 of vagina, 72-73 normal components of smear in, 838-842 of vulva, 26-28 ovarian. See Aspiration cytology of ovaries of ovary in ovarian adenocarcinoma, 860 mucinous, 529-531 parabasal cells in, 838 serous, 517 posterior fornix aspiration in, 866 benign, 520-523 radiation affecting, 856-858 Cystadenoma of ovary spermatozoa in, 841 mucinous in squamous carcinoma of cervix, invasive, 852-854 benign, 525-528 in squamous metaplasia, 844 borderline, 528-529 superficial cells in, 838-839 in childhood, 688 in trichomoniasis, 846 serous in tubal adenocarcinoma, 860 benign, 512-515 vaginal smear in, 866 in childhood, 685-688 in vaginal squamous cell carcinoma, 861 Cystathioninuria, prenatal diagnosis of, 807 in vulvar epidermoid carcinoma, 861 Cystic fibrosis, prenatal diagnosis of, 807 Cytogenetics, and sex chromosome disorders, 480-484 Cystinosis, prenatal diagnosis of, 808 Cytomegalovirus infection Cystoma, parvilocular, of ovary, 542 cytologic findings in, 849 Cytology of female genital tract, 838-866 endometritis in, 283 in adenocarcinoma of cervix, 854-855 oophoritis in, 446-447 alkylating agents affecting, 858-859 Cytotrophoblast cells, 753-754 basal cells in, 839-840 in choriocarcinoma, 626, 797 in candidiasis, 846 in cervical intraepithelial neoplasia, 849-852 mild dysplasia in, 850-851 Darier's disease, vulva in, 25 moderate dysplasia in, 851 Dermatophytes of vulva, 23 severe dysplasia in, 851-852 Dermoid cyst of ovary, 632-636 cervical smears in, 182, 865 aspiration cytology of, 746 in clear cell adenocarcinoma, 861 in childhood, 678-684 in condylomata of cervix, 848-849 Diethylstilbestrol contaminants of smears in, 841-842 prenatal exposure to, 99-117 cryosurgery affecting, 858 atypical vaginal adenosis from, 109-111 diethylstilbestrol exposure affecting, 869 and clear cell adenocarcinoma of vagina or cervix, endocervical cells in, 840 99-105 changes in, 843 cytologic changes from, 109, 859 endometrial aspiration in, 866 and ectropion and squamous metaplasia in cervix, 108 in endometrial carcinoma, 859-860 and frequency of changes in vagina and cervix, 108- endometrial cells in, 840 109 epithelial cells in, 838-840 and gross structural changes of vagina and cervix, 105 changes in, 843 microglandular hyperplasia from, 111-112 Index 923

Diethylstilbestrol-Cont. Endodermal sinus tumor of ovary, 542, 612-622 uterine changes from, 114-116 in childhood, 672-673 and vaginal adenosis, 69-71, 105-108 Endometrial cells, in gynecologic smears, 840 and tumor induction in animals, 896, 902 Endometrioid tumors of ovary, 531-542 Diverticula Endometrioma of vulva, 33-34 suburethral, 51 Endometriosis, 464-477 tubal, and ectopic pregnancy, 762 of cervix uteri, 152-154 DMBA, and tumor induction in animals, 898-899, 904, diagnosis of, 468 907 gastrointestinal, 475-477 DMNU, and tumor induction in animals, 907 incidence of, 465 Donovan bodies, in granuloma inguinale, 21-22 infertility in, 467-468, 835 Dopamine, as prolactin inhibitory factor, 229, 231 ovarian, 468-472, 531-532 Drug-induced lesions of endometrium, 288-292 aspiration cytology of, 725, 730-732, 743 Duct system, development of, 5-8 endometrioid carcinoma with, 472-474, 533 in female, 6-8 pathogenesis of, 465 indifferent stage in, 5-6 in rectovaginal septum, 477 in male, 6 adenocarcinoma in, 474-475 Duval sinuses, 616 sites of, 464-465 Dysfunctional uterine bleeding symptoms of, 465-468 anovulatory cycles in, 286-287 tubal, 404 irregular shedding in, 287-288 Endometritis, 279-284 Dysgenesis, gonadal, 490-50l. See also Gonadal dysgenesis acute, 279-280 of ovary, 495, 603-612 clinicopathologic correlation in, 279-280 aspiration cytology of, 745 pathology of, 279 in childhood, 668-670 chronic gonadoblastoma with, 609, 612, 647, 650 clinicopathologic correlations in, 280-282 in endometriosis, 465 nonspecific, 280-282 Dysplasia pathology of, 280 of cervix uteri, 156-175 specific, 282-284 postirradiation, 215-216 granulomatous, from foreign bodies, 284 vaginal, 114 infertility in, 832 and carcinoma in situ, 81-84 in malacoplakia, 284 Dystrophic conditions of vulva, 35-40 mycotic, 283 parasitic, 283 pneumopolycystic, 283 Eccrine sweat glands of vulva, 14 salpingitis with, 282 Echinococcosis in sarcoidosis, 283 cervical, 140 tuberculous, 282-283 endometritis in, 283 Endometrium, 253-276 Eclampsia of pregnancy, 779 abnormalities of, and infertility, 832-834 Ectopic pregnancy, 761-767 adenocarcinoma of Ectropion, cervical, 126 clear-cell, 335 from prenatal exposure to DES, 108 metastases to vagina, 94 Edema of ovaries, massive, 589-590 mucinous, 335 in childhood, 698-700 with neuroendocrine granules, 335-336 Embolism of amniotic fluid, 773 with squamous differentiation, 331-333 Embryology, 1-9 typical, 330-331 duct development in, 5-8 in adenomyosis, 297-299 external genitalia in, 8-9 in anovulatory cycles, 286-287 and factors affecting gonad differentiation, 4-5 in Asherman syndrome, 294-295 gonadal primordia in, 2-4 aspiration techniques, 866 hormones affecting, 9 benign diseases of, 279-305 primordial germ cells in, 1-2 blood supply of, 237-239 and sexual abnormalities, 9-11 carcinoma of, 311-347 Embryoma of ovary, polyembryonic, 624 after oral contraceptives, 291, 339 of ovary, 622-624 after polyps, 297 in childhood, 670-672 argyrophil cell, 335-336 Emphysematous cervicovaginitis, 141 cytologic diagnosis of, 859-860 Emphysematous vaginitis, 67, 284 estrogens related to, 339-340 Endocervical cells, in gynecologic smears, 840 hyperplasia linked to, 341-342 924 Index

Endometrium-Cant. Endometrium-Cant. in situ, 330 macrophages in, 269 metastasis from, 342-343, 705 at menopause, 247-248 progestin therapy of, 344-345 metaplasia of, epithelial, 262-267, 313-315 radiation in, 345-347 clear cell, 265-266 squamous, 333-334 eosinophilic, 264 in Stein-Leventhal syndrome, 461 hobnail, 266 treatment of, 343-347 mucinous, 264-265, 315 typical, 330-331 papillary, 263-264 ultrastructural features of, 320-322 squamous, 266-267, 313-315 undifferentiated, 336 tubal or ciliated, 262-263, 313 cell physiology of, 270-276 morphological variations in, 262-270 changes in menstrual cycle, 225, 239-240, 260, 285 morule formation in, 267, 313 in postovulatory phase, 241-247 neoplasia of, 311-347 in preovulatory phase, 240-241 classification of, 322-323 choriocarcinoma of, 336 clinical features of, 336-339 ciliated cells of, 257, 314 epithelial changes in, 312-316 hyperplasia of, 263 epithelial-stromal relationships in, 317-319 curettings from, processing of, 868-869 estrogen and progesterone receptors in, 340 degenerating decidual tissue in, 270 estrogens related to, 339-340 development of, 235-237 gross examination of, 873 drug-induced lesions of, 288-292 gross pathology of, 311 clomiphene citrate, 291-292 microscopic pathology of, 311-319 estrogens, 288, 339 oncofetal protein tumor markers in, 340-341 oral contraceptives, 288-291 and polycystic ovarian disease, 337-338 progestins, 291 stroma in, 316-317 in dysfunctional uterine bleeding, 285-288 ultrastructural features of, 319-322 in ectopic pregnancy, 767 nonreactive glands in, 268 ectopic sites of, 464-465. See also Endometriosis physical-induced lesions in, 292-295 enzyme activity in, 270-276 pink cell anaplasia of, 264 estrogen receptors in, 240 in placental site trophoblastic tumor, 299-303 in hyperplasia and carcinoma, 340 polyps of, 296-297 progesterone affecting, 276, 285 and carcinoma development, 297 foam cells in, 269, 316 progesterone receptors in hyperplasia and carcinoma, gland-in-gland appearance of, 268 340 glandular epithelium of, 248-255 proliferative phase of, 258 chromatin in, 254-255 prostaglandins in, 276, 292 giant mitochondria of, 252 radiation affecting, 295 glycogen accumulation in, 252-254 secretions in, 243-245 postovulatory, 252-255 age affecting, 247 preovulatory, 245-252 secretory phase of, 258-262 granulocytes in, 245-247 steroid hormone action on, 274-276, 284-285 heterotopic tissues in stroma, 268-269, 303-305 stromal cells in, 255-257 bone, 268, 305 stromal nodules in, 376-377 cartilage, 268, 305 stromal sarcomas of, 377-382 glia, 268, 305 clinical aspects of, 378 smooth muscle, 268, 305 high-grade, 379 hyperplasia of, 311-347 low-grade, 378-379 adenomatous, 326 microscopic appearance and ultrastructure of, 379- atypical, 319, 329-330 381 and carcinoma development, 341-342 treatment and prognosis of, 381-382 mild, 324-326 stromal tumors of, 376-384 moderate, 326-329 resembling ovarian sex cord tumors, 382-384 treatment of, 343 variants of, 382-384 ultrastructural features of, 319 stromal variations in, 269-270 inflammations of, 279-284 stromomyoma of, 384 intrauterine devices affecting, 292-294 ultrastructure of, 248-262 in luteal phase deficiency, 287 scanning electron microscopy of, 257-262 lymphatics of, 239 venous drainage of, 239 lymphoid tissue in, 270 Endosalpingiosis, 405, 472 Index 925

Entamoeba histolytica infection Fallopian tubes-Cont. gynecologic smears in, 849 hydrosalpinx of, 398-401 vaginitis in, 68 intercalary or peg cells in, 394 Enterobius vermicularis infestation, 24. See also Pinworms intussusception of, 404 Entropion, cervical, 127 lymphatics of, 393 Enzyme activity in endometrium, 270-276 lymphomas of, 411 Eosinophilic metaplasia, endometrial, 264 mesodermal tumors of Epidermoid cyst of ovary, 645 benign, 407 Epithelial cells, in gynecologic smears, 838-840 mixed,4lO-411 Epithelial-stromal neoplasms of ovary, in childhood, 684- mesothelioma of, 407-408 688 metaplasia of, 395 Epithelial tumors of ovary, 511-556 nerve supply of, 393-394 Epithelioma, pfliigerien, 652 ovum transport through, 396, 752 Erythrasma of vulva, 23-24 paratubal cysts and tumors, 411-412 Erythroblastoma fetalis, 780 physiology of, 396-397 amniotic fluid in, 812 pregnancy in, 761-766 Erythrocytes, in gynecologic smears, 841 prolapse of, 404 Estrogens psammoma bodies in, 295 actions during menstrual cycle, 227 salpingitis of, 397-404 endometrial pathology from, 288 sarcomas of, 4lO-411 endometrial receptors for, 240 secretory cells in, 394 progesterone affecting, 276, 285 teratomas of, benign, 408 feedback loops involving, 230-232 torsion of, 404 gonadoblastoma production of, 651 trophoblastic tumors of, 411 in granulosa cell tumors of ovary, 582 tumors of and hormonal cytology, 861-866 benign, 406-408 ovarian secretion of, 225, 433 malignant, 408-411 relation to endometrial neoplasia, 339-340 Farber's disease, prenatal diagnosis of, 808 synthesis and metabolism of, 226 Farre-Waldeyer line, 418 and tumor induction in animals, 896, 902, 905-906 Feminization, testicular, 501-503 urinary, in Krukenberg tumors, 711 incomplete syndrome of, 503 Euchromatin, in endometrial cells, 255 vaginal smears in, 865 Ferning of cervical mucus, 124 Fabry's disease, prenatal diagnosis of, 808 Fertilization of ovum, 752 Fallopian tubes a -F etoprotein abscess of, tubovarian, 442-443 in endodermal sinus tumors of ovary, 613, 617, 619- adenocarcinoma of 621 cytologic diagnosis of, 860 in endometrial carcinoma, 341 invasive, 409-4lO Fetal disorders, prenatal diagnosis by amniocentesis, 807- adnexal wolffian adenoma of, 411-412 811 adrenal rests in, 411 Fetal lung maturity, estimation of, 813-816 anatomy of, 393-394 Fetal maturity estimation, and amniotic fluid assay, 812- blood supply of, 393 813 and causes of infertility, 405-406, 832 Fetus in fetu, differential diagnosis of, 634-635 carcinoma of Fibroadenoma of cervix uteri, 152 in situ, 408-409 Fibroma invasive, 409-4lO of ovary, 562, 588-590 carcinosarcomas of, 410 of vulva, 29 choriocarcinoma of, 411 Fibrosarcoma ciliated cells in, 394, 396 of ovary, 562-563 contraceptive procedures in, 406 of vulva, 50 cysts of, 412 Foam cells, endometrial, 269, 316 inclusion, 406 Folic acid deficiency, cytologic changes in, 868 diverticula of, and ectopic pregnancy, 762 Follicle(s), ovarian, 431-434 endometriosis of, 404 aspiration cytology of, 716-724 endosalpingiosis of, 405 atresia of, 433-434 epithelial tumors of, benign, 406 cysts of, 451, 718 gross examination of, 874 in childhood, 697-698 histology of, 394-396 unruptured, luteinized, and infertility, 831 926 Index

Follicle-stimulating hormone, 224 Gonadal dysgenesis-Cant. deficiency of, and infertility, 829 and structural aberrations in X chromosome, 496-498 levels during menstrual cycle, 229-230 vaginal smears in, 865 releasing hormone, 229 Gonadal primordia, 2-4 Foreign bodies Gonadoblastoma of ovary, 495, 646-652 cervicitis from, 136 dysgerminoma with, 609, 612, 647, 650 endometritis from, granulomatous, 284 Gonadotropins, 229-230 salpingitis from, 402 deficiency of, and infertility, 828-829 Fornices, vaginal, 59 human chorionic Fox-Fordyce disease, 28 in choriocarcinoma, 799 FTA-ABS test in syphilis, 20 in endometrial carcinoma, 341 Fucosidosis, prenatal diagnosis of, 808 in endodermal sinus tumor of ovary, 621 Fungus infections in hydatidiform mole, 795 endometritis, 283 releasing hormone, 229 of vulva, 23 resistant ovary syndrome, infertility in, 829-830 and tumor induction in animals, 897 Gonocytoma, 603, 646 Galactosemia, prenatal diagnosis of, 808 in childhood, 668 Gametogenesis, 223 Gonocytoma II, 652 Ganglioneuroma of ovary, 571 Gonorrhea Gangliosidoses, prenatal diagnosis of, 808 cervical, 136 Gartner's duct, cysts of, 8, 72-73 endometritis in, 280 Gastrointestinal tract oophoritis in, 442 endometriosis of, 475-477 salpingitis in, 397 tumor metastasis to ovaries, 705-709 vaginitis in, 65 Gaucher's disease, prenatal diagnosis of, 808 Graafian follicles. See Follicle(s), ovarian Genetic sex differentiation, abnormal, 480-488 Granular cell tumor of vagina, 77-78 Genital swellings, 9 Granulocytes, endometrial, 245-247 Genitalia, external, 13 Granuloma ambiguous, and sex differentiation disorders, 479-506 inguinale, 21-22 embryology of, 8-9 cervix in, 140 Germ cell(s), primordial, 1-2 pyogenic, of vulva, 28 migratory ability of, 2 Germ cell tumors of ovary, 602-656 Granulomatous conditions aspiration cytology of, 745-746 endometritis from foreign bodies, 284 in childhood and adolescence, 668-684 oophoritis, chronic, 443-446 Germinal epithelium, 2-3 salpingitis, 401-403 Germinal spot, 433 Granulosa cell, luteinized. See Lutein cells Germinal vesicle, 433 Granulosa cell tumors of ovary, 582-587 Germinoma of ovary, 603 aspiration cytology of, 745 in childhood, 668-670 in childhood, 688-691 Glial tissue in endometrium, 268, 305 differential diagnosis of, 641 Glioma ovarii, 683 theca cells in, 584-586 Gliomatosis, peritoneal, teratomas with, 678 aspiration cytology of, 745 Glucose 6-phosphate dehydrogenase deficiency, prenatal in childhood, 693 diagnosis of, 809 vaginal smears in, 865 Glycogen storage diseases, prenatal diagnosis of, 809 Gross examination of specimens, 868-889 Gonad(s) abortion tissue, 885-888 differentiation of, 3-4 from coned cervix, 869-871 factors affecting, 4-5 from endocervical curettings, 869 indifferent, 2 from endometrial curettings, 868-869 Gonadal dysgenesis, 490-501 equipment for, 868, 888 and autosomal abnormalities, 498-499 fallopian tube, 874 and dysgerminoma of ovary, 669 from hydatid mole evacuation, 869 and gonadoblastoma, 646-652 and injection apparatus to study fetal vessels, 888-889 infertility in, 829 ovary, 874-875 mixed,500 , 877-885 monosomy X, 490-494 processing for transmission electron microscopy, 868 mosaicism for, 494-496 umbilical cord, 882-883 pure, 499-500 uterus, 871-874 Index 927

Gross examination of specimens-Cont. Hydatidiform mole, 791-796 vagina, 875-877 and choriocarcinoma, 791, 799 vulva, 877 complete, 793 Growth hormone, pituitary, and tumor induction in ani­ complications of, 795 mals,903 incidence of, 794 Gynandroblastoma of ovary, 597-598 partial, 793 pathogenesis of, 792-793 Haemophilus ducreyi infection, 22-23 tissue from evacuation of, 869 cervix in, 140 Hydramnios,769 Haemophilus vagina lis vaginitis, 65-66 Hydropic villi, placental, 786 Hailey-Hailey disease, vulva in, 25 Hydrosalpinx, 398-401 17-Hydroxylase deficiency, infertility in, 831-832 of ovary, 565 Hymen, 13 of uterus, 387 Hyperammonemia, prenatal diagnosis of, 809 Hemangioma Hyperglycinemia, ketotic, prenatal diagnosis of, 810 of cervix uteri, 147-148 Hyperkeratosis, cervical, 138 of ovary, 564-565 Hyperlysinemia, prenatal diagnosis of, 809 tubal,407 Hyperplasia of endometrium, 311-347 of uterus, 386 Hyperreactio luteinalis, in hydatidiform mole, 795 of vulva, 28 Hyperthecosis, ovarian, 459 Hypospadias, pseudovaginal perineoscrotal, 503 of uterus, 386-387 Hypothalamo-adenohypophysial axis, 228-229 of vulva, 29 feedback in, 230-232 of ovary, 565 and infertility, 828-829 Hemolytic anemia, and teratoma of ovary, 635 Hysterectomy, and carcinoma of cervical stump, 199 Hemorrhagic infarct of ovary, massive, 700 Hermaphroditism, 488-490 Herpeslike lesions, cervical, 141-142 I cell disease, prenatal diagnosis of, 809 Herpes simplex infection Ichthyosis uteri, 266-267, 333 cervical, 139 Immunologic factors in infertility endometritis in, 283 antibodies to ovarian steroids, 830-831 gynecologic smears in, 847-848 antibodies to sperm, 834-835 and tumor induction in animals, 907-908 antibodies to zona pellucida, 831 vulvitis in, 18-19 Implantation of ovum, 753 Heterochromatin, in endometrial cells, 255 abnormal sites of, 760-767 Hidradenitis suppurativa, vulva in, 25 Infarct Hidradenoma of vulva of ovary, massive hemorrhagic, 700 clear cell, 32 of placenta, 776-778 papillary, 30-32 Infertility, 828-835 Hirsutism, in Stein-Leventhal syndrome, 460 anovulatory, 828-832 Histiocytoma of vulva, 29-30 and antisperm antibodies, 834-835 Hobnail metaplasia, endometrial, 266 anti-steroid antibodies in, 830-831 Hodgkin's disease anti-zona pellucida antibodies in, 831 of ovary, 576-577 in Asherman syndrome, 832-833 of uterus, 387 cervical factors in, 834-835 Hofbauer cells, 758 classification of, 828 Homocystinuria, prenatal diagnosis of, 809 endometrial factors in, 832-834 Hormones in endometriosis, 467-468, 835 adenohypophysial, 224 in gonadotropin deficiency, 828-829 in cytology, 861-866 in 17-hydroxylase deficiency, 831-832 ovarian, 223-233 hypothalamic-pituitary factors in, 828-829 and sex differentiation, 9 in luteal phase insufficiency, 833 and sexual abnormalities, 9-10 in luteinized unruptured follicle syndrome, 831 and tumor induction in animals, 896-897, 902-903, 905- myometrial factors in, 834 906 ovarian factors in, 829-831 Hunter's syndrome, prenatal diagnosis of, 809 ovulatory, 832-835 Hurler's syndrome, prenatal diagnosis of, 809 in polycystic ovary syndrome, 831 Hydatid cysts in pseudocorpus luteum insufficiency, 833-834 cervical, 140 in salpingitis, 832 of Morgagni, paramesonephric, 412 tubal factors in, 405-406, 832 928 Index

Inflammatory diseases Lentigo simplex, of vulva, 34 cervical, 442-447 Leprosy, salpingitis in, 402 of ovary, 136-142 Lesch-Nyhan syndrome, prenatal diagnosis of, 810 of vulva, 24-26 Leukemia, ovarian involvement in, 577-578 Intermediate cells, in gynecologic smears, 838 Leukocytes, in gynecologic smears, 841 Intestinal endometriosis, 475-477 Leukoderma of vulva, 34 Intrauterine devices. See Contraception, intrauterine de- Leukodystrophy vices in globoid cell, prenatal diagnosis of, 810 Intussusception, tubal, 404 metachromatic, prenatal diagnosis of, 810 Isochromosomes, 484, 496 Leydig cell(s) in gonadoblastoma, 649, 651 Isoleucine catabolism disorders, prenatal diagnosis of, 809 Leydig cell tumors of ovary, 593-596 IUD users. See Contraception, intrauterine devices in in childhood, 691-693 Lice, pubic, 24 Lichen sclerosus, 37-39 Kallman's syndrome, 829 Lipomas Karyorrhexis of nuclei, 843 tubal, 407 Karyotype analysis, 480-481 of vulva, 29 in abortions, 785 Listeriosis, placentitis in, 782 in gonadal dysgenesis, 490-501 Luteal phase in menstrual cycle, 224-225 in gonadoblastoma, 647, 652 deficiency in, 287 in hydatidiform mole, 793 and infertility, 833 in ovarian teratomas, 628 Lutein cells, 434-437, 724-725 Keratoacanthoma of vulva, 33 cysts of, 454 Keratosis in childhood, 697--698 follicularis, vulva in, 25 and hydatidiform mole, 795 seborrheic, of vulva, 33 in ovarian epithelial tumors, 554-556 Ketotic hyperglycinemia, prenatal diagnosis of, 810 Lutein-like cells, in gonadoblastoma, 649, 651 Koebner phenomenon, in psoriasis, 25 Luteinizing hormone, 224 Krabbe's disease, prenatal diagnosis of, 810 deficiency of, and infertility, 829 of ovary, 705-709 releasing hormone, 229 aspiration cytology of, 747 surge in menstrual cycle, 229-230 differential diagnosis of, 641 of ovary, 565-567 virilism in, 711 of ovary, 567 Lymphatics of fallopian tubes, 393 Labia majora and minora, 13 and metastases to ovary, 710-711 embryology of, 9 ovarian, 418 Lactosyl ceramidosis, prenatal diagnosis of, 810 of uterus, 239 Laser therapy of vagina, 64-65 in cervical intraepithelial neoplasia, 174 of vulva and clitoris, 15 cytologic changes from, 859 Lymphogranuloma venereum, 22 Lecithin:sphingomyelin ratio, and fetal lung maturity, cervix in, 140 813-815 Lymphomas Leiomyoblastoma of uterus, 358 cervical, 217-218 Leiomyoma of ovary, 573-577 of cervix uteri, 147 in childhood, 695 myometrial, and infertility, 834 tubal, 411 of ovary, 563 of uterus, 387 aspiration cytology of, 746 Lysosomal acid phosphatase deficiency, prenatal diagnosis tubal, 407 of, 810 of uterus, 353-358 of vagina, 73 of vulva, 29 Macrophages, in endometrium, 269 Leiomyomatosis of uterus, intravenous, 361-362 Malacoplakia, genital, 284 Mannosidosis, prenatal diagnosis of, 810 cervical, 217 Maple syrup urine disease, prenatal diagnosis of, 810 of ovary, 563-564 Marfan's syndrome, prenatal diagnosis of, 810 of uterus, 362-364 Maroteaux-Lamy syndrome, prenatal diagnosis of, 810 of vagina, 86 Masculinization. See Virilization of vulva, 50 Meconium, 769-770 Index 929

Meigs syndrome, ovarian fibroma in, 588 Mites, scabies from, 24 Meiosis, 481-483 Mitosis, stages in, 481 and nondisjunction, 483 and nondisjunction, 483 Melanoma Molar pregnancy, 791-797 cervical, 216-217 Molluscum contagiosum, 21 of vagina, 85-86 Moniliasis. See Candida infection of vulva, 48-49 Morquio syndrome, prenatal diagnosis of, 811 Melanotic of ovary, 645 Morule formation in endometrium, 267, 313 Melatonin, 232 Mosaicism, sex chromosome, 483-484, 494-496 Membranes, placental, 769-773 Mucinous metaplasia, endometrial, 264-265, 315 Menarche, 223, 237 Mucinous tumors Menopause adenocarcinoma of endometrium, 335 endometrium in, 247-248 of ovary, 525-531, 645 ovary in, 440 in childhood, 688 surface cells of, 423-424 Mucous cysts of vulva, 27 premature, infertility in, 830 Mucous membrane, vaginal, 59-63 vaginal smears in, 864-865 Mucus, cervical, 124 Menstrual cycle abnormalities in secretion of, and infertility, 834 abnormalities in, 232-233 in pregnancy, 133 anovulatory cycles in, 286-287 Mullerian duct, 5-6 dating system for, 239 abnormal development of, 506 duration of, 223-224 Mullerian tumors of ovary and dysfunctional uterine bleeding, 285-288 mixed, 538-542 endometrial changes in, 225, 239-240, 260, 285 sarcoma, 694 follicular phase in, 224 Mumps, oophoritis in, 442 irregular shedding in, 287-288 Munro abscess, in psoriasis, 25 luteal phase in, 224-225 Muscle, smooth, in endometrial stromal cells, 268, 305 deficiency in, 287, 833 Mycobacterium tuberculosis infection. See Tuberculosis ovarian changes in, 224-225 Mycoplasma hominis infection, salpingitis in, 398 postovulatory phase of, 241-247 Mycotic infections. See Fungus infections preovulatory phase of, 240-241 Myeloma, multiple, ovarian involvement in, 578-579 regulation of, 228-232 Myoblastoma, granular tubal epithelium in, 396 of vagina, 77-78 vaginal smears in, 864 of vulva, 29 Mesenchymal tumors Myometrium of ovary, 561-572 in adenomyosis, 297-299 of uterus, 352-387 hypertrophy of, 385 Mesoblastoma vitellinum, 612 leiomyomas of, and infertility, 834 Mesodermal mixed tumors of ovary, 538-542 Myxoma of ovary, 571-572 Mesonephric duct, 5. See also Wolffian duct Mesonephroma of ovary, 612 Mesothelioma Neisseria gonococcus infections. See Gonorrhea tubal, 407-408 Neonates of uterus, adenomatoid, 385-386 ovary in, 437-438 Mesovarium, 416 uterus in, 235-237 Metaplasia vaginal smears in, 863 of endometrium, epithelial, 262-267, 313-315 Neural tube defects, and a-fetoprotein in amniotic fluid, of fallopian tubes, 395 811 of ovarian surface cells, 424 Neurilemmoma of ovary, 571 squamous, gynecologic smears in, 844 Neurofibroma Metastases of ovary, 571 to cervix uteri, 218-219 of vagina, 73 to ovary, 705-715 of vulva, 30 aspiration cytology of, 746-747 N eurofibrosarcoma to vulva, 50 of ovary, 571 3-Methylcholanthrene, and tumor induction in animals, of vulva, 50 903-904, 906-907 Nevus Methylmalonic aciduria, prenatal diagnosis of, 810 basal cell nevus syndrome, ovarian fibroma in, 589 Metropathia hemorrhagica, 233 of vulva, 34 Michaelis-Gutman bodies, in malacoplakia, 284 vasculosis, 28 930 Index

Niemann-Pick disease, prenatal diagnosis of, 811 Ovary-Cont. Nodules, endometrial stromal, 376-377 embryonal carcinoma, 670--672 Nuck canal, cysts of, 28 endodermal sinus tumors, 672--673 Nucieopyknosis, 843 etiologic factors in, 666--667 follicular and lutein cysts, 697--698 frequency of histogenetic categories of, 667 Oligohydramnios, 769 germ cell tumors, 668--684 Oogenesis, 223 germinoma, 668--670 Oophoritis granulosa cell tumor, 688--691 in actinomycosis, 445 granulosa-theca cell tumor, 693 acute, 442 immature teratoma, 674--678 chronic granulomatous, 443-446 incidence of, 665 in cytomegalovirus infection, 446-447 Leydig cell tumor, 691--693 in pinworms, 445 lymphoma, 695 sarcoid, 445 massive hemorrhagic infarct, 700 in schistosomiasis, 445-446 mature teratomas, 678--684 tuberculous, 443-445 mesenchymal tumors, 693--695 Ornithine-a-ketoacid transaminase deficiency, prenatal di- mucinous neoplasms, 688 agnosis of all, 811 and paraneoplastic syndrome, 666 Orotic aciduria, prenatal diagnosis of, 811 sarcomas, 693--695 Osteoma of ovary, 570 sclerosing stromal tumor, 691 Osteosarcoma of ovary, 570-571 serous tumors, 685--688 Ovarian artery, 416 Sertoli cell tumors, 691 Ovarian vein, 418 Sertoli-Leydig cell tumor, 693 Ovary sex cord-sex mesenchyme tumors, 688--693 accessory, 416 teratocarcinoma, 673--674 adenoacanthoma of, 536 , 691 adenocarcinoma of, 532-538, 554 chondroma of, 569 cytologic diagnosis of, 860 chondrosarcoma of, 569-570 adenofibroma of choriocarcinoma of, 625--627 benign serous, 523-525 behavior and prognosis of, 627 malignant, 525 in childhood, 673 adenohypophysial-ovarian axis, 229-230 clinical aspects of, 626 of, 553-554, 572 adenosarcoma of, 538-539 incidence of, 626 in adolescence, 438 microscopic appearance of, 626--627 age affecting, 437-440 treatment of, 627 anatomy of, 416-418 clear cell carcinoma of, 542-547 aspiration cytology of, 716-739. See also Aspiration, for aspiration cytology of, 744 ovarian cytology corpus luteum of, 224-225, 434-437. See also Corpus Berger's tumor in childhood, 691--693 luteum blood supply of, 416-418 cortex of, 424-430 Brenner tumors of, 547-553 cyst(s) of, 449-462 benign, 547-551 chocolate, 531 malignant, 552-553 corpus luteum, 451-454 proliferating, 551-552 endometrial, 468 carcinoid tumors of, 639--643 epidermoid, 645 insular or islet, 639-642 follicular, 451, 718 and , 643--645 inclusion, 450-451 trabecular, 642-643 of pregnancy and puerperium, 457 carcinoma of low malignant potential serous, 449-450 mucinous, 528-529 theca-lutein, 456-457, 718, 723-724 serous, 515-517 cystadenocarcinoma of carcinosarcoma of, 539-540 mucinous, 529-531 changes in menstrual cycle, 224-225 serous, 517 childhood neoplasms of, 665-700 cystadenofibroma of, benign serous, 520-523 choriocarcinoma, 673 cystadenoma of classification of, 667 benign mucinous, 525-528 clinical manifestations of, 666 benign serous, 512-515 coelomic epithelial neoplasms, 684-688 borderline, mucinous, 528-529 Index 931

Ovary-Cant. Ovary-Cant. dermoid cyst of, 632-636 endometriosis of, 468-472, 531-532 aspiration cytology of, 746 aspiration cytology of, 725, 730-732, 743 in childhood, 678-684 and endometrioid carcinoma, 472-474, 533 complications of, 635 epithelial tumors of, 511-556 hemolytic anemia with, 635 aspiration cytology of, 743-744 infection of, 635 in childhood, 684-688 macroscopic appearance of, 632-633 enzymatically active stromal cells in, 556 malignant transformation of, 636 luteinized cells in, 554-556 microscopic appearance of, 633-635 fibromas of, 562, 588-590 rupture of, 635 fibrosarcoma of, 562-563 torsion of, 635 follicle structure in, 431-434. See also Follicle(s), ovarian treatment of, 635 follicular cysts of, 451, 718 dysgerminoma of, 495, 603-612 in childhood, 697-698 aspiration cytology of, 745 ganglioneuroma of, 571 association with other tumors, 608-609 germ cell tumors of, 602-656 behavior of, 609-610 in childhood and adolescence, 668-684 in childhood, 668-670 classification of, 602-603 clinical aspects of, 604 glioma ovarii, 683 endocrine aspects of, 611 gonadal dysgenesis, 490-501 genetic aspects of, 611-612 gonadoblastoma of, 646-652 gonadoblastoma with, 609, 612, 647, 650 clinical aspects of, 647 histogenesis of, 603 dysgerminoma with, 647, 650 incidence of, 603-604 endocrine aspects of, 651 macroscopic appearance of, 604-605 familial aspects of, 652 microscopic appearance of, 605-609 genetic aspects of, 651-652 prognosis of, 610 macroscopic appearance of, 647-648 treatment of, 610-611 microscopic appearance of, 648-650 ectopic, 416 treatment of, 651 edema of, massive, 589-590 granulosa cell tumors of, 582-587 in childhood, 698-700 aspiration cytology of, 745 embryology of, 3-4 in childhood, 688-691 embryonal carcinoma of, 612, 622-624 theca cells in, 584-586, 693 behavior and prognosis of, 623-624 vaginal smears in, 865 in childhood, 670-672 gross examination of, 874-875 differential diagnosis of, 618 gynandroblastoma of, 597-598 with lymphoid stroma, 603 hemangioma of, 564-565 microscopic appearance of, 622-623 hemangiosarcoma of, 565 treatment of, 624 hemorrhagic infarct of, massive, 700 endodermal sinus tumor of, 542, 612-622 hilar cells of, 431 alveolar-glandular or cystic pattern of, 616-617 histology and histochemistry of, 41&-423 behavior of, 619 hormones of, 225-228 in childhood, 672-673 actions of, 227 clinical aspects of, 613 androgens, 226 differential diagnosis of, 618-619 antibodies to, and infertility, 830--831 a-fetoprotein in, 613, 617, 619-621 estrogens, 225, 433 histogenesis of, 612-613 feedback loops involving, 230-232 incidence of, 613 mechanism of action, 227-228 macroscopic appearance of, 613 progestogens, 225 microcystic pattern of, 614 receptors for, 227 microscopic appearance of, 613-618 synthesis and metabolism of, 225-227 perivascular formations in, 614-616 hyperthecosis of, 459 polyvesicular vitelline pattern of, 617 inflammatory diseases of, 442-447 prognosis of, 619 Krukenberg tumors of, 705-709 solid cellular pattern of, 616 aspiration cytology of, 747 treatment of, 619 virilism in, 711 endometrioid carcinoma of, 532-538 leiomyoma of, 563 aspiration cytology of, 744 aspiration cytology of, 746 differential diagnosis of, 597 leiomyosarcoma of, 563-564 and endometriosis, 472-474, 533 in leukemia, 577-578 932 Index

Ovary-Cant. Ovary-Cant. Leydig cell tumor of, 593-596 parovarian tumors and cysts, 412 in childhood, 691-693 parvilocular cystoma of, 542 lutein cysts of, 454 pheochromocytoma of, 571 in childhood, 697-698 in plasma cell dyscrasias, 578-579 and hydatidiform mole, 795 polycystic, 457-462 lymphangioma of, 565-567 endocrine abnormalities in, 461 lymphangiosarcoma of, 567 and endometrial neoplasia, 337-338 lymphatics of, 418 estrinism with, 460 lymphomas of, 572-577 etiology of, 461-462 Burkitt, 573, 695 infertility in, 831 in childhood, 695 in Stein-Leventhal syndrome, 460-461 in disseminated disease, 577 vaginal smears in, 865 extranodal, 573-576 polyembryoma of, 624-625 Hodgkin, 576-577 microscopic appearance of, 624-625 medulla of, 430-431 pregnancy in, 766-767 melanotic neoplasm of, 645 pregnancy affecting, 437 in menopause, 440 progesterone synthesis in, 225, 435 mesenchymal tumors of, 561-572 prolactin affecting, 230 of adipose tissue origin, 571 in reproductive period, 438-440 of bone origin, 570-571 rhabdomyosarcoma of, 567-569 of cartilage origin, 569-570 sarcoma of in childhood, 693-695 in childhood, 693-695 of fibrous tissue origin, 562-563 Mullerian, 694 of neural tissue origin, 571 stromal, 694-695 of smooth muscle origin, 563-564 teratoid, 694 of striated muscle origin, 567-569 undifferentiated, 572 of vascular origin, 564-567 sclerosing stromal tumors of, 590 mesodermal (Mullerian) mixed tumors of, 538-542 in childhood, 691 heterologous, 540-542 sebaceous gland tumor of, 645 homologous, 539-540 serous tumors of, 512-525 metastatic carcinoma in, 705-715 aspiration cytology of, 743-744 aspiration cytology of, 746-747 benign, 512-515, 520-525 from breast, 710 of borderline malignancy, 515-517 endometrial, 705 in childhood, 685-688 hormonal activity of, 711-715 malignant, 517-520, 525 Krukenberg tumors, 705-709 Sertoli cell tumors in childhood, 691 pathways of spread in, 710-711 Sertoli-Leydig cell tumors of, 590-597, 693 mixed germ cell-sex cord stroma tumor of, 652-656 in childhood, 693 clinical aspects of, 652-653 sex cord-sex mesenchyme tumors in childhood, 688-693 endocrine aspects of, 656 sex cord-stromal tumors of, 581-599 genetic aspects of, 656 aspiration cytology of, 745 microscopic appearance of, 653-656 with annular tubules, 598-599 prognosis and treatment of, 656 aspiration cytology of, 725, 738-739 mixed germ cell tumors of, 645-652 struma ovarii, 636-639 malignant, 673-674 and carcinoid, 643-645 mucinous tumors of, 525-531, 645 in childhood, 683 aspiration cytology of, 743-744 malignant change in, 639 benign, 525-528 supernumerary, 416 of borderline malignancy, 528-529 surface epithelium of, 419-424 in childhood, 688 aspiration cytology of, 725, 733-737 malignant, 529-531 histochemistry of cells in, 422-423 myxoma of, 571-572 in menopause, 423-424 neonatal, 437-438 metaplasia of, 424 nerve supply of, 418 ovulation affecting, 423 neurilemmoma of, 571 in pregnancy, 423 neurofibroma of, 517 tumors of, 511-556 neurofibrosarcoma of, 571 teratocarcinoma in childhood, 673-674 osteoma of, 570 teratoma of, 627-645 osteosarcoma of, 570-571 aspiration cytology of, 746 Index 933

Ovary-Cant. Phallus, development of, 9 classification of, 627-628 Phenotypic sex differentiation, 479-480 with embryoid bodies, 624 abnormal,501-506 histogenesis of, 628 Pheochromocytoma of ovary, 571 immature, 628-630, 674-678 Phosphohexose isomerase deficiency, prenatal diagnosis of, malignant, 673-674 811 mature cystic, 632-636, 678-684. See also Ovary, der- Picket cells, endocervical, 124 moid cyst of in gynecologic smears, 839 mucinous, 645 Pigmentation disorders of vulva, 34-35 solid mature, 630-632 Pineal gland, and gonadal function, 232 and struma ovarii, 636-639 Pink cell anaplasia, endometrial, 264 thecoma of, 587-588 Pinworms, 24 aspiration cytology of, 745 endometritis in, 283 in childhood, 691 gynecologic smears in, 849 tumors of oophoritis in, 445 animal models for, 891-90l salpingitis in, 402 infertility in, 832 Pituitary unclassified, 590, 598-599 adenohypophysial-ovarian axis, 229-230 Ovulation, 224 adenoma of, prolactin-secreting, 829 and anovulatory infertility, 828-832 hypothalamo-adenohypophysial axis, 228-229 and mitochondrial ultrastructure, 252 feedback in, 230-232 morphologic evidence for, 241 and infertility, 828-829 ovarian surface epithelium in, 423 Placenta and tubal transport of ovum, 396, 752 abnormal architecture of, 773-776 Ovum abruption of, 779 fertilization of, 752 accreta, 760-761 follicle cells surrounding, 433 chorangioma of, 780-781 implantation of, 753 chorangiosis of, 781 abnormal sites of, 760-767 circummarginate and circumvallate, 775-776 tubal transport of, 396, 752 cotyledons of, 756 Oxyphil metaplasia, endometrial, 264 in erythroblastosis fetalis, 780 gross examination of, 877-885 increta, 761 Paget's disease of vulva, 42-45 infarction of, 776-778 Papillary metaplasia, endometrial, 263-264 membranacea, 774-775 Papillary tumors percreta, 761 adenofibroma of cervix uteri, 151-152 previa, 760 hidradenoma of vulva, 30-32 succenturiate or accessory lobes of, 773-774 Papilloma in toxemia of pregnancy, 779-780 cervical, of children, mesonephric, 152 twin, 770-773 tubal, epithelial, 406 dichorionic, 772-773 of vulva, squamous, 32 gross description of, 883-885 Parabasal cells, in gynecologic smears, 838 monoamnionic, 772 Parakeratosis, cervical, 138 monochorionic, 771-772 Paralutein cells, 436 weight of, 756 Parasitic infections Placental membranes, 769-773 cervical, 140-141 Placental site trophoblastic tumor, 299-303 endometritis in, 283 Placentation, 753-759 of placenta, 782 and involution of placental site, 759 vaginitis in, 68 Placentitis, 781-783 of vulva, 24 Plasma cells, in endometritis, 280 Parvilocular cystoma of ovary, 542 Plasmacytoma, ovarian involvement in, 578-579 Pelvic infections, in IUD users, 293 Pneumopolycystic endometritis, 284 Pemphigus Podophyllin-treated condylomata acuminata familial benign, vulva in, 25 epithelial changes from, 17-18 vulgaris, cervical, 141-142 overdiagnosis of, 150 Penis, embryology of, 9 Polyembryoma of ovary, 624-625 Peritoneal gliomatosis, teratomas with, 678 Polyps Pfliigerome, 652 cervical, 142-144 PH, vaginal, 59 endometrial, 296-297 934 Index

Polyps-Cant. Psammoma bodies-Cant. tubal, 406 in serous cystadenoma of ovary, benign, 515 of vagina, fibroepithelial, 73 in tubal epithelium, 395 Porphyria, erythropoietic congenital, prenatal diagnosis of, Pseudohermaphrodites, 10 808 female, 504-506 Precocity, sexual, in granulosa cell tumors of ovary, 582, male, 501-504 688 and adrenal hyperplasia, 504 Preeclampsia of pregnancy, 779 with normal virilization at puberty, 503 Pregnancy and pseudovaginal perineoscrotal hypospadias, 503 aborted, 785-789 Pseudomyxoma peritonei, 527 cervical carcinoma in, 199-200 Pseudotumor of uterus, trophoblastic, 299 cervix uteri in, 132-134 Psoriasis, vulva in, 25-26 choriocarcinoma in, 797-802 Pudendal arteries, 15 corpus luteum in, 725, 729 Puerperium ectopic, 761-767 cervix uteri in, 132-134 endometrium in, 767 ovarian cyst in, 457 etiology of, 761-763 Punch biopsy, cervical, 182 in myometrium, 763 Pyruvate decarboxylase deficiency, prenatal diagnosis of, ovarian, 766-767 811 pathology of, 763-766 tubal, 761-766 and fertilization of ovum, 752 Radial arteries, 238 high-risk factors in, 804-805 Radiation molar, 791-797 cervical morphology after, 214-216 ovary in, 437 cytologic changes from, 856-858 cyst of, 457 in endometrial carcinoma, 345-347 surface cells in, 423 endometrial changes from, 295 placentation in, 753-759 and tumor induction in animals, 897-898, 905 toxemia of, 779-780 Rectovaginal septum, endometriosis of, 477 trophoblast disease in, 791-802 adenocarcinoma in, 474-475 twin, 770-773 Refsum's disease, prenatal diagnosis of, 811 and gross description of placenta, 883-885 Relaxin, 245 umbilical cord in, 767-769 Respiratory distress syndrome, pulmonary surfactant in, vaginal smears in, 865 813 Primordia, gonadal, 2-4 Rhabdomyoma of vagina, 73-76 Primordial germ cells, 1-2 Rhabdomyosarcoma Progesterone of ovary, 567-569 actions during menstrual cycle, 227 of vagina, embryonal, 87-90 endometrial receptors for, in hyperplasia and carci- of vulva, 50 noma, 340 Rokitansky-Kiister-Houser syndrome, 11, 506 and estrogen receptors in endometrium, 276, 285 Rokitansky protuberance, in dermoid cyst of ovary, 633, feedback loops involving, 230-232 679 ovarian synthesis of, 225, 226, 435 RPR test, in syphilis, 20 Progestogens Rubella, placental lesions in, 782 affecting vaginal smear, 865 Rupture of dermoid cyst of ovary, 635 endometrial pathology from, 291 as therapy in endometrial carcinoma, 344-345 and tumor induction in animals, 896, 903, 906 Salpingitis, 397-404 Prolactin in actinomycosis, 402 feedback loop involving, 231-232 acute, 397-398 infertility in hyperprolactinemia, 829 chronic, 398 inhibitory factors, 229 in Crohn's disease, 402 and ovarian function, 230 and ectopic pregnancy, 762 Prolapse endometritis with, 282 tubal, 404 from foreign bodies, 402 urethral, 50-51 granulomatous, 401-403 of uterus, vaginal changes in, 68 hydrosalpinx in, 398-401 Prostaglandins, endometrial, 276, 292 and infertility, 832 Psammoma bodies, 862 isthmica nodos a, 403-404, 832 in serous of ovary, 518 in pinworms, 402 Index 935

Salpingitis-Cant. Sex cord-stromal tumors of ovary-Cant. sarcoid, 402 aspiration cytology of, 745 in schistosomiasis, 402 mixed germ cell-sex cord tumors, 652-656 tuberculous, 401-402 Sex differentiation, 479-480 Sandhoff disease, prenatal diagnosis of, 808 factors affecting, 4-5 Sanfilippo syndrome, prenatal diagnosis of, 811 genetic, abnormal, 480-483 Sarcoidosis gonadal, abnormal, 488-501 endometritis in, 283 hormones affecting, 9 of fallopian tubes, 402 phenotypic, 479-480 oophoritis in, 445 abnormal, 501-506 Sarcoma Sexual abnormalities, developmental factors in, 9-11 botryoides Sexual precocity, in granulosa cell tumors of ovary, 582, cervical, 217 688 and pseudo sarcomatous botryoid polyps of cervix, 143 Sinovaginal bulbs, 7 of vagina, 87-90 Skene's glands, 14 cervical, 217-218 Smears, gynecologic. See Cytology of female genital tract of ovary Spermatozoa in childhood, 693-695 antibodies to, and infertility, 834-835 undifferentiated, 572 in gynecologic smears, 841 tubal, 410-411 tubal transport of, 396-397 of uterus, 362-364 Spiral arteries, 238 of vagina, 86-93 Spirochetal infections, syphilis in, 19-20 of vulva, 50 Squamous carcinoma Savage syndrome, infertility in, 829-830 cervical, 191-199 Scabies, 24 of endometrium, 333-334 Scheie syndrome, prenatal diagnosis of, 811 Squamous metaplasia Schiller-Duval bodies, 616 endometrial, 266-267, 313-315 Schiller test, for cancer of cervix, 179-181 gynecologic smears in, 844 Schistosomiasis Staphylococcal infections, endometritis in, 280 cervical, 141 Stein-Leventhal syndrome, 460-461. See also Ovary, poly­ endometritis in, 283 cystic endometrial carcinoma with, 461 oophoritis in, 445-446 Sterility. See Infertility salpingitis in, 402 Steroid hormones, ovarian Sclerosing stromal tumor of ovary, 590 antibodies to, and infertility, 830-831 in childhood, 691 production of, 223-233 Sclerotic villi, placental, 786 Stomach tumors, metastatic to ovaries, 705-709 Scrotum, embryology of, 9 Straight arteries, 238 Sebaceous gland tumor of ovary, 645 Streptococcal infections, endometritis in, 280 Seborrheic keratosis of vulva, 33 Stromomyoma of uterus, 384 Seminoma, ovarian, 603 Struma ovarii, 636-639 in childhood, 668 and carcinoid, 643-645 Serous tumors of ovary, 512-525 in childhood, 683 in childhood, 684-688 malignant change in, 639 Sertoli cell tumors of ovary, in childhood, 691 Superficial cells, in gynecologic smears, 838-839 Sertoli-Leydig cell tumors of ovary, 590-597 Surfactant pulmonary, and fetal lung maturity, 813 in childhood, 693 Suspensory ligament, ovarian, 416 Sex chromatin, 484-487 Sweat glands, eccrine, of vulva, 14 Sex chromosomes Syncytioma, 299 autosomal abnormalities in, 498-499 Syncytiotrophoblast cells, 753-754 deletions in, 484, 496-498 in choriocarcinoma, 626, 797 disorders of, 487-488 Syphilis, 19-20 and cytogenetics, 480-484 cervix in, 140 in gonadal dysgenesis, 490-501 placentitis in, 782 mosaicism of, 483-484, 494-496 serologic tests in, 20 translocations of, 498 Syringoma of vulva, 32 Sex cord(s) primitive, 2 Sex cord-sex mesenchyme tumors of ovary, in childhood, 688-693 Talc powder Sex cord-stromal tumors of ovary, 581-599 endometritis from, granulomatous, 284 annular tubules with, 598-599 salpingitis from, 402 936 Index

Tay-Sachs disease, prenatal diagnosis of, 808 Trophoblastic tumor Teilum tumor of ovary, 612 placental site, 299-303 Teratoblastoma of ovary, in childhood, 670 tubal, 411 Teratocarcinoma of ovary, in childhood, 673-674 Tubal conditions. See Fallopian tubes Teratoma Tuberculosis animal models of, 899-900 cervical, 140 of ovary, 627-645. See also Ovary, teratoma of aspiration endometritis in, 282-283 cytology of, 746 oophoritis in, 443-445 with embryoid bodies, 624 of placenta, 782 tubal, benign, 408 salpingitis in, 401-402 of vulva, 23 of uterus, 303 Tumors. See also specific tumor types Testicular feminization, 501-503 animal models for, 891-909 incomplete syndrome of, 503 of cervix uteri Testis benign, 147-154 embryology of, 3 malignant, 184-219 grafts of, and tumor induction in female rats, 903 of fallopian tubes Testosterone benign, 406-408 -binding protein levels, in polycystic ovarian syndrome, malignant, 408-411 461 of ovary, unclassified, 590, 598-599 gonadoblastoma production of, 651 of vagina Theca granulosa cell tumors, 584-586 benign, 73-76 aspiration cytology of, 745 malignant, 78-93 in childhood, 693 of vulva Theca interna, 433 benign, 28-34 luteinization of, in polycystic ovary, 459 malignant, 45-50 Theca-lutein cysts of ovary, 456-457, 718, 723-724 Tunica albuginea, ovarian, 418 Thecoma of ovary, 587-588 in polycystic ovary, 458 aspiration cytology of, 745 Turner's syndrome, 490, 491-494. See also Gonadal dys­ in childhood, 691 genesis Thyroid hormone, and tumor induction in animals, 897 Twin pregnancy, 770-773 Thyroid tissue in struma ovarii, 636-639 and gross description of placenta, 883-885 in childhood, 683 Tzank cells, in pemphigus vulgaris of cervix, 142 Thyrotropin releasing hormone, 229 Tiger substance, in dysgerminoma of ovary, 745 Tissue specimens, examination of, 868-889. See also Gross Ulcers, genital, diseases with, 24-25 examination of specimens Umbilical artery, single, 768 Torsion Umbilical cord, 767-769 of dermoid cyst of ovary, 635 gross examination of, 882-883 tubal, 404 length of, 768 Toxemia of pregnancy, 779-780 valamentous insertion of, 768-769 in molar pregnancy, 795 Urea plasma urealyticum infection, salpingitis in, 398 Urethra and placental infarction, 777, 778 carcinoma of, 51 Toxoplasmosis caruncles of, 51 endometritis in, 283-284 prolapse of, 50-51 of placenta, 782 suburethral diverticula, 51 Trachoma inclusion conjunctivitis, gynecologic smears in, Urogenital sinus, 7 849 Utero-ovarian ligament, 416 Treponema pallidum infection, syphilis in, 19-20 Uterus Trichomonas vagina lis infection, 67 adenofibroma of, 371-373 cervical, 136 treatment of, 373 and cervicovaginitis emphysematosa, 141 adenomyosis of, 297-299 gynecologic smears in, 846 adenosarcoma of, 373-376 Trophoblast, proliferation of, 753 recurrent, 374 Trophoblast disease, gestational, 791-802 treatment and prognosis of, 374 choriocarcinoma, 797-802 in adults, 237 hydatidiform mole, 791-796 animal models for tumors of, 901-905 invasive mole, 796-797 anomalies of, 10-11 pseudo tumor of uterus, 798-799 blood supply of, 237-239 Index 937

Uterus-Cant. Uterus-Cant. Brenner tumor of, 303 prolapse of, vaginal changes in, 68 broad ligaments of. See Broad ligament sarcoma of carcinosarcoma of, 367-371 adenosarcoma, 373-376 clinical features of, 367-368 carcinosarcoma, 367-371 pathology of, 368-370 of endometrial stroma, 377-382 treatment and prognosis of, 370-371 leiomyosarcoma, 362-364 cervix of. See Cervix uteri smooth muscle tumors of, 353-367 changes from prenatal exposure to DES, 114-116 epithelioid, 358-360 development of, 235-237 leiomyomas, 353-358 dysfunctional uterine bleeding, 285-288 stromomyoma of, 384 embryology of, 8 teratomas of, 303 endometrium of. See Endometrium trophoblastic pseudotumor of, 798-799 gross examination of, 871-874 vascular tumors of, 386-387 hemangioendothelioma of, 387 venous drainage of, 238 hemangioma of, 386 hemangiopericytoma of, 386-387 ichthyosis uteri, 266-267, 333 Vaccinia, genital, cytologic findings in, 849 leiomyoblastoma of, 358 Vagina, 59-96 leiomyomas of, 353-358 adenocarcinoma of atypical, 355-356 clear cell, and prenatal exposure to DES, 99-105 benign metastasizing, 365 relation to adenosis, 70, 71 cellular, 354-356 adenosis from prenatal exposure to DES, 69-71, 105- clear cell, 358 108 clinical features of, 353-354 atypical, 109-111 epithelioid, 358-360 relation to adenocarcinoma, 70, 71 fat in, 357 anatomy of, 59-65 gross pathology of, 354 anomalies of, 71-72 microscopic appearance of, 354-358 blood supply of, 64 myxoid,358 candidiasis of, 66-67 plexiform, 358 carcinoma of prolapse of, 353 basal cell-like, 84 vascular, 356-357 in infancy, 84-85 leiomyomatosis of in situ, and dysplasia, 81-84 diffuse, 366-367 cysts of, 72-73 intravenous, 361-362 peritonealis, disseminated, 365-366 dysplasia of, 114 leiomyosarcoma of, 362-364 embryology of, 8 clinical aspects of, 362-363 granular myoblastoma of, 77-78 pathology of, 363-364 gross examination of, 875-877 treatment and prognosis of, 364 gross structural changes from prenatal exposure to DES, lipoleiomyomas of, 357 105 lymphatics of, 239 innervation of, 64 lymphomas of, 387 leiomyosarcoma of, 86-87 mesenchymal tumors of, 352-387 lymphatics of, 64-65 mesothelioma of, adenomatoid, 385-386 melanoma of, 85-86 clinical features of, 385 metastases to, 93-96 pathology of, 385-386 microglandular hyperplasia from prenatal exposure to mixed mesodermal tumors of, 367-376 DES, 111-112 clinical features of, 367-368 mucous membrane of, 59-63 malignant, 367-371 polyps of, fibroepithelial, 73 pathology of, 368-370 in prolapse of uterus, 68 treatment and prognosis of, 370-371 rhabdomyoma of, 73-76 myolipomas of, 357 sarcoma of, 86-93 myometrium of alveolar soft part, 90-93 in adenomyosis, 297-299 botryoides, 87-90 hypertrophy of, 385 synovial-like, 90 leiomyomas of, and infertility, 834 smears from. See Cytology of female genital tract neonatal, 235-237 squamous cell carcinoma of, 78-80 placental site trophoblastic tumor of, 299-303 cytologic diagnosis of, 861 938 Index

Vagina-Cant. Vulva-Cant. squamous metaplasia from prenatal exposure to DES, cysts of, 26-28 105-108 Bartholin, 26 transverse septum of, 72 in canal of Nuck, 28 trichomoniasis of, 67 dysontogenetic, 27 tumors of keratinous, 26 animal models for, 905-908 mesonephric, 27 benign, 73-76 mucous, 27 malignant, 78-93 in Darier's disease, 25 mixed,76 developmental defects in, 15-16 ulcerations of, 68-69 dystrophic conditions of, 35-40 vaginitis, 65-68 hyperplastic, 36-37 Vaginal plate, 7-8 mixed,39 Vaginitis, 65-68 endometrioma of, 33-34 desquamative inflammatory, 67-68 epithelial tumors of, 30-34 emphysematous, 67, 141,284 erythrasma of, 23-24 gonorrheal, 65 fibroma of, 29 Haemaphilus vaginalis, 65-66 Fox-Fordyce disease of, 28 in parasitic disease, 68 fungus infections of, 23 Vascular tumors of uterus, 386-387 granular cell tumor of, 29 VORL test in syphilis, 20 granuloma of, pyogenic, 28 in granuloma inguinale, 21-22 Verrucous carcinoma of cervix, 200 gross examination of, 877 in Hailey-Hailey disease, 25 of vulva, 47-48 hemangioma of, 28 Vestibule of vulva, 13 hemangiopericytoma of, 29 cysts of, 27 herpetic vulvitis of, 18-19 Virilization hidradenitis suppurativa of, 25 in female pseudohermaphroditism, 504-506 hidradenoma of in gonadoblastoma, 651 clear cell, 32 in Krukenberg tumors, 711 papillary, 30-32 in ovarian cysts, 461 histiocytoma of, 29-30 in Sertoli-Leydig cell tumors of ovary, 591 infectious diseases of, 16-24 Virus infections inflammatory diseases of, 24-26 endometritis in, 283 innervation of, 15 of placenta, 782-783 keratoacanthomas of, 33 and tumor induction in animals, 905, 907-908 leiomyoma of, 29 Vitamin B12 deficiency, cytologic changes in, 858 lentigo simplex of, 34 Vitelline carcinoma of ovary, in childhood, 672 lice affecting, 24 Vitligo of vulva, 34 in lichen sclerosus, 37-39 Vulva, 13-54 lipoma of, 29 accessory breast tissue in, 30 lymphatics of, 15 acrochordon of, 30 in lymphogranuloma venereum, 22 adenocarcinoma of, 50 melanoma of, 48-49 in albinism, 34 metastases to, 50 anatomy of, 13-16 molluscum contagiosum of, 21 angiokeratoma of, 28 neurofibromata of, 30 atypical changes in, 39-40 nevi of, 34 biopsies of, 52 Paget's disease of, 42-45 blood supply to, 15 papilloma of, squamous, 32 carcinoma of pigmentation disorders of, 34-35 adenoid,47 pinworms affecting, 24 basal cell, 49-50 in psoriasis, 25-26 epidermoid, cytologic diagnosis of, 861 sarcoma of, 50 in situ, 40-42 scabies of, 24 squamous cell, invasive, 45-48 seborrheic keratosis of, 33 verrucous, 47-48 specimen processing in pathology laboratory, 51-52 chancroid of, 22-23 structure of, 13-15 condylomata acuminata of, 16-18 syphilis of, 19-20 connective tissue tumors of, 28-30 syringoma of, 32 Index 939

Vulva-Cant. Wolffian duct-Cant. tuberculosis of, 23 cysts of, 27 tumors of and origin of cervical papilloma of children, 152 animal models for, 905-908 remnants of, 395 benign, 28-34 vestigial elements in cervices, 134 malignant, 45-50 Wolman's disease, prenatal diagnosis of, 811 and urethral pathology, 50-51 vitiligo of, 34 Vulvectomy, 52-54 Xeroderma pigmentosum, prenatal diagnosis of, 811 Yolk sac, primordial germ cells in, 1 Yolk-sac tumor, 612 Walthard cell nests, and Brenner tumors of ovary, 547- animal models of, 899-900 548 carcinoma in childhood, 672 Walthard rests, tubal, 406 Wolffian adenoma, tubal attachment of, 411-412 Wolffian duct, 5 Zona pellucida, 431 abnormal development of, 506 antibodies to, and infertility, 831