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Research Article| Volume 7, ISSUE 1, P117-156, March 1987

The Ultrastructure of Selected Gynecologic Neoplasms*

  • G. Richard Dickersin
    Correspondence
    Corresponding Author: Department of Pathology, Harvard Medical School, Massachusetts General Hospital, Boston, Massachusetts 02114.
    Affiliations
    Associate Professor, Department of Pathology, Harvard Medical School, and Head, Diagnostic Electron Microscopy Unit, The James Homer Wright Laboratories of the Massachusetts General Hospital, Boston, Massachusetts
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      This paper is only available as a PDF. To read, Please Download here.
      The ultrastructural appearance of a variety of neoplasms that may occur in the female genital tract is presented. Emphasis is placed on well-known gonadal lesions, including the common epithelial tumors, sex cord stromal tumors, and germ-cell tumors, but several other, incompletely classified neoplasms are also covered. The intent of the text is to review the current knowledge of the morphology and histogenesis of these neoplasms and to present photographs that are representative of their structure.
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      References

      Serous Tumors

        • Blaustein A.
        Papillary serous tumors of the ovary: An electron microscopic study.
        Gynecol Oncol. 1976; 4: 314-323
        • Fenoglio C.M.
        • Castadot M.
        • Ferenczy A.
        • et al.
        Serous tumors of the ovary. I. Ultrastructural and histochemical studies of the epithelium of the benign serous neoplasms, serous cystadenoma and serous cystadenofibroma.
        Gynecol Oncol. 1977; 5: 203-218
        • Gondos B.
        Electron microscopic study of papillary serous tumors of the ovary.
        Cancer. 1971; 27: 1455-1464
        • Scully R.E.
        Tumors of the ovary and maldeveloped gonads. Atlas of Tumor. Pathology Second Series. Fascicle 16. Armed Forces Institute of Pathology, Washington DC1979: 55-74
        • White P.F.
        • Merino M.J.
        • Barwick K.W.
        Serous surface papillary carcinoma of the ovary: A clinical, pathologic, ultrastructural, and immunohistochemical study of 11 cases.
        Pathol Annu. 1985; 20: 403-418

      Mucinous Tumors

        • Fenoglio C.M.
        • Ferenczy A.
        • Richart R.M.
        Mucinous tumors of the ovary. Ultrastructural studies of mucinous cystadenomas with histogenetic considerations.
        Cancer. 1975; 36: 1709-1722
        • Fenoglio C.M.
        • Ferenczy A.
        • Richart R.M.
        Mucinous tumors of the ovary. II. Ultrastructural features of mucinous cystadenocarcinomas.
        Am J Obstet Gynecol. 1976; 125: 990-999
        • Langley F.A.
        • Cummins P.A.
        • Fox H.
        An ultrastructural study of mucin secreting epithelia in ovarian neoplasms.
        Acta Pathol Microbiol Scand (A). 1972; 80: 76-78
        • Scully R.E.
        Tumors of the ovary and maldeveloped gonads. Atlas of Tumor Pathology. Second Series. Fascicle 16. Armed Forces Institute of Pathology, Washington DC1979: 75-91
        • Stenback K.
        Morphology of ovarian mucinous cystadenoma: Surface ultrastructure, development and biologic behavior.
        Int J Gynaecol Obstet. 1980; 18: 157-167
        • Szymanska K.
        • Szamborski J.
        • Miechowiecka N.
        • Czerwinski W.
        Malignant transformation of mucinous ovarian cystadenomas of intestinal epithelial type.
        Histopathology. 1983; 7: 497-509

      Endometrioid Tumors

        • Cummins P.A.
        • Fox H.
        • Langley F.A.
        An electron microscopic study of the endometrioid adenocarcinoma of the ovary and a comparison of its fine structure with that of normal endometrium and of adenocarcinoma of the endometrium.
        J Pathol. 1974; 13: 165-173
        • Fenoglio C.M.
        • Puri S.
        • Richart R.M.
        The ultrastructure of endometrioid carcinoma of the ovary.
        Gynecol Oncol. 1978; 6: 152-164

      Clear-Cell Carcinoma

        • Dickersin G.R.
        • Welch W.R.
        • Erlandson R.
        • Robboy S.J.
        Ultrastructure of 16 cases of clear cell adenocarcinoma of the vagina and cervix in young women.
        Cancer. 1980; 45: 1615-1624
        • Okagaki T.
        • Richart R.M.
        Mesonephroma ovarii (hypernephroid carcinoma): Light and ultrastructural study of one case.
        Cancer. 1970; 26: 453-461
        • Ohkawa K.
        • Amasaki H.
        • Terashima Y.
        • et al.
        Clear cell carcinoma of the ovary. Light and electron microscopic studies.
        Cancer. 1977; 40: 3019-3029
        • Roth L.M.
        Clear-cell adenocarcinoma of the female genital tract. A light and electron microscopic study.
        Cancer. 1974; 33: 990-1001
        • Silverberg S.G.
        Ultrastructure and histogenesis of clear cell carcinoma of the ovary.
        Am J Obstet Gynecol. 1973; 115: 394-400
      1. Scully RE: Tumors of the ovary and maldeveloped gonads. Atlas of Tumor Pathology. Second Series Fascicle 16. Washington DC, Armed Forces Institute of Pathology. Second Series. 1979, pp. 117-127

        • Scully R.E.
        • Barlow J.F.
        Mesonephroma of the ovary: Tumor of miillerian nature related to the endometrioid carcinoma.
        Cancer. 1967; 20: 1405-1417

      Brenner’s Tumors

        • Aguirre P.
        • Scully R.E.
        • Wolfe H.J.
        • DeLellis R.A.
        Argyrophil cells in Brenner tumors: Histochemical and immunohistochemical analysis.
        Int J Gynaecol Pathol. 1986; 5: 223-234
        • Arey L.B.
        The origin and form of Brenner tumor.
        Am J Obstet Gynecol. 1961; 81: 743-751
        • Fetissof F.
        • Berger G.
        • Dubois M.P.
        • et al.
        Endocrine cells in the female genital tract.
        Histopathology. 1985; 9: 133-145
        • Kennedy M.
        • Holch S.
        • Bock J.
        Bilateral malignant Brenner tumor. A light and electron microscopic study.
        Acta Pathol Microbiol Immunol Scand (A). 1984; 92: 161-166
        • Klemi P.J.
        Epithelial mucosubstances and argyrophil cells in Brenner tumors.
        Acta Pathol Microbiol Immunol Scand (A). 1977; 85: 819-825
        • Langley F.A.
        • Cummins P.A.
        • Fox H.
        An ultrastructural study of mucin secreting epithelia in ovarian neoplasms.
        Acta Pathol Microbiol Immunol Scand (A). 1972; 80: 76-86
        • Roth L.M.
        Fine structure of the Brenner tumor.
        Cancer. 1971; 27: 1482-1488
        • Scully R.E.
        Tumors of the ovary and maldeveloped gonads. Atlas of Tumor Pathology. Second Series. Fascicle 16. Armed Forces Institute of Pathology, Washington DC1979: 117-127
        • Shevchuk M.M.
        • Fenoglio C.M.
        • Richart R.M.
        Histogenesis of Brenner tumors. I: Histology and ultrastructure.
        Cancer. 1980; 46: 2607-2616
        • Shevchuk M.M.
        • Fenoglio C.M.
        • Richart R.M.
        Histogenesis of Brenner tumors. II: Histochemistry and CEA.
        Cancer. 1980; 46: 2617-2622
        • Shikary A.
        • Petrelli M.
        • Hamilton P.
        • Reid J.D.
        The Brenner tumor.
        Arch Pathol Lab Med. 1981; 105: 207-213
        • Silverberg S.G.
        • Wilson M.A.
        Ultrastructure of the Brenner tumor.
        Am J Obstet Gynecol. 1972; 112: 91-100

      Granulosa-Cell Tumors

        • Bjersing L.
        • Frankendal B.
        • Anstrom T.
        Studies on a feminizing ovarian mesenchymoma (granulosa cell tumor). I. Aspiration biopsy cytology, histology, and ultrastructure.
        Cancer. 1973; 32: 1360-1369
        • Gaffney E.F.
        • Majmudar B.
        • Hertzler G.L.
        • et al.
        Ovarian granulosa cell tu mors—immunohistochemical localization of estradiol and ultrastructure, with functional correlations.
        Obstet Gynecol. 1983; 61: 311-319
        • Gondos B.
        Ultrastructure of a metastatic granulosa-theca cell tumor.
        Cancer. 1969; 24: 954-959
        • Gondos B.
        • Monroe S.A.
        Cystic granulosa cell tumor with massive hemoperitoneum. Light and electron microscopic study.
        Obstet Gynecol. 1971; 38: 683-689
        • MacAulay M.A.
        • Weliky I.
        • Schulz R.A.
        Ultrastructure of a biosynthetically active granulosa cell tumor.
        Lab Invest. 1967; 17: 562-570
        • Pedersen P.H.
        • Larsen J.F.
        Ultrastructure of a granulosa cell tumour.
        Acta Obstet Gynecol Scand. 1970; 49: 270-272
        • Salazar H.
        • Gonzales-Angulo A.
        Ultrastructural diagnosis in gynecological pathology.
        Clin Obstet Gynecol. 1984; 11: 25-77
        • Toker C.
        Ultrastructure of a granulosa cell tumor.
        Am J Obstet Gynecol. 1968; 100: 388-392

      Juvenile Granulosa-Cell Tumors

        • Roth L.M.
        • Nicholas T.R.
        • Ehrlich C.E.
        Juvenile granulosa cell tumor. A clinicopathologic study of three cases with ultrastructural observations.
        Cancer. 1979; 44: 2194-2205
        • Takeuchi H.
        • Sodemoto Y.
        • Ushigome S.
        Juvenile granulosa cell tumor associated with rapid distant metastases.
        Acta Pathol Jpn. 1983; 33: 537-545
        • Young R.H.
        • Dickersin G.R.
        • Scully R.E.
        Juvenile granulosa cell tumor. A clinicopathological analysis of 125 cases.
        Am J Surg Pathol. 1984; 8: 575-596

      Sertoli-Leydig Cell Tumors

        • Able M.E.
        • Lee J.C.
        Ultrastructure of a Sertoli-cell adenoma of the testis.
        Cancer. 1969; 23: 481-486
      1. Ferry J, Scully RE, Dickersin GR: Charcot-Böttcher crystalloids as an ultrastructural Sertoli-cell marker, in poorly differentiated sex cord tumors. Unpublished observations

        • Jenson A.B.
        • Fechner R.E.
        Ultrastructure of an intermediate Sertoli-Leydig cell tumor. A histogenetic misnomer.
        Lab Invest. 1969; 21: 527-535
        • Kalderon E.E.
        • Tucci J.R.
        Ultrastructure of a human chorionic gonadotropin—and adrenocorticotropin—responsive functioning Sertoli-Leydig cell tumor (Type I).
        Lab Invest. 1973; 29: 81-89
        • Ramzy I.
        • Bos C.
        Sertoli cell tumors of ovary.
        Cancer. 1976; 38: 2447-2456
        • Roth L.M.
        • Cleary R.E.
        • Rosenfield R.L.
        Sertoli-Leydig cell tumor of the ovary, with an associated mucinous cystadenoma. An ultrastructural and endocrine study.
        Lab Invest. 1975; 31: 648-657
        • Schnoy H.
        Ultrastructure of a verilizing ovarian Leydig-cell-tumor.
        Virchows Arch (A). 1982; 397: 17-27
        • Scully R.E.
        Tumors of the ovary and maldeveloped gonads. Atlas of Tumor Pathology. Second Series. Fascicle 16. Armed Forces Institute of Pathology, Washington DC1979: 190-191
        • Tavassoli F.A.
        A combined germ cell—gonadal stromal-epithelial tumor of the ovary.
        Am J Surg Pathol. 1983; 7: 73-84

      Sex-Cord Tumors with Annular Tubules

        • Ahn G.H.
        • Chic J.G.
        • Lee S.K.
        Ovarian sex cord tumor with annular tubules.
        Cancer. 1986; 57: 1066-1073
        • Astenso-Osuna C.
        Ovarian sex cord tumor with annular tubules. Case report with ultrastructural findings.
        Cancer. 1984; 54: 1070-1075
        • Crissman J.D.
        • Hart W.R.
        Ovarian sex cord tumors with annular tubules. An ultrastructural study of three cases.
        Am J Clin Pathol. 1981; 75: 11-17
        • Hertel B.F.
        • Kempson R.L.
        Ovarian sex cord tumors with annular tubules: An ultrastructural study.
        Am J Surg Pathol. 1977; 1: 145-153
        • Tavassoli F.A.
        • Norris H.J.
        Sertoli tumors of the ovary: A clinicopathological study of 28 cases with ultrastructural observations.
        Cancer. 1980; 46: 2281-2297
        • Young R.H.
        • Welch W.R.
        • Dickersin G.R.
        • Scully R.E.
        Ovarian sex cord tumor with annular tubules.
        Cancer. 1982; 50: 1384-1402

      Lipid-Cell Tumors

        • Green J.A.
        • Maqueo M.
        Histopathology and ultrastructure of an ovarian hilar cell tumor.
        Am J Obstet Gynecol. 1966; 96: 478-485
        • Ishida L.
        • Okagaki T.
        • Tagatz G.E.
        • et al.
        Lipid cell tumor of the ovary: An ultrastructural study.
        Cancer. 1977; 40: 234-243
        • Koss L.G.
        • Rothschild E.O.
        • Fleisher M.
        • Francis J.E.
        Masculinizing tumor of the ovary, apparently with adrenocortical activity.
        Cancer. 1969; 23: 1245-1258
        • Merkow L.P.
        • Slifkin M.
        • Acevedo H.F.
        • et al.
        Ultrastructure of an interstitial (hilar) cell tumor of the ovary.
        Obstet Gynecol. 1971; 37: 845-859
        • Muechler E.K.
        • Gillette M.B.
        • Cary D.
        • et al.
        Ovarian lipoid cell tumor. Steroid hormones and ultrastructure.
        Diagn Gynecol Obstet. 1982; 4: 309-315
        • Scully R.E.
        Tumors of the ovary and maldeveloped gonads. Atlas of Tumor Pathology. Second Series. Fascicle 16. Armed Forces Institute of Pathology, Washington DC1979: 215-218

      Dysgerminoma

        • Ferenczy A.
        • Richart R.M.
        Female Reproductive System: Dynamics of Scan and Transmission Electron Microscopy. John Wiley, New York1974: 336-338
        • Koide O.
        • Iwai S.
        An ultrastructural study on seminoma cells.
        Acta Pathol Jpn. 1981; 31: 755-766
        • Markesberg W.R.
        • Brooks W.H.
        • Milsow L.
        • Mortara R.H.
        Ultrastructural study of the pineal germinoma in vivo and in vitro.
        Cancer. 1976; 37: 327-337
        • Scully R.E.
        Tumors of the ovary and maldeveloped gonads. Atlas of Tumor. Pathology Second Series. Fascicle 16. Armed Forces Institute of Pathology, Washington DC1979: 227-232

      Endodermal Sinus Tumors

        • Cohen M.D.
        • Mulchahey K.M.
        • Molnar J.J.
        Ovarian endodermal sinus tumor with intestinal differentiation.
        Cancer. 1986; 57: 1580-1583
        • Klemi P.J.
        • Meurman L.
        • Gronroos M.
        • Talerman A.
        Clear cell (mesonephroid) tumors of the ovary with characteristics resembling endodermal sinus tumor.
        Int J Gynaecol Pathol. 1982; 1: 95-100
        • Prat J.
        • Bhan A.K.
        • Dickersin G.R.
        • et al.
        Hepatoid yolk sac tumor of the ovary (endodermal sinus tumor with hepatoid differentiation): A light microscopic, ultrastructural and immunohistochemical study of seven cases.
        Cancer. 1982; 50: 2355-2368
        • Nogales-Fernandez F.
        • Silverberg S.G.
        • Blaustein P.A.
        • et al.
        Yolk sac carcinoma (endodermal sinus tumor).
        Cancer. 1977; 39: 1462-1474
        • Salazar H.
        • Kanbour A.
        • Tobon H.
        • Gonzalez-Angulo A.
        Endoderm cell derivatives in embryonal carcinoma of ovary: An electron microscopic study of two cases.
        Am J Pathol. 1974; 74: 108a
        • Scully R.E.
        Tumors of the ovary and maldeveloped gonads. Atlas of Tumor Pathology. Second Series. Fascicle 16. Armed Forces Institute of Pathology, Washington DC1979: 233-238
        • Sekine T.
        • Ito H.
        • Tanaka T.
        • et al.
        Studies on the histogenesis of experimentally induced yolk sac tumor in rats.
        Nippon Sanka Fujinka Gakkai Zasshi. 1983; 35: 1999-2006
        • Takashina T.
        An ultrastructural study of human ovarian yolk sac tumor—an investigation of its histogenesis compared to that of human yolk sacs.
        Acta Obstet Gynaecol Jpn. 1981; 33: 916-924
        • Teilum G.
        Classification of endodermal sinus tumor (mesoblastoma vitellinum) and so-called “embryonal carcinoma” of the ovary.
        Acta Pathol Microbiol Immunol Scand (A). 1965; 64: 407-429
        • Teilum G.
        • Albrechtsen R.
        • Norgaard-Pedersen B.
        Immunofluorescent localization of alpha fetoprotein synthesis in endodermal sinus tumor (yolk sac tumor).
        Acta Pathol Microbiol Scand (A). 1974; 82: 586-588
        • Ulbright T.M.
        • Roth L.M.
        • Brodhecker C.A.
        Yolk sac differentiation in germ cell tumors. A morphological study of 50 cases with emphasis on hepatic, enteric and parietal yolk sac features.
        Am J Surg Pathol. 1986; 10: 151-164

      Female Adnexal Tumors of Probable Wolffian Origin

        • Brescia R.J.
        • Cardoso de Almeida P.
        • Fuller Jr, A.F.
        • et al.
        Female adnexal tumor of probable Wolffian origin with multiple recurrences over 16 years.
        Cancer. 1985; 56: 1456-1461
        • Demopoulos R.I.
        • Sitelman A.
        • Flotte T.
        • Bigelow B.
        Ultrastructural study of a female adnexal tumor of probable Wolffian origin.
        Cancer. 1980; 46: 2273-2280
        • Kariminejad M.H.
        • Scully R.E.
        Female adnexal tumor of probable Wolffian origin: A distinctive pathologic entity.
        Cancer. 1973; 31: 671-677
        • Taxy J.B.
        • Battifora H.
        Female adnexal tumor of probable Wolffian origin: Evidence for low grade malignancy.
        Cancer. 1976; 37: 2349-2354
        • Young R.H.
        • Scully R.E.
        Ovarian tumors of probable Wolffian origin: A report of 11 cases.
        Am J Surg Pathol. 1983; 7: 125-135

      Small-Cell Carcinoma (with Hypercalcemia)

        • Dickersin G.R.
        • Kline I.W.
        • Scully R.E.
        Small cell carcinoma of the ovary with hypercalcemia. A report of eleven cases.
        Cancer. 1982; 49: 188-197

      Summary and General Ultrastructural Reviews

        • Fenoglio C.M.
        Overview article: Ultrastructural features of the common epithelial tumors of the ovary.
        Ultrastruct Pathol. 1980; 1: 419-444
        • Roth L.M.
        Application of electron microscopy to diagnosis in gynecologic neoplasms and tumor-like conditions.
        Ultrastruct Pathol. 1985; 9: 131-136
        • Salazar H.
        • Gonzalez-Angulo A.
        Ultrastructural diagnosis in gynecological pathology.
        Clin Obstet Gynecol. 1984; 11: 25-77