Ed's Histology Notes: Female
One or the other produces one egg per month during reproductive life. The ovary's spongy medulla is a mass of vessels in a loose connective tissue stroma. It fades into the cortex, where the eggs are. Cortical fibroblasts (or whatever these spindle-cells really are) are arranged in dense cellular whorls (cartwheels, fireworks, whatever), and are called "ovarian stroma". They respond curiously to hormones as we'll see below. Around the cortex is a super-tough fibrous capsule (tunica albuginea), and attached and folded over most of the surface of the ovary is the peritoneal membrane ("mesovarium" here), its mesothelium (simple-squamous to cuboidal to pseudostratified to tall-columnar) being misnamed germinal epithelium.
Oocytes actually form in the unborn child's yolk sac (they are called oogonia here), and divide and migrate to the genital ridge, where they continue dividing until the fifth month. At this time, there are 3 million oocytes in each ovary. In the third trimester, some of them enter the prophase of their first meiotic division and become primary oocytes. Many of the rest undergo apoptosis (Junqueira calls it "atresia" which actually means "a hole failed to open" which is a dumb misnomer.) A girl at menarche has about 400,000 ova per ovary, each in its little follicle. Several follicles develop rapidly each month, but only one discharges its ovum, and while this is happening, others undergo apoptosis.
Oocytes are surrounded by one or more spheres composed of more-or-less cuboidal follicular cells, making up a follicle. There are no blood or lymphatic vessels in a follicle (until it becomes a corpus luteum). A primordial follicle has a 25-micron ovum and a single layer of squamous follicular cells joined by desmosomes and surrounded in turn by a basement membrane. Nobody knows for sure either how a particular follicle gets the signal to start growing, or how many months it takes before it has a chance to be the winner, or for that matter why only one is released.
As a follicle begins to grow, the egg enlarges to about 150 microns (grain of sand). (Non-testable: I have never heard anybody but Junqueira calls its nucleus the "germinal vesicle" and the term makes me laugh.) The squamous follicle cells form a single cuboidal layer, making this a unilaminar primary follicle.
Next, the follicular cells divide and become stratified, and are separated by gap junctions (!); now you call them granulosa cells, they join the egg in synthesizing the zona pellucida (glycoproteins through which ovum microvilli contact filopodia of granulosa cells). Just outside the follicle, the local fibroblasts line up circumferentially around the follicle, get plump, get pale (smooth ER and lipid in the cytoplasm), and are called the theca folliculi. Those closer to the follicle ("theca interna") are looser-packed, while those farther from the follicle ("theca externa") are attached snug to each other. I don't think you need to make the distinction. The theca cells supposedly make estrogen precursors which the granulosa cells supposedly turn into estrogen. Exactly who does what isn't important; estrogen gets produced somewhere in or around the follicle. At this stage, the structure is a multilaminar primary follicle.
Pretty soon the granulosa cells start to come apart in areas, leaving accumulations of fluid called liquor folliculi. The fluid accumulations eventually coalesce into a pool of fluid called the antrum, leaving a few granulosa cells surrounding the ovum as the cumulus oophorus while the rest cover the inner wall as the membrana granulosa. Now it's called a secondary (vesicular) follicle.
By midcycle, the follicle has developed further, with the layer of granulosa cells around the ovum now elongated, as the corona radiata. This will stay attached to the ovum during and for a while after fertilization. Now it's called a mature (graafian) follicle; contrary to Junqueira, it's only 0.25 cm, not 2.5 cm, but it's easy to see bulging.
Just before ovulation, the oocyte undergoes its first meiotic division, producing one cell with all the cytoplasm, and one polar body. The ovum then goes into second meiosis and stops in metaphase, where it will remain until fertilization occurs (if it does). Junqueira's account of ovulation merely suggests the complexity. Nobody knows how it works.
Once ovulation occurs, the other follicles stop, as if by magic. The liquor folliculi is released with the egg, and (since there's no obvious reason for it to form otherwise) it must do something; it contains (among many other things) a hormone called "inhibin" which seems a good candidate for somehow keeping the runner-up follicles from releasing their eggs. (Just speculating.) The follicles which mature (maybe partway, at least some all-the-way, maybe some not-at-all) but which don't ovulate undergo atresia, i.e., the hole does not form because the egg is not released. The process continues throughout girlhood and reproductive life.
Junqueira claims that theca cells of atretic follicles give rise to the interstitial cells analogous to the Leydig cells of the testis. I'm more familiar with little Leydig cells in the hilus of the ovary, away from the cortex.
After ovulation, the granulosa cells and the theca interna become the corpus luteum, a new endocrine organ which makes estrogen and progesterone will last until the end of the cycle, longer if pregnancy takes place. The wall of the follicle collapses into folds which are mirrored into the structure. Blood and lymph vessels invade at once. The granulosa cells expand greatly ("luteinize") and become steroid-secreters. At the center is the blood from ovulation, which organizes into scar just like in wound healing. The scar will remain as a wiggly corpus albicans (plural corpora albicantia). The corpus luteum is maintained by LH from the pituitary and (if pregnancy occurs) chorionic gonadotropin (hCG) from the trophoblast.
After menopause, the spongy medulla, a thin rim of cortex without follicles, and a lot of corpora albicantia remain.
01883 CORONA RADIATA, OVARY, NORMAL
09937 OVARY, GRANULOMA CELL TUMOR
11829 OVARY, ANTERIOR
11830 OVARY, MODEL
14949 OVARY, MONKEY, NORMAL
14950 OVARY, MONKEY, NORMAL
14965 OVARY MONKEY (CORTEX), NORMAL
14966 OVARY MONKEY (CORTEX), NORMAL
14967 OVARY, CORTEX, NORMAL
14968 OVARY, CORTEX, NORMAL
14980 CORONA RADIATA, OVARY, NORMAL
20662 OVARY, NORMAL
20663 OVARY, NORMAL
20664 OVARY, PRIMORDIAL OOCYTE, NORMAL
20665 OVARY, PRIMORDIAL OOCYTE, NORMAL
20666 CORPUS ALBICANS, OVARY, NORMAL, PRIMARY FOLLICLE BOTTOM RIGHT
20667 PRIMARY OOCYTE, OVARY, NORMAL
20668 SECONDARY FOLLICLE, PRIMARY FOLLICLE, OVARY, NORMAL
20669 CORPUS ALBICANS, OVARY, NORMAL
20670 SECONDARY FOLLICLE, OVARY, NORMAL
20671 OVARY, BLOOD VESSELS, NORMAL
20672 CORPUS LUTEUM, OVARY, NORMAL
20674 GRANULOSA LAYERS, OVARY CORPORA ALBICANS
20953 OVARY, PRIMARY OOCYTE
20954 OVARY, PRIMARY OOCYTE
20955 OVARY, PRIMORDIAL FOLLICLE
20956 OVARY, SECONDARY FOLLICLE
20957 OVARY, CUMULUS OOPHORUS
20958 OVARY, ATRETIC FOLLICLE
20959 OVARY, GRANULOSA CELLS
20960 OVARY, CORPUS LUTEUM
24196 OVARY, NORMAL
24695 GRAAFIAN FOLLICLE OVARY
24696 GRAAFIAN FOLLICLE OVARY
44450 OVARY, FOLLICLES
44451 OVARY, FOLLICLES
44452 OVARY, FOLLICLES
44453 OVARY, FOLLICLES
44454 OVARY, FOLLICLES
44458 CORPUS LUTEUM, OVARY, PARTIAL
46596 OVARY, MODEL
48665 OVARIAN FOLLICLE, SECONDARY
48666 OVARIAN FOLLICLE, SECONDARY
50502 OVARY, FOLLICLES
50503 OVARY, PRIMARY FOLLICLE
50504 OVARY, FOLLICLE
A coiled, wiggly, muscular "fallopian" tube. "Salpynx" literally means "trumpet." Most of the serosa is covered with peritoneum. It's very vascular, and supposedly slightly erectile around the time of ovulation, moving the fimbriae right up to the ovary. The muscularis is thick, with an inner circular layer and outer spiral ("longitudinal") layer. The mucosa is infolded, least while the tube passes through the myometrium, with the complexity increasing toward the ovarian end. The lamina propria doesn't look like much but is quite capable of decidualizing and allowing an implanted egg to grow for a while ("ectopic pregnancy"). The epithelium has two cells types. One is secretory, these cells together produce a small amount of sticky, viscous fluid. The rest of the cells are ciliated, and these cilia direct the fluid (and an egg, when there is one) into the uterus. (Even if the cilia do not move because of a birth defect, the egg usually makes it to the uterus just by peristalsis.) A few cells have almost no cytoplasm (the mysterious "peg cells"). The fimbriae (fringe) at the free end receive the egg.
The pear-shaped womb. You are acquainted with the cervix and its canal, the external os, the internal os, and the body (corpus) and its cavity. The fundus is the portion that's rostral to the entry of the ovarian tubes. Peritoneum drapes over the fundus and the front and back of most of the body, providing a serosa; the rest of the uterus, except for the portion of the cervix at the end of the vagina, has an adventitia.
The myometrium gives most of the mass and shape to the uterus. It is a spongy mass of smooth muscle fibers going in all directions, and Junqueira's "poorly-defined layers" are so poorly-defined that I've never seen them or heard anybody talk about them. In children, the myometrium is rather small. During pregnancy, the myometrium undergoes hypertrophy, hyperplasia, and collagenization. These are all reversible. After menopause the myometrium loses much of its size.
The endometrium is a layer of mucosa with an epithelium and a lot of tubular glands, and a lamina propria. The surface epithelium is a mix of ciliated-columnar and non-ciliated-columnar-with-microvilli ("secretory", Junqueira's term which will confuse you in this context) cells. The tubular glands are lined mostly by non-ciliated cells. The lamina propria has a great deal of ground substance, and its strength comes almost entirely from reticulin rather than type I collagen. The functionalis is the upper two-thirds or so of the endometrium, and is the portion which is lost monthly during reproductive life. The basalis is the lower two-thirds. The tubular glands may branch a bit in the deep basalis. The basalis regenerates a new functionalis during reproductive life. During girlhood and after menopause, the endometrium is thin and contains some small glands.
The arteries of the uterus are worth knowing. The arcuate arteries run through the middle of the myometrium as a huge arcade. They give rise to the straight arteries which supply the basalis. These in turn sprout coiled arteries each month to supply the new functionalis.
The uterine cervix has a canal lined by simple columnar mucus-secreting cells (endocervix, an important term missing from Junqueira), a wall made mostly of dense irregular connective tissue instead of muscle, and a portion in the vagina covered with stratified squamous epithelium (ectocervix, also missing from Junqueira). The squamocolumnar junction is the usual site where pre-cancers and cancers pop up. Around puberty, the shape of the cervix changes a bit and the squamocolumnar junction, which is located low in the canal in girls before puberty, moves outward and becomes exposed. Since stratified squamous epithelium is opaque white and simple mucin-producing columnar epithelium is transparent and exposes the red connective tissue beneath, this has given rise to the moronic term "erosion" because people used to think that... but let us not be silly. The healthy endocervical tissue is thrown up into extremely complex folds ("palmate folds" are visible grossly, and the microscopic folds are mistaken by Junqueira and others for branched glands). When things get a bit scarred up and/or squamous-metaplastic, it's easy to develop a nabothian cyst (mass of retained mucus) here, and the usual cervix has a few. Endocervical mucus changes its composition at the time of ovulation to invite the sperms; other times, the main function of the mucus plug is to keep the bacteria out. When it's time for the unborn child to be delivered, the collagen of the cervix mostly gets hydrolyzed and the cervix gets soft (ripe).
Day 1: Defined to be the first day of bleeding, i.e., the beginning of the menstrual phase. From lack of hormones and constriction of the coiled arteries, the functionalis (including its arteries) dies, liquefies, and is lost.
Day 5: Around this time, menstruation is complete and the proliferative phase ("follicular phase", why?) begins. The basalis regenerates a new functionalis, which gets to be about 3 mm thick by the time of ovulation. The tubules are straight, with narrow lumens, and mitotic figures are easy enough to find. Estrogen makes this happen, and if estrogen is given to a woman after menopause, it may happen again.
Day 14: We'll say this is the day of ovulation. The secretory phase ("luteal phase", why?) begins. Mitotic activity diminishes, the endometrium thickens to 5 mm or so, the glands get long and coily and their lumens dilate from the accumulation of glycoprotein secretory product, the arteries get thicker and more robust. Early, a droplet of glycogen appears under the nuclei of the glandular cells. Late, progesterone causes the stromal cells to plump up (decidualization, skipped in Junqueira). I'll be nice and not make you learn any more about setting a more precise date for an endometrium. If pregnancy occurs, hCG from the unborn child sustains the corpus luteum. Otherwise, when the corpus luteum involutes, the cycle repeats.
You can learn the details about hormonal effects in "Physiology". This isn't the place.
I am going to assume you know about morulas, blastomeres, blastocysts, trophoblast, and so forth. Around the time of implantation, the sphere of trophoblast surrounding the unborn child differentiates into cytotrophoblast, a simple cuboidal epithelium, and syncytiotrophoblast, a layer of multinucleated cells (syncyt-) which surrounds it and is adapted for invasion, pinocytosis, and hormone production (hCG, placental lactogen, estrogen, progesterone). (Not testable: A distinguishable, third type of trophoblast called X-cells produces placental lactogen. Don't worry about it.) The primary villi are little outpoutchings of cytotrophoblast, and later these will be invaded by underlying extra-embryonic mesenchyme which makes them into secondary villi. When implantation occurs, the endometrium turns into the decidua. The stromal cells get big and polygonal and their borders are easy to see. The decidua basalis is between the embryo and the myometrium; this will be invaded by the trophoblast. (When it's time for the baby to be born, there's a decidua basalis proper, a stratum compactum below it, and then a stratum spongiosum below that just above the myometrium. The stratum compactum, but not the stratum spongiosum, separates from the uterine wall.) The decidua capsularis overlies the embryo between it and the endometrial cavity. The decidua parietalis is the rest of the altered endometrium. (Not testable: The decidua can get bizarre-looking, the Arias-Stella reaction, which fools beginning pathology residents into diagnosing cancer.)
The placenta begins where the chorionic plate (the early secondary villi) joins the decidua. The plate sprouts branching villi which grow down into the decidualizing endometrium. Some of the villi anchor to the decidua to keep the placenta from falling off, while others sit free. The trophoblast and its fibrous cores forms the fetal part or chorion. The trophoblast cells continue to fuse into syncytiotrophoblast until delivery, but in spite of Junqueira, you can often see some cytotrophoblast (i.e., single cells) in a mature placenta too. The villi soon become vascularized, and fetal venous blood picks up what it needs, and gets rid of what it must, into the mother's blood lakes (see below). The placental barrier includes the basement membrane and endothelium of the fetal capillaries, the mesenchyme of the villi, the basement membrane under the trophoblast, and the trophoblast itself, i.e., in other words, the whole thing. Syncytiotrophoblast produces hCG, the noted hormone somatomammotropin (which makes the breasts grow), progesterone, estrogen, and (in Junqueira, anyway) some other hormones of doubtful existence which stimulate the thyroid, zona fasciculata, uh-huh.
The amnion surrounds the unborn child, as a tough fibrous membrane with a simple (usually low-cuboidal with microvilli) epithelium on its inside. You can peel the fibrous membrane off the trophoblast (there's a lot of those X-cells right along here), but there's no epithelium between them. There's not much to the amnion; perhaps this is why Junqueira doesn't mention it. The inner epithelium runs up along the sides of the umbilical cord and becomes stratified squamous epithelium near where the joins the belly-button skin. The cord isn't much more than a tube of Wharton's-jelly undifferentiated avascular mesenchyme with two arteries and a vein (no elastica, no vasa vasora, no real adventitia). There may be a short remnant of yolk sac duct, evidence by a tube lined by simple-squamous epithelium.
The maternal part of the placenta is the decidua basalis. This gets throw up in folds surrounding the villi, each is called a placental septum. Blood spurts out from the bottom plate of the decidua basalis to percolate through the intervillous spaces (lacunes, same word as "lagoons"). I got ridiculed as a beginning resident for asking whether pathologists consider this part of the placenta; we do not, which is weird, because anatomists apparently do. By the time there's placenta, the blood vessels in the decidua have grown into blood lakes (no wonder the peripheral resistance goes down in pregnancy and the need for high cardiac output goes up). The blood in these lakes flows slowly around the villi, and chemicals (though not large proteins or cells) exchange. (Blood cells exchange during delivery and sometimes before.) And of course by this time, the endometrial stromal cells have become very large, very pink, and very easy-to-see decidua cells, making prolactin and goodness-knows-what-else to maintain the unborn child. Some pink stuff called "Nitubach's perivillous fibrin" sits between the floor of the placenta and the maternal decidual, supposedly useful in preventing the immune response from noticing the unborn child.
An "embryo" is eight weeks or less; after that, it's a "fetus".
15867 CHORIONIC INVASION OF MYOMETRIAL ARTERY
15868 CHORIONIC INVASION OF DECIDUAL ARTERY
15869 PLACENTA, SECOND TRIMESTER
15870 TERM PLACENTA
15872 CHORIOAMNIONITIS, ACUTE
15877 PLACENTA TWIN DICHORIONIC DIAMNIOTIC
15878 PLACENTA ACCRETA
15883 PLACENTA, FIRST PREGNANCY
16010 PLACENTA, MEMBRANES, AMNION, CHORION
16011 PLACENTA MEMBRANES
16014 PLACENTA MEMBRANES CHORIOAMNIONITIS
16031 PLACENTA PERIVILLOUS FIBRIN
16032 PLACENTA PERIVILLOUS FIBRIN
16050 PLACENTA PLASMA CELLS IN BASAL DECIDUA
16051 PLACENTA PLASMA CELLS IN BASAL DECIDUA
24666 PLACENTA, NORMAL
27035 TWIN PLACENTA DIVIDING MEMBRANE
27185 CHORIOAMNIONITIS, PLACENTAL MEMBRANES
35957 FALLOPIAN TUBE, DECIDUAL REACTION
39421 TROPHOBLASTS, NORMAL
39422 PLACENTA, NORMAL
39423 TROPHOBLAST, NORMAL
46502 ABORTION, PLACENTA
46607 PLACENTA AND UMBILICAL CORD
46608 PLACENTA AND UMBILICAL CORD
46610 BIRTH, INFERIOR VIEW, AMNIONIC MEMBRANE
46613 PLACENTA, DELIVERING
46614 PLACENTA, DELIVERING
46615 PLACENTA, DELIVERING
Vulva and vagina
The vagina ("sheath") is a tough tube of stratified squamous epithelium, usually without glands (there's a joke based on poor enunciation) unless there has been exposure to abnormally high levels of estrogens, in which case muellerian duct remnants may survive here. (There are often a few tiny glands in the unborn child; these vanish soon after birth.) The epithelium is thickest just before ovulation. Estrogen in the first half of the cycle causes the epithelial cells to fill with glycogen (becomes glucose for sperm food when the cells desquamate; bacteria tend to degrade the glucose into lactic acid imparting the low pH). If anybody still believes in "the vaginal orgasm", I'd like to know why. Junqueira makes a big deal about lymphocytes and neutrophils in the epithelium, but you can see these anyplace where there's friction. I have often seen and heard it alleged that the epithelial cells separate ("porosities of the itercellular crevices") during sexual response to allow fluid to enter the vagina. I doubt this and have never seen physical evidence that this is true, and if it is, it would make the vaginal mucosa truly extraordinary. The vaginal mucosa itself has very few sensory nerves. The lamina propria is extremely rich in veins and elastic fibers, and there are abundant lymphatics. Junqueira doesn't mention the rugal folds, which (when and where they're present, it varies) make the vagina just a bit rough; these enable the pathology crew to distinguish vagina from ectocervix. There's a layer of muscle (as usual, some will tell you "multiple muscle layers") around the vagina, too; contrary to what one might expect, this is almost all longitudinal. The adventitia is very vascular. Remnants of "Gartner's wolffian mesonephric duct" may be found along the vagina.
basal cells bottom cells in stratified squamous epithelium. Tiny cells, small nuclei, very little cytoplasm.
parabasal cells just above the bottom cells (ignore Junqueira); not much bigger than a basal cell.
intermediate cells Abundant cytoplasm, big busy-looking nuclei, stain green on Pap smear. Some have lots of glycogen depending on the time of cycle.
superficial cells Junqueira, but nobody else I know, calls them "precornified cells". Smaller nuclei, orange-pink cytoplasm on pap smear. Often lots of glycogen depending on the time of cycle. You might see a few keratohyalin granules.
cornified cells Orange on pap smear. "Cornified", of course, means "keratinized", and you shouldn't see these in health.
Before puberty, after menopause: Not much in the way of hormones. Thin mucosa. Mostly parabasal and intermediate cells.
Just before ovulation: Mostly estrogen. Mostly superficial cells with lots of glycogen.
After ovulation / during pregnancy: Mostly progesterone. Intermediate cells.
Not testable: I hope you laughed at Junqueira's suggestion that counting the numbers of these cells in a pap smear tells you whether there's cancer. We look for ANAPLASIA, Doc....
Not testable: Diethylstilbestrol, a cheap synthetic estrogen, given in the middle of this century in the hope that it would help women who'd lost unborn children. Surprisingly, the only problems that exposed children seem to have faced was glandular hamartomas in the upper vagina, which has about a 1-in-a-thousand chance of turning malignant ("clear cell adenocarcinoma") in the teens, which was bad. It is cheap; the estrogens used to supplement older women at risk for osteoporosis are more physiological (?) and more expensive; they come from mare's urine, and in 1996 animal-rights activists targeted this practice as evil ("exploiting mares"). All right, folks, show the courage of your convictions and either take evil-synthetic DES or don't complain if you end up crippled. You'll run into militant vegetarians from time to time; like most activists, most of the militant vegetarians I've met lie skillfully both with statistics and with wordplay. Typical is "Diethylstilbestrol is proved to cause cancer in humans but the wicked people still use it to fatten cattle." What's the fallacy? If you've got any regard for truth, you need to be able to answer this stuff. By the way, I strongly prefer my beef low-fat and wish this was easier to find.
The clitoris corresponds in anatomy to the penis, but is much more sensitive. Bartholin's glands ("major glands of the vestibule") are located along the urethra and match a man's bulbourethral glands, and like the matching parts on a man, there are mucus-secreters all around the clitoris, minor folds, and vestibule. The minor folds are smooth skin (there are sweat and sebaceous glands here, and the skin tends to keratinize) around a loose, elastic-rich connective tissue. The major folds are skin with all types of adnexa, including apocrine sweat glands, around a core of connective tissue that includes fat. Incredibly, Junqueira fails to describe the erectile tissue deep within the minor folds that correspond to the corpora around a man's bulbous urethra, or the hymen, which has non-keratinized epithelium on its vaginal surface and keratinized on its outer surface.
Not testable: The G-spot, described by a mystically-inclined psychiatrist in a book in the late 1970's, is supposed to be the magic site where stimulating a woman brings forth a gush of mystical sexual fluid through the vaginal mucosa. It turned out that the G-spot was the urethral meatus, and the mystical sexual fluid, when analyzed by the pathologists, was simply urine. I am not making this up.
08341 COCCOBACILLI, GRAM POSITIVE, CERVIX SPECIMEN
08343 COCCOBACILLI, GRAM POSITIVE, CERVIX SPECIMEN
08914 CERVIX, NORMAL
08915 ENDOMETRIUM, PROLIFERATIVE
10271 CERVIX, NORMAL
10274 CERVIX, NORMAL ENDOCERVIX
11765 CERVIX, NORMAL
11766 CERVIX, NORMAL
11768 CERVIX, NORMAL
14318 SECRETORY ENDOMETRIUM
14321 SECRETORY ENDOMETRIUM
14981 OVIDUCT, NORMAL FALLOPIAN TUBE
14982 OVIDUCT, NORMAL WITH FALLOPIAN TUBE WITH CILIA
14983 OVIDUCT (UTERINE PORTION), FALLOPIAN TUBE
14984 OVIDUCT (UTERINE PORTION) FALLOPIAN TUBE
14985 ENDOMETRIUM SECRETORY, NORMAL
14986 ENDOMETRIUM SECRETORY, NORMAL
14987 ENDOMETRIUM SECRETORY (GLYCOGEN STAIN)
14988 ENDOMETRIUM SECRETORY (GLYCOGEN STAIN)
14989 VAGINA, NORMAL
14990 VAGINA, PAP SMEAR, NORMAL
14991 VAGINA, PAP SMEAR, NORMAL
15091 VAGINA, NORMAL, ARROW ON NUCLEUS
17496 MYOMETRIUM, NORMAL
20675 OVIDUCT, AMPULLA, NORMAL
20676 OVIDUCT, AMPULLA, NORMAL
20677 OVIDUCT, AMPULLA, NORMAL
20678 OVIDUCT, ISTHMUS, NORMAL
20679 OVIDUCT, ISTHMUS, NORMAL
20680 OVIDUCT, ISTHMUS, NORMAL
20681 UTERUS, SECRETORY ENDOMETRIUM, NORMAL
20682 UTERUS, MYOMETRIUM, NORMAL
20685 UTERUS, RESTING ENDOMETRIUM, NORMAL
20687 CERVIX, NORMAL
20689 VAGINA, STRATIFIED SQUAMOUS EPITHELIUM
20788 ENDOMETRIUM SURFACE, NORMAL
20961 OVIDUCT, AMPULLA
20962 OVIDUCT, PEG CELLS
20963 OVIDUCT, ISTHMUS
20966 CERVIX, SQUAMOCOLUMNAR JUNCTION
24446 FALLOPIAN TUBE, NORMAL
24699 PAGET'S DISEASE, VULVA
24700 PAGET'S DISEASE, VULVA
24701 ENDOMETRIUM, PROLIFERATIVE
24702 ENDOMETRIUM, EARLY SECRETORY
25873 STRATIFIED SQUAMOUS EPITHELIUM, NORMAL CERVIX
25878 TRANSFORMATION ZONE, NORMAL CERVIX
25882 ENDOCERVICAL EPITHELIUM, TISSUE SECTION ENDOCERVIX
26783 EPITHELIUM, SIMPLE COLUMNAR, CERVIX WITH TRANSITIONAL ZONE ON RIGHT
26786 EPITHELIUM, STRATIFIED SQUAMOUS, CERVIX NEAR TRANSFORMATION ZONE 27050 ADENOSIS, VAGINA, SECONDARY TO DIETHYLSTILBESTROL EXPOSURE, DES
27128 ECTOCERVIX, NORMAL GLYCOGENATED EPITHELIUM
27140 WOLFFIAN DUCT REMNANTS, CERVIX
27143 ADENOCARCINOMA, CERVIX
27149 PROLIFERATIVE ENDOMETRIUM
27152 SECRETORY ENDOMETRIUM
27155 SECRETORY ENDOMETRIUM
27158 MENSTRUAL ENDOMETRIUM
29291 ENDOMETRIAL CELLS, NORMAL
29307 ENDOMETRIAL CELLS, NORMAL
35957 FALLOPIAN TUBE, DECIDUAL REACTION
35982 ENDOMETRIUM, EARLY SECRETORY, NORMAL
35985 ENDOMETRIUM, EARLY SECRETORY, NORMAL
44459 UTERUS, ENDOMETRIUM, MENSTRUAL PHASE
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