Hysterectomy pp 259-295 | Cite as

Processing and Histopathological Workup of Hysterectomy Specimens

  • Lars-Christian HornEmail author
  • Anne K. Höhn


The challenges of histopathology have been changed dramatically during the last years. The pathologist nowadays is a diagnostic oncologist. The histopathologic report is one cornerstone and within the majority of cases the basement of quality control and decision making for patients treatment. The final pathology report bases on a very accurate macroscopic description and cutting of the specimens. The quality of the histopathological report is mainly influenced by the available clinical information. So, it is necessary that the pathologist and the clinician speak the same language. This chapter describes the requirements for good clinical practice in handling and reporting of different kinds of hysterectomy specimens and gives an overview about the needs as well as for the clinicians but also for gynaecologic pathologists. Special focus was made on the requirements for optimal handlings influenced by the clinicians. The procedure colloquially known, as frozen section is one of the most important and potentially stressful tasks that the pathologist performs in practice. The advances and limitations of that technique is discussed. Detailed descriptions are given for the parameters included in the histopathology report for benign and malignant disease within hysterectomies, lymphonodectomy and omentectomy specimens.


Hysterectomy Gross description Handling Cutting Frozen section Quality assurance Histopathology report Lymphonodectomy Guidelines Omentectomy 


  1. 1.
    Abassi-Ghadi N, Boshier PR, Goldin R, Hanna GB. Techniques to increase lymph node harvest from gastrointestinal cancer specimens: a systematic review and meta-analysis. Histopathology. 2012;61(4):531–42.CrossRefGoogle Scholar
  2. 2.
    Abiko K, Baba T, Ogawa M, Mikami Y, Koyama T, Mandai M, Konishi I. Minimal deviation mucinous adenocarcinoma (‘adenoma malignum’) of the uterine corpus. Pathol Int. 2010;60(1):42–7.PubMedCrossRefGoogle Scholar
  3. 3.
    Ahmed QF, Gattoc L, Al-Wahab Z, Abdulfatah E, Ruterbusch JJ, Cote M, Bandyopadhyay S, Morris RT, Ali-Fehmi R. Vanishing endometrial cancer in hysterectomy specimens: a myth or a fact. Am J Surg Pathol. 2015;39(2):221–6.PubMedCrossRefGoogle Scholar
  4. 4.
    Ali A, Black D, Soslow RA. Difficulties in assessing the depth of myometrial invasion in endometrial carcinoma. Int J Gynecol Pathol. 2007;26:115–23.PubMedCrossRefGoogle Scholar
  5. 5.
    Argani P, Cimino-Mathews A. Intraoperative frozen sections. Diagnostic pitfalls. New York: demosMedical; 2014. p. 255–8.Google Scholar
  6. 6.
    Atienza-Amores M, Guerini-Rocco E, Soslow RA, Park KJ, Weigelt B. Small cell carcinoma of the gynecologic tract: a multifaceted spectrum of lesions. Gynecol Oncol. 2014;134(2):410–8.PubMedCrossRefGoogle Scholar
  7. 7.
    AWMF. S3-Leitlinie Diagnostik, Therapie und Nachsorge der Patientin mit Zervixkarzinom. Langversion; 2014.
  8. 8.
    Bachtiary B, Boutros PC, Pintilie M, Shi W, Bastianutto C, Li JH, Schwock J, Zhang W, Penn LZ, Jurisica I, Fyles A, Liu FF. Gene expression profiling in cervical cancer: an exploration of intratumor heterogeneity. Clin Cancer Res. 2006;12(19):5632–40.PubMedCrossRefGoogle Scholar
  9. 9.
    Baker P, Oliva E. A practical approach to intraoperative consultation in gynecological pathology. Int J Gynecol Pathol. 2008;27(3):353–65.PubMedCrossRefGoogle Scholar
  10. 10.
    Bartosch C, Exposito MI, Lopes JM. Low-grade endometrial stromal sarcoma and undifferentiated endometrial sarcoma: a comparative analysis emphasizing the importance of distinguishing between these two groups. Int J Surg Pathol. 2010;18(4):286–91.PubMedCrossRefGoogle Scholar
  11. 11.
    Bartosch C, Manuel Lopes J, Oliva E. Endometrial carcinomas: a review emphasizing overlapping and distinctive morphological and immunohistochemical features. Adv Anat Pathol. 2011;18(6):415–37.PubMedCrossRefGoogle Scholar
  12. 12.
    Bjornsson BL, Nelson BE, Reale FR, Rose PG. Accuracy of frozen section for lymph node metastasis in patients undergoing radical hysterectomy for carcinoma of the cervix. Gynecol Oncol. 1993;51(1):50–3.PubMedCrossRefGoogle Scholar
  13. 13.
    Bojahr B, Tchartchian G, Ohlinger R. Laparoscopic supracervical hysterectomy: a retrospective analysis of 1000 cases. JSLS. 2009;13(2):129–34.PubMedPubMedCentralGoogle Scholar
  14. 14.
    Buchanan DD, Tan YY, Walsh MD, Clendenning M, Metcalf AM, Ferguson K, Arnold ST, Thompson BA, Lose FA, Parsons MT, Walters RJ, Pearson SA, Cummings M, Oehler MK, Blomfield PB, Quinn MA, Kirk JA, Stewart CJ, Obermair A, Young JP, Webb PM, Spurdle AB. Tumor mismatch repair immunohistochemistry and DNA MLH1 methylation testing of patients with endometrial cancer diagnosed at age younger than 60 years optimizes triage for population-level germline mismatch repair gene mutation testing. J Clin Oncol. 2014;32(2):90–100.PubMedCrossRefGoogle Scholar
  15. 15.
    Burke WM, SGO Clinical Practice Endometrial Cancer Working Group, Orr J, Leitao M, Salom E, Gehrig P, Olawaiye AB, Brewer M, Boruta D, Villella J, Herzog T, Abu Shahin F, Society of Gynecologic Oncology Clinical Practice Committee. Endmetrial cancer: a review and current management strategies: part I. Gynecol Oncol. 2014;134(2):385–92.PubMedCrossRefGoogle Scholar
  16. 16.
    Burke WM, SGO Clinical Practice Endometrial Cancer Working Group, Orr J, Leitao M, Salom E, Gehrig P, Olawaiye AB, Brewer M, Boruta D, Herzog TJ, Shahin FA, Society of Gynecologic Oncology Clinical Practice Committee. Endometrial cancer: a review and current management strategies: part II. Gynecol Oncol. 2014 Aug;134(2):393–402.PubMedCrossRefGoogle Scholar
  17. 17.
  18. 18.
    Charames GS, Millar AL, Pal T, Narod S, Bapat B. Do MSH6 mutations contribute to double primary cancers of the colorectum and endometrium? Hum Genet. 2000;107:623–9.PubMedCrossRefGoogle Scholar
  19. 19.
    Cibula D, Abu-Rustum NR, Dusek L, Zikán M, Zaal A, Sevcik L, Kenter GG, Querleu D, Jach R, Bats AS, Dyduch G, Graf P, Klat J, Lacheta J, Meijer CJ, Mery E, Verheijen R, Zweemer RP. Prognostic significance of low volume sentinel lymph node disease in early-stage cervical cancer. Gynecol Oncol. 2012;124(3):496–501.PubMedCrossRefGoogle Scholar
  20. 20.
    Cibula D, Sláma J, Svárovský J, Fischerova D, Freitag P, Zikán M, Pinkavová I, Pavlista D, Dundr P, Hill M. Abdominal radical trachelectomy in fertility-sparing treatment of early-stage cervical cancer. Int J Gynecol Cancer. 2009;19(8):1407–11.PubMedCrossRefGoogle Scholar
  21. 21.
    Clement PB. The pathology of endometriosis: a survey of the many faces of a common disease emphasizing diagnostic pitfalls and unusual and newly appreciated aspects. Adv Anat Pathol. 2007;14(4):241–60.PubMedCrossRefGoogle Scholar
  22. 22.
    Clement PB. The pathology of uterine smooth muscle tumors and mixed endometrial stromal-smooth muscle tumors: a selective review with emphasis on recent advances. Int J Gynecol Pathol. 2000;19:39–55.PubMedCrossRefGoogle Scholar
  23. 23.
    Coindre JM. Grading and staging of sarcoma. In: CDM F, Bridge JA, PCW H, Mertens F, editors. WHO classification of tumours of soft tissue and bone. Lyon: IARC Press; 2013. p. 17–8.Google Scholar
  24. 24.
    Coindre JM. Grading of soft tissue sarcomas: review and update. Arch Pathol Lab Med. 2006;130(10):1448–53.PubMedGoogle Scholar
  25. 25.
    CAP: College of American Pathologists. Protocol for the examination of specimens from patients with carcinoma of the ovary. 2015.
  26. 26.
    Coffey D, Kaplan AL, Ramzy I. Intraoperative consultation in gynecologic pathology. Arch Pathol Lab Med. 2005;129:1544–57.PubMedGoogle Scholar
  27. 27.
    Conklin CMJ, Longacre TA. Lynch syndrome in endometrial carcinoma: a sentinel diagnosis. Pathol Case Rev. 2014;19:78–84.CrossRefGoogle Scholar
  28. 28.
    Delgado G, Bundy B, Zaino R, Sevin BU, Creasman WT, Major F. Prospective surgical-pathological study of disease-free interval in patients with stage IB squamous cell carcinoma of the cervix: a Gynecologic Oncology Group study. Gynecol Oncol. 1990;38(3):352–7.PubMedCrossRefGoogle Scholar
  29. 29.
    Dempster WT. Rates of penetration of fixing fluids. Am J Anat. 1960;107:59–72.PubMedCrossRefGoogle Scholar
  30. 30.
    Deyrup AT, Weiss SW. Grading of soft tissue sarcomas: the challenge of providing precise information in an imprecise world. Histopathology. 2006;48(1):42–50.PubMedCrossRefGoogle Scholar
  31. 31.
    Diaz De Vivar A, Roma AA, Park KJ, Alvarado-Cabrero I, Rasty G, Chanona-Vilchis JG, Mikami Y, Hong SR, Arville B, Teramoto N, Ali-Fehmi R, Rutgers JK, Tabassum F, Barbuto D, Aguilera-Barrantes I, Shaye-Brown A, Daya D, Silva EG. Invasive endocervical adenocarcinoma: proposal for a new pattern-based classification system with significant clinical implications: a multi-institutional study. Int J Gynecol Pathol. 2013;32(6):592–601.PubMedCrossRefGoogle Scholar
  32. 32.
    Doig T, Monaghan H. Sampling the omentum in ovarian neoplasia: when one block is enough. Int J Gynecol Cancer. 2006;16:36–40.PubMedCrossRefGoogle Scholar
  33. 33.
    Roma AA, Diaz De Vivar A, Park KJ, Alvarado-Cabrero I, Rasty G, Chanona-Vilchis JG, Mikami Y, Hong SR, Teramoto N, Ali-Fehmi R, Rutgers JK, Barbuto D, Silva EG. Invasive endocervical adenocarcinoma: a new pattern-based classification system with important clinical significance. Am J Surg Pathol. 2015;39(5):667–72.PubMedCrossRefGoogle Scholar
  34. 34.
    Doering DL, Barnhill DR, Weiser EB, et al. Intraoperative evaluation of depth of myometrial invasion in stage I endometrial adenocarcinoma. Obstet Gynecol. 1989;74:930–3.PubMedGoogle Scholar
  35. 35.
    Downes MR, Allo G, McCluggage WG, Sy K, Ferguson SE, Aronson M, Pollett A, Gallinger S, Bilbily E, Shaw P, Clarke BA. Review of findings in prophylactic gynaecological specimens in Lynch syndrome with literature review and recommendations for grossing. Histopathology. 2014;65(2):228–39.PubMedCrossRefGoogle Scholar
  36. 36.
    Dubé V, Macdonald D, Allingham-Hawkins DJ, Kamel-Reid S, Colgan TJ. Vanishing endometrial carcinoma. Int J Gynecol Pathol. 2007;26(3):271–7.PubMedCrossRefGoogle Scholar
  37. 37.
    Ehdaivand S, Simon RA, Sung CJ, Steinhoff MM, Lawrence WD, Quddus MR. Incidental gynecologic neoplasms in morcellated uterine specimens: a case series with follow-up. Hum Pathol. 2014;45(11):2311–7.PubMedCrossRefGoogle Scholar
  38. 38.
    El-Bahrawy M, Ganesan R. Frozen section in gynaecology: uses and limitations. Arch Gynecol Obstet. 2014;289(6):1165–70.PubMedCrossRefGoogle Scholar
  39. 39.
    Emons G, Mallmann P, members of the Uterus Commission of AGO. Recommendations for the diagnosis and treatment of endometrial caner, update 2013. Geburtshilfe Frauenheilk. 2014;74:244–7.CrossRefGoogle Scholar
  40. 40.
    Estape RE, Angioli R, Madrigal M, Janicek M, Gomez C, Penalver M, Averette H. Close vaginal margins as a prognostic factor after radical hysterectomy. Gynecol Oncol. 1998;68(3):229–32.PubMedCrossRefGoogle Scholar
  41. 41.
    Euscher E, Fox P, Bassett R, Al-Ghawi H, Ali-Fehmi R, Barbuto D, Djordjevic B, Frauenhoffer E, Kim I, Hong SR, Montiel D, Moschiano E, Roma A, Silva E, Malpica A. The pattern of myometrial invasion as a predictor of lymph node metastasis or extrauterine disease in low-grade endometrial carcinoma. Am J Surg Pathol. 2013;37(11):1728–36.PubMedPubMedCentralCrossRefGoogle Scholar
  42. 42.
    Fader AN, Edwards RP, Cost M, Kanbour-Shakir A, Kelley JL, Schwartz B, Sukumvanich P, Comerci J, Sumkin J, Elishaev E, Rohan LC. Sentinel lymph node biopsy in early-stage cervical cancer: utility of intraoperative versus postoperative assessment. Gynecol Oncol. 2008;111(1):13–7.PubMedCrossRefGoogle Scholar
  43. 43.
    Fanning J, Tsukada Y, Piver MS. Intraoperative frozen section diagnosis of depth of myometrial invasion in endometrial adenocarcinoma. Gynecol Oncol. 1990;37:47–50.PubMedCrossRefGoogle Scholar
  44. 44.
    Ferguson SE, Aronson M, Pollett A, Eiriksson LR, Oza AM, Gallinger S, Lerner-Ellis J, Alvandi Z, Bernardini MQ, MacKay HJ, Mojtahedi G, Tone AA, Massey C, Clarke BA. Performance characteristics of screening strategies for Lynch syndrome in unselected women with newly diagnosed endometrial cancer who have undergone universal germline mutation testing. Cancer. 2014;120(24):3932–9.PubMedCrossRefGoogle Scholar
  45. 45.
    Franchi M, Ghezzi F, Melpignano M, Cherchi PL, Scarabelli C, Apolloni C, Zanaboni F. Clinical value of intraoperative gross examination in endometrial cancer. Gynecol Oncol. 2000;76(3):357–61.PubMedCrossRefGoogle Scholar
  46. 46.
    Fregnani JH, Latorre MR, Novik PR, Lopes A, Soares FA. Assessment of pelvic lymph node micrometastatic disease in stages IB and IIA of carcinoma of the uterine cervix. Int J Gynecol Cancer. 2006;16:1188–94.PubMedCrossRefGoogle Scholar
  47. 47.
    Friedlander ML, Covens A, Glasspool RM, Hilpert F, Kristensen G, Kwon S, Selle F, Small W, Witteveen E, Russell P. Gynecologic Cancer InterGroup (GCIG) consensus review for mullerian adenosarcoma of the female genital tract. Int J Gynecol Cancer. 2014;24(9 Suppl 3):S78–82.PubMedCrossRefGoogle Scholar
  48. 48.
    Ganesan R, Brown LJ, Kehoe S, McCluggage WG, El-Bahrawy MA. The role of frozen sections in gynaecological oncology: survey of practice in the United Kingdom. Eur J Obstet Gynecol Reprod Biol. 2013;166(2):204–8.PubMedCrossRefGoogle Scholar
  49. 49.
    Garg G, Shah JP, Toy EP, Field JB, Bryant CS, Liu JR, Morris RT. Intra-operative detection of nodal metastasis in early stage cervical cancer: a survey of the practice patterns of SGO members. Gynecol Oncol. 2011;121(1):143–7.PubMedCrossRefGoogle Scholar
  50. 50.
    Ghaemmaghami F, Behnamfar F, Ensani F. Intraoperative frozen sections for assessment of female cancers. Asian Pac J Cancer Prev. 2007;8(4):635–9.PubMedGoogle Scholar
  51. 51.
    Goff BA, Rice LW. Assessment of depth of myometrial invasion in endometrial adenocarcinoma. Gynecol Oncol. 1990;38(1):46–8.PubMedCrossRefGoogle Scholar
  52. 52.
    Graebe K, Garcia-Soto A, Aziz M, Valarezo V, Heller PB, Tchabo N, Tobias DH, Salamon C, Ramieri J, Dise C, Slomovitz BM. Incidental power morcellation of malignancy: a retrospective cohort study. Gynecol Oncol. 2015;136(2):274–7.PubMedCrossRefGoogle Scholar
  53. 53.
    Grosse-Drieling D, Schlutius JC, Altgassen C, Kelling K, Theben J. Laparoscopic supracervical hysterectomy (LASH), a retrospective study of 1,584 cases regarding intra- and perioperative complications. Arch Gynecol Obstet. 2012;285(5):1391–6.PubMedCrossRefGoogle Scholar
  54. 54.
    Hagemann IS, Hagemann AR, LiVolsi VA, Montone KT, Chu CS. Risk of occult malignancy in morcellated hysterectomy: a case series. Int J Gynecol Pathol. 2011;30(5):476–83.PubMedCrossRefGoogle Scholar
  55. 55.
    Hart WR. Symposium 2: mesenchymal lesions of the uterus. Histopathology. 2002;41:12–31.CrossRefGoogle Scholar
  56. 56.
    Herfs M, Yamamoto Y, Laury A, Wang X, Nucci MR, McLaughlin-Drubin ME, Münger K, Feldman S, McKeon FD, Xian W, Crum CP. A discrete population of squamocolumnar junction cells implicated in the pathogenesis of cervical cancer. Proc Natl Acad Sci U S A. 2012;109(26):10516–21.PubMedPubMedCentralCrossRefGoogle Scholar
  57. 57.
    Hirschowitz L, Nucci M, Zaino RJ. Problematic issues in the staging of endometrial, cervical and vulval carcinomas. Histopathology. 2013;62(1):176–202.PubMedCrossRefGoogle Scholar
  58. 58.
    Höckel M, Hentschel B, Horn LC. Association between developmental steps in the organogenesis of the uterine cervix and locoregional progression of cervical cancer: a prospective clinicopathological analysis. Lancet Oncol. 2014;15(4):445–56.PubMedCrossRefGoogle Scholar
  59. 59.
    Höckel M, Horn LC, Hentschel B, Höckel S, Naumann G. Total mesometrial resection: high resolution nerve-sparing radical hysterectomy based on developmentally defined surgical anatomy. Int J Gynecol Cancer. 2003;13(6):791–803.PubMedCrossRefGoogle Scholar
  60. 60.
    Höckel M, Horn LC, Illig R, Dornhöfer N, Fritsch H. Ontogenetic anatomy of the distal vagina: relevance for local tumor spread and implications for cancer surgery. Gynecol Oncol. 2011;122(2):313–8.PubMedCrossRefGoogle Scholar
  61. 61.
    Höckel M, Horn LC. The puzzle of close surgical margins is not puzzling. Gynecol Oncol. 2013;130(1):224–5.PubMedCrossRefGoogle Scholar
  62. 62.
    Horn LC, Beckmann MW, Follmann M, Koch MC, Mallmann P, Marnitz S, Schmidt D. 3-Leitlinie Diagnostik und Therapie des Zervixkarzinoms – Anforderungen an die Pathologie. Pathologe. 2015, im Druck.Google Scholar
  63. 63.
    Horn LC, Dallacker M, Bilek K. Carcinosarcomas (malignant mixed Mullerian tumors) of the uterus. Morphology, pathogenetic aspects and prognostic factors. Pathologe. 2009;30(4):292–301.PubMedCrossRefGoogle Scholar
  64. 64.
    Horn LC, Einenkel J, Höckel M, Kölbl H, Kommoss F, Lax SF, Reich O, Riethdorf L, Schmidt D. Pathoanatomical preparation and reporting for dysplasias and cancers of the cervix uteri: cervical biopsy, conization, radical hysterectomy and exenteration. Pathologe. 2007;28(4):249–60.PubMedCrossRefGoogle Scholar
  65. 65.
    Horn LC, Einenkel J, Höckel M, Kölbl H, Kommoss F, Lax SF, Riethdorf L, Schnürch HG, Schmidt D. Recommendations for the handling and oncologic pathology report of lymph node specimens submitted for evaluation of metastatic disease in gynecologic malignancies. Pathologe. 2005;26(4):266–72.PubMedCrossRefGoogle Scholar
  66. 66.
    Horn LC, Fischer U, Raptis G, Bilek K, Hentschel B, Richter CE, Braumann UD, Einenkel J. Pattern of invasion is of prognostic value in surgically treated cervical cancer patients. Gynecol Oncol. 2006;103(3):906–11.PubMedCrossRefGoogle Scholar
  67. 67.
    Horn LC, Hentschel B, Fischer U, Peter D, Bilek K. Detection of micrometastases in pelvic lymph nodes in patients with carcinoma of the cervix uteri using step sectioning: Frequency, topographic distribution and prognostic impact. Gynecol Oncol. 2008;111(2):276–81.PubMedCrossRefGoogle Scholar
  68. 68.
    Horn LC, Hentschel B, Galle D, Bilek K. Extracapsular extension of pelvic lymph node metastases is of prognostic value in carcinoma of the cervix uteri. Gynecol Oncol. 2008;108(1):63–7.PubMedCrossRefGoogle Scholar
  69. 69.
    Horn LC, Hommel N, Roschlau U, Bilek K, Hentschel B, Einenkel J. Peritumoral stromal remodeling, pattern of invasion and expression of c-met/HGF in advanced squamous cell carcinoma of the cervix uteri, FIGO stages III and IV. Eur J Obstet Gynecol Reprod Biol. 2012;163(1):76–80.PubMedCrossRefGoogle Scholar
  70. 70.
    Horn LC, Meinel A, Fischer U, Bilek K, Hentschel B. Perineural invasion in carcinoma of the cervix uteri–prognostic impact. J Cancer Res Clin Oncol. 2010;136(10):1557–62.PubMedCrossRefGoogle Scholar
  71. 71.
    Horn LC, Meinel A, Handzel R, Einenkel J. Histopathology of endometrial hyperplasia and endometrial carcinoma: an update. Ann Diagn Pathol. 2007;11:297–311.PubMedCrossRefGoogle Scholar
  72. 72.
    Horn LC, Schierle K, Schmidt D, Ulrich U, Liebmann A, Wittekind C. Current TNM/FIGO classification for cervical and endometrial cancer as well as malignant mixed müllerian tumors. Facts and background. Pathologe. 2011;32(3):239–43.PubMedCrossRefGoogle Scholar
  73. 73.
    Horn LC, Schnurrbusch U, Bilek K, Hentschel B, Einenkel J. Risk of progression in complex and atypical endometrial hyperplasia: clinicopathologic analysis in cases with and without progestogen treatment. Int J Gynecol Cancer. 2004;14(2):348–53.PubMedCrossRefGoogle Scholar
  74. 74.
    Horn LC, Trost M, Bilek K. Staging of endometrial carcinoma: aspects of ovarian and cervical involvement. Int J Gynecol Pathol. 2010;29(1):63–6.PubMedCrossRefGoogle Scholar
  75. 75.
    Horn LC, Wagner S. Frozen section analysis of vulvectomy specimens: results of a 5-year study period. Int J Gynecol Pathol. 2010;29(2):165–72.PubMedCrossRefGoogle Scholar
  76. 76.
    Horn LC, Klostermann K. Precancerous lesions of the uterine cervix: morphology and molecular pathology. Pathologe. 2011;32(Suppl 2):242–54.PubMedCrossRefGoogle Scholar
  77. 77.
    Hunt JL, Baloch ZW, LiVolsi VA. Sentinel lymph node evaluation for tumor metastasis. Semin Diagn Pathol. 2002;19(4):263–77.PubMedGoogle Scholar
  78. 78.
    Ioffe OB. Recent developments and selected diagnostic problems in carcinomas of the endometrium. Am J Clin Pathol. 2005;124(Suppl):S42–51.PubMedGoogle Scholar
  79. 79.
    Ip PP, Cheung AN. Pathology of uterine leiomyosarcomas and smooth muscle tumours of uncertain malignant potential. Best Pract Res Clin Abstet Gynaecol. 2011;25(6):691–704.CrossRefGoogle Scholar
  80. 80.
    Jaiman S, Surampudi K, Gundabattula SR, Garg D. Bilateral ovarian metastatic squamous cell carcinoma arising from the uterine cervix and eluding the Mullerian mucosa. Diagn Pathol. 2014;9:109.PubMedPubMedCentralCrossRefGoogle Scholar
  81. 81.
    Kalyanasundaram K, Ganesan R, Perunovic B, McCluggage WG. Diffusely infiltrating endometrial carcinomas with no stromal response: report of a series, including cases with cervical and ovarian involvement and emphasis on the potential for misdiagnosis. Int J Surg Pathol. 2010;18(2):138–43.PubMedCrossRefGoogle Scholar
  82. 82.
    Karamurzin Y, Soslow RA, Garg K. Histologic evaluation of prophylactic hysterectomy and oophorectomy in Lynch syndrome. Am J Surg Pathol. 2013;37(4):579–85.PubMedCrossRefGoogle Scholar
  83. 83.
    Kato T, Watari H, Takeda M, Hosaka M, Mitamura T, Kobayashi N, Sudo S, Kaneuchi M, Kudo M, Sakuragi N. Multivariate prognostic analysis of adenocarcinoma of the uterine cervix treated with radical hysterectomy and systematic lymphadenectomy. J Gynecol Oncol. 2013;24(3):222–8.PubMedPubMedCentralCrossRefGoogle Scholar
  84. 84.
    Kimmig R, Aktas B, Buderath P, Wimberger P, Iannaccone A, Heubner M. Definition of compartment-based radical surgery in uterine cancer: modified radical hysterectomy in intermediate/high-risk endometrial cancer using peritoneal mesometrial resection (PMMR) by M Höckel translated to robotic surgery. World J Surg Oncol. 2013;11:198.PubMedPubMedCentralCrossRefGoogle Scholar
  85. 85.
    Kir G, Kir M, Cetiner H, Karateke A, Gurbuz A. Diagnostic problems on frozen section examination of myometrial invasion in patients with endometrial carcinoma with special emphasis on the pitfalls of deep adenomyosis with carcinomatous involvement. Eur J Gynaecol Oncol. 2004;25(2):211–4.PubMedGoogle Scholar
  86. 86.
    Kodama J, Kusumoto T, Nakamura K, Seki N, Hongo A, Hiramatsu Y. Factors associated with parametrial involvement in stage IB1 cervical cancer and identification of patients suitable for less radical surgery. Gynecol Oncol. 2011;122(3):491–4.PubMedCrossRefGoogle Scholar
  87. 87.
    Koshiyama M, Suzuki A, Ozawa M, Fujita K, Sakakibara A, Kawamura M, Takahashi S, Fujii H, Hirano T, Okagaki A, Nagano T, Ban C. Adenocarcinomas arising from uterine adenomyosis: a report of four cases. Int J Gynecol Pathol. 2002;21(3):239–45.PubMedCrossRefGoogle Scholar
  88. 88.
    Kucera E, Kainz C, Reinthaller A, Sliutz G, Leodolter S, Kucera H, Breitenecker G. Accuracy of intraoperative frozen-section diagnosis in stage I endometrial adenocarcinoma. Gynecol Obstst Invest. 2000;49(1):62–6.CrossRefGoogle Scholar
  89. 89.
    Kumar S, Bandyopadhyay S, Semaan A, Shah JP, Mahdi H, Morris R, Munkarah A, Ali-Fehmi R. The role of frozen section in surgical staging of low risk endometrial cancer. PLoS One. 2011;6(9):e21912.PubMedPubMedCentralCrossRefGoogle Scholar
  90. 90.
    Kurman RJ, Amin MB, Members of the Cancer Committee, College of American Pathologists. Protocol for the examination of specimens from patients with carcinomas of the cervix. A basis for checklists. Arch Pathol Lab Med. 1999;123:55–61.PubMedGoogle Scholar
  91. 91.
    Lachiewicz MP, Kravochuck SE, O'Malley MM, Heald B, Church JM, Kalady MF, Drake RD. Prevalence of occult gynecologic malignancy at the time of risk reducing and nonprophylactic surgery in patients with Lynch syndrome. Gynecol Oncol. 2014;132(2):434–7.PubMedCrossRefGoogle Scholar
  92. 92.
    Lancaster JM, Powell CB, Chen LM, Richardson DL, SGO Clinical Practice Committee. Society of Gynecologic Oncology statement on risk assessment for inherited gynecologic cancer predispositions. Gynecol Oncol. 2015;136(1):3–7.PubMedCrossRefGoogle Scholar
  93. 93.
    Landoni F, Maneo A, Colombo A, Placa F, Milani R, Perego P, Favini G, Ferri L, Mangioni C. Randomised study of radical surgery versus radiotherapy for stage IB-IIA cervical cancer. Lancet. 1997;350:535–40.PubMedCrossRefGoogle Scholar
  94. 94.
    Landry D, Mai KT, Senterman MK, Perkins DG, Yazdi HM, Veinot JP, Thomas J. Endometrioid adenocarcinoma of the uterus with a minimal deviation invasive pattern. Histopathology. 2003;42(1):77–82.PubMedCrossRefGoogle Scholar
  95. 95.
    Langlois PL. The size of the normal uterus. J Reprod Med. 1970;4(6):220–8.PubMedGoogle Scholar
  96. 96.
    Langreder W. Das Parametrium. In: Schröder R (Hrsg). Zwanglose Abhandlungen auf dem Gebiete der Frauenheilkunde. Band 18, Leipzig: Thieme; 1955.Google Scholar
  97. 97.
    Lawrence WD, Abdul-Karim FW, Crum C, Fu YS for the Association of Directors of Anatomic and Surgical Pathology. Recommendations for the reporting of surgical specimens containing uterine cervical neoplasms. Hum Pathol. 2000;31:1194–8.Google Scholar
  98. 98.
    Lawrence WD, Association of Directors of Anatomic and Surgical Pathology. ADASP recommendations for processing and reporting of lymph node specimens submitted for evaluation of metastatic disease. Virchows Arch. 2001;439(5):601–3.PubMedCrossRefGoogle Scholar
  99. 99.
    Lax S, Tamussino K, Prein K, Lang P. Intraoperative frozen sections in diseases of the female genital tract. Pathologe. 2012;33(5):430–40.PubMedCrossRefGoogle Scholar
  100. 100.
    Lee AH, Key HP, Bell JA, Kumah P, Hodi Z, Ellis IO. The effect of delay in fixation on HER2 expression in invasive carcinoma of the breast assessed with immunohistochemistry and in situ hybridisation. J Clin Pathol. 2014;67:573–5.PubMedCrossRefGoogle Scholar
  101. 101.
    Lentz SE, Muderspach LI, Felix JC, Ye W, Groshen S, Amezuca CA. Identification of mircometastases in histologically negative nodes of early-stage cervical cancer patients. Obstet Gynecol. 2004;103:1204–10.PubMedCrossRefGoogle Scholar
  102. 102.
    Lim P, Al Kushi A, Gilks B, Wong F, Aquino-Parsons C. Early stage papillary serous carcinoma of the endometrium: effect of adjuvant whole abdominal radiotherapy and pathologic parameters on outcome. Cancer. 2001;91:752–7.PubMedCrossRefGoogle Scholar
  103. 103.
    Liebig C, Ayala G, Wilks JA, Berger DH, Albo D. Perineural invasion in cancer: a review of the literature. Cancer. 2009;115:3379–91.PubMedCrossRefGoogle Scholar
  104. 104.
    Lindor NM, Petersen GM, Hadley DW, Kinney AY, Miesfeldt S, Lu KH, Lynch P, Burke W, Press N. Recommendations for the care of individuals with an inherited predisposition to Lynch syndrome: a systematic review. JAMA. 2006;296(12):1507–17.PubMedCrossRefGoogle Scholar
  105. 105.
    Lopez-Garcia MA, Palacios J. Pathologic and molecular features of uterine carcinosarcomas. Semin Diagn Pathol. 2010;27(4):274–86.PubMedCrossRefGoogle Scholar
  106. 106.
    Mai KT, Perkins DG, Yazdi HM, Thomas J. Endometrioid carcinoma of the endometrium with an invasive component of minimal deviation carcinoma. Hum Pathol. 2002;33(8):856–8.PubMedCrossRefGoogle Scholar
  107. 107.
    Marchiole P, Buenerd A, Benchaib M, Nezhat K, Dargent D, Mathevet P. Clinical significance of lympho vascular space involvement and lymph node micrometastases in early-stage cervical cancer: a retrospective case-control surgico-pathological study. Gynecol Oncol. 2005;97:727–32.PubMedCrossRefGoogle Scholar
  108. 108.
    McCann GA, Taege SK, Boutsicaris CE, Phillips GS, Eisenhauer EL, Fowler JM, O'Malley DM, Copeland LJ, Cohn DE, Salani R. The impact of close surgical margins after radical hysterectomy for early-stage cervical cancer. Gynecol Oncol. 2013;128(1):44–8.PubMedCrossRefGoogle Scholar
  109. 109.
    McCluggage WG, Colgan T, Duggan M, Hacker NF, Mulvany N, Otis C, Wilkinson N, Zaino RJ, Hirschowitz L. Dataset for reporting of endometrial carcinomas: recommendations from the International Collaboration on Cancer Reporting (ICCR) between United Kingdom, United States, Canada, and Australasia. Int J Gynaecol Pathol. 2012;32:45–65.CrossRefGoogle Scholar
  110. 110.
    Metindir J, Bilir Dilek G. Evaluation of prognostic significance in extracapsular spread of pelvic lymph node metastasis in patients with cervical cancer. Eur J Gynaecol Oncol. 2008;29(5):476–8.PubMedGoogle Scholar
  111. 111.
    Kidd EA, Grigsby PW. Intratumoral metabolic heterogeneity of cervical cancer. Clin Cancer Res. 2008;14(16):5236–41.PubMedCrossRefGoogle Scholar
  112. 112.
    McCluggage WG, Fisher C, Hirschowitz L for the Roayl College of Pathologists. Dataset for histological reporting of uterine sarcomas. 2014.
  113. 113.
    McCluggage WG, Ganesan R, Herrington CS. Endometrial stromal sarcomas with extensive endometrioid glandular differentiation: report of a series with emphasis on the potential for misdiagnosis and discussion of the differential diagnosis. Histopathology. 2009;54(3):365–73.PubMedCrossRefGoogle Scholar
  114. 114.
    McCluggage WG, Hirschowitz L, Wilson GE, Oliva E, Soslow RA, Zaino RJ. Significant variation in the assessment of cervical involvement in endometrial carcinoma: an interobserver variation study. Am J Surg Pathol. 2011;35(2):289–94.PubMedCrossRefGoogle Scholar
  115. 115.
    McCluggage WG, Judge MJ, Clarke BA, Davidson B, Gilks CB, Hollema H, Ledermann JA, Matias-Guiu X, Mikami Y, Stewart CJR, Vang R, Hirschowitz L. Dataset for reporting of ovary, fallopian tube and primary peritoneal carcinoma: recommendations from the International Collaboration on Cancer Reporting (ICCR). Mod Pathol. 2015;28(8):1101–22.PubMedCrossRefGoogle Scholar
  116. 116.
    McCluggage WG. Malignant biphasic uterine tumours: carcinosarcomas or metaplastic carcinomas? J Clin Pathol. 2002;55(5):321–5.PubMedPubMedCentralCrossRefGoogle Scholar
  117. 117.
    Medeiros F, Muto MG, Lee Y, Elvin JA, Callahan MJ, Feltmate C, Garber JE, Cramer DW, Crum CP. The tubal fimbria is a preferred site for early adenocarcinoma in women with familial ovarian cancer syndrome. Am J Surg Pathol. 2006;30:230–6.PubMedCrossRefGoogle Scholar
  118. 118.
    Meinel A, Fischer U, Bilek K, Hentschel B, Horn LC. Morphological parameters associated with perineural invasion (PNI) in carcinoma of the cervix uteri. Int J Surg Pathol. 2011;19(2):159–63.PubMedCrossRefGoogle Scholar
  119. 119.
    Mileshkin L, Paramanathan A, Kondalsamy-Chennakesavan S, Bernshaw D, Khaw P, Narayan K. Smokers with cervix cancer have more uterine corpus invasive disease and an increased risk of recurrence after treatment with chemoradiation. Int J Gynecol Cancer. 2014;24(7):1286–91.PubMedCrossRefGoogle Scholar
  120. 120.
    Mills AM, Liou S, Ford JM, Berek JS, Pai RK, Longacre TA. Lynch syndrome screening should be considered for all patients with newly diagnosed endometrial cancer. Am J Surg Pathol. 2014;38(11):1501–9.PubMedPubMedCentralCrossRefGoogle Scholar
  121. 121.
    Mirkovic J, Howitt BE, Roncarati P, Demoulin S, Suarez-Carmona M, Hubert P, McKeon FD, Xian W, Li A, Delvenne P, Crum CP, Herfs M. Carcinogenic HPV infection in the cervical squamo-columnar junction. J Pathol. 2015;236(3):265–71.PubMedPubMedCentralCrossRefGoogle Scholar
  122. 122.
    Moatamed NA, Nanjangud G, Pucci R, Lowe A, Shintaku IP, Shapourifar-Tehrani S, Rao N, Lu DY, Apple SK. Effect of ischemic time, fixation time, and fixative type on HER2/neu immunohistochemical and fluorescence in situ hybridization results in breast cancer. Am J Clin Pathol. 2011;136(5):754–61.PubMedCrossRefGoogle Scholar
  123. 123.
    Montag AG. The frozen section: historical background, technique and quality assurance. In: Taxy JB, Husain AN, Montag AG, editors. Biopsy interpretation: the frozen section. Philadelphia/Baltimore/New York/London/Buenos Aires/Hong Kong/Sydney/Tokyo: Wolters Kluwer/Lippincott Williams & Wilkin; 2014. p. 1–15.Google Scholar
  124. 124.
    Moodley M, Bramdev A. Frozen section: its role in gynaecological oncology. J Obstet Gynaecol. 2005;25(7):629–34.PubMedCrossRefGoogle Scholar
  125. 125.
    Morotti M, Menada MV, Moioli M, Sala P, Maffeo I, Abete L, Fulcheri E, Menoni S, Venturini P, Papadia A. Frozen section pathology at time of hysterectomy accurately predicts endometrial cancer in patients with preoperative diagnosis of atypical endometrial hyperplasia. Gynecol Oncol. 2012;125(3):536–40.PubMedCrossRefGoogle Scholar
  126. 126.
    Movahedi-Lankarani S, Gilks CB, Soslow R, Oliva E, Members of the Cancer Committee, College of American Pathologists. Protocol for the examination of specimens from patients with carcinoma of the endometrium.
  127. 127.
    Murray SK, Young RH, Scully RE. Unusual epithelial and stromal changes in myoinvasive endometrioid adenocarcinoma: a study of their frequency, associated diagnostic problems, and prognostic significance. Int J Gynecol Pathol. 2003;22(4):324–33.PubMedCrossRefGoogle Scholar
  128. 128.
    Nakao Y, Yamasaki F, Yokoyama M, Aihara S, Yasunaga M, Iwasaka T. Minimal deviation endometrioid adenocarcinoma of the endometrium and its MRI findings. Eur J Gynaecol Oncol. 2014;35(2):185–7.PubMedGoogle Scholar
  129. 129.
    Nayar AG, Cross PA, Bulmer JN, Deen S, El-Sherif A. Comparison of examination of the entire uterine cervix with routine cervical sampling in hysterectomy specimens from women with endometrial cancer. J Clin Pathol. 2008;61(5):621–2.PubMedCrossRefGoogle Scholar
  130. 130.
    Nucci MR, Quade BJ. Uterine mesenchymal tumors. In: Crum CP, Lee KR, editors. Diagnostic gynecologic and obstetric pathology. Philadelphia: Elsevier; 2006. p. 655–7.Google Scholar
  131. 131.
    Oliva E, Carcangiu ML, Carinelli SG, Ip P, Loening T, Longacre TA, Nucci MR, Prat J, Zaloudek CJ. Mesenchymal tumors of the uterine corpus. In: Kurman RJ, Carcangiou ML, Herrington S, Young RH, editors. WHO classification of tumours of femal reproductive organs. Lyon: IARC Press; 2014. p. 135–48.Google Scholar
  132. 132.
    Oliva E. Cellar mesenchymal tumors of the uterus: a review emphasizing recent observations. Int J Gynecol Pathol. 2014;33(4):374–84.PubMedCrossRefGoogle Scholar
  133. 133.
    Ober KG, Huhn FO. Die Ausbreitung des Cervixkrebses auf die Parametrien und die Lymphknoten der Beckenwand. Arch Gynäkol. 1962;197:262–90.PubMedCrossRefGoogle Scholar
  134. 134.
    Orezzoli JP, Sioletic S, Olawaiye A, Oliva E, del Carmen MG. Stage II endometrioid adenocarcinoma of the endometrium: clinical implications of cervical stromal invasion. Gynecol Oncol. 2009;113(3):316–23.PubMedCrossRefGoogle Scholar
  135. 135.
    Otis CN, Ocampo AC, Nucci MR, McCluggage WG, For the Members of the Cancer Committee, College of American Pathologists. Protocol for the examination of specimens from patients with sarcoma of the uterus.
  136. 136.
    Ozturk E, Dikensoy E, Balat O, Ugur MG, Aydin A. Intraoperative frozen section is essential for assessment of myometrial invasion but not for histologic grade confirmation in endometrial cancer: a ten-year experience. Arch Gynaecol Obstet. 2012;285(5):1415–9.CrossRefGoogle Scholar
  137. 137.
    Pautier P, Nam EJ, Provencher DM, Hamilton AL, Mangili G, Siddiqui NA, Westermann AM, Reed NS, Harter P, Ray-Coquard I. Gynecologic Cancer InterGroup (GCIG) consensus review for high-grade undifferentiated sarcomas of the uterus. Int J Gynecol Cancer. 2014;24(9 Suppl 3):S73–7.PubMedCrossRefGoogle Scholar
  138. 138.
    Pavlakis K, Vrekoussis T, Pistofidis G, Gavresea T, Panoskaltsis T. Methylene blue: how to visualize the endometrium in uterine morcellation material. Int J Gynecol Pathol. 2014;33(2):135–9.PubMedCrossRefGoogle Scholar
  139. 139.
    Prat J. Prognostic parameters of endometrial carcinoma. Hum Pathol. 2004;35:649–62.PubMedCrossRefGoogle Scholar
  140. 140.
    Quinlivan JA, Petersen RW, Nicklin JL. Accuracy of frozen section for the operative management of endometrial cancer. BJOG. 2001;108(8):798–803.PubMedGoogle Scholar
  141. 141.
    Rabban JT, Calkins SM, Karnezis AN, Grenert JP, Blanco A, Crawford B, Chen LM. Association of tumor morphology with mismatch-repair protein status in older endometrial cancer patients: implications for universal versus selective screening strategies for Lynch syndrome. Am J Surg Pathol. 2014;38(6):793–800.PubMedCrossRefGoogle Scholar
  142. 142.
    Rakha EA, Pinder SE, Bartlett JM, Ibrahim M, Starczynski J, Carder PJ, Provenzano E, Hanby A, Hales S, Lee AH, Ellis IO, National Coordinating Committee for Breast Pathology. Updated UK Recommendations for HER2 assessment in breast cancer. J Clin Pathol. 2015;68(2):93–9.PubMedCrossRefGoogle Scholar
  143. 143.
    Rakha E, Wong SC, Soomro I, Chaudry Z, Sharma A, Deen S, Chan S, Abu J, Nunns D, Williamson K, McGregor A, Hammond R, Brown L. Clinical outcome of atypical endometrial hyperplasia diagnosed on an endometrial biopsy: institutional experience and review of literature. Am J Surg Pathol. 2012;36(11):1683–90.PubMedCrossRefGoogle Scholar
  144. 144.
    Rob L, Robova H, Chmel R, Komar M, Halaska M, Skapa P. Surgical options in early cervical cancer. Int J Hyperthermia. 2012;28:489–500.PubMedCrossRefGoogle Scholar
  145. 145.
    Robboy SJ, Mutter GL, Shako-Levy R, Bean SM, Prat J, Bentley RC, Russel P. Cutup – gross description and processing of specimens. In: Robboy SJ, Mutter GL, Prat J, Bentley RC, Russel P, Anderson MC, editors. Robboy’s pathology of the female reproductive tract. Edinburgh/London/New York/Oxford/Philadelphia/St. Louis/Sydney/Toronto: Elsevier; 2009. p. 979–91.CrossRefGoogle Scholar
  146. 146.
    Rosai J. Foreword. In: Argani P, Cimino-Mathews A, editors. Intraoperative frozen sections. Diagnostic pitfalls. New York: demosMedical; 2014. p. XIII–XV.Google Scholar
  147. 147.
    Rosai J, editor. Rosai and Ackerman’s surgical pathology. Edinburgh/London/New York/Oxford/Philadelphia/St. Louis/Sydney/Toronto: Elsevier; 2011. p. 2553–4, 2579–83, 2633–6.Google Scholar
  148. 148.
    Sanjuán A, Cobo T, Pahisa J, Escaramís G, Ordi J, Ayuso JR, Garcia S, Hernández S, Torné A, Martínez Román S, Lejárcegui JA, Vanrell JA. Preoperative and intraoperative assessment of myometrial invasion and histologic grade in endometrial cancer: role of magnetic resonance imaging and frozen section. Int J Gynecol Cancer. 2006;16(1):385–90.PubMedCrossRefGoogle Scholar
  149. 149.
    Savelli L, Testa AC, Mabrouk M, Zannoni L, Ludovisi M, Seracchioli R, Scambia G, De Iaco P. A prospective blinded comparison of the accuracy of transvaginal sonography and frozen section in the assessment of myometrial invasion in endometrial cancer. Gynecol Oncol. 2012;124(3):549–52.PubMedCrossRefGoogle Scholar
  150. 150.
    Schmeler KM, Lynch HT, Chen LM, Munsell MF, Soliman PT, Clark MB, Daniels MS, White KG, Boyd-Rogers SG, Conrad PG, Yang KY, Rubin MM, Sun CC, Slomovitz BM, Gershenson DM, Lu KH. Prophylactic surgery to reduce the risk of gynecologic cancers in the Lynch syndrome. N Engl J Med. 2006;354(3):261–9.PubMedCrossRefGoogle Scholar
  151. 151.
    Seidman MA, Oduyebo T, Muto MG, Crum CP, Nucci MR, Quade BJ. Peritoneal dissemination complicating morcellation of uterine mesenchymal neoplasms. PLoS One. 2012;7(11):e50058.PubMedPubMedCentralCrossRefGoogle Scholar
  152. 152.
    Seidman JD, Soslow RA, Vang R, Berman JJ, Stoler MH, Sherman ME, Oliva E, Kajdacsy-Balla A, Berman DM, Copeland LJ. Borderline ovarian tumors: diverse contemporary viewpoints on terminology and diagnostic criteria with illustrative images. Hum Pathol. 2004;35(8):918–33.PubMedCrossRefGoogle Scholar
  153. 153.
    SGO. Society of Gynecologic Oncologists Clinical Practice Committee statement on prohpylactic Salpingo-oophorectomy. Gynecol Oncol. 2005;98:179–81.CrossRefGoogle Scholar
  154. 154.
    Shia J, Black D, Hummer AJ, Boyd J, Soslow RA. Routinely assessed morphological features correlate with microsatellite instability status in endometrial cancer. Hum Pathol. 2008;39(1):116–25.PubMedCrossRefGoogle Scholar
  155. 155.
    Shimada M, Kigawa J, Nishimura R, Yamaguchi S, Kuzuya K, Nakanishi T, Suzuki M, Kita T, Iwasaka T, Terakawa N. Ovarian metastasis in carcinoma of the uterine cervix. Gynecol Oncol. 2006;101(2):234–7.PubMedCrossRefGoogle Scholar
  156. 156.
    Shutter J, Wright TC Jr. Prevalence of underlying adenocarcinoma in women with atypical endometrial hyperplasia. Int J Gynecol Pathol. 2005;24(4):313–8.PubMedCrossRefGoogle Scholar
  157. 157.
    Silverberg SG. Protocol for the examination of specimens from patients with carcinomas of the endometrium: a basis for checklists. Cancer Committee, College of American Pathologists. Arch Pathol Lab Med. 1999;123(1):28–32.PubMedGoogle Scholar
  158. 158.
    Silverberg SG. The endometrium. Pathologic principles and pitfalls. Arch Pathol Lab Med. 2007;131:372–82.PubMedGoogle Scholar
  159. 159.
    Singh R. Review literature on uterine carcinosarcoma. J Cancer Res Ther. 2014;10(3):461–8.PubMedGoogle Scholar
  160. 160.
    Skala SL, Hagemann IS. Optimal sampling of grossly normal omentum in staging of gynecologic malignancies. Int J Gynecol Pathol. 2015;34(3):281–7.PubMedCrossRefGoogle Scholar
  161. 161.
    Sobin LH, Gospodarowicz MK, Wittekind C. TNM-classification of malignant tumors. 7th ed. London: Wiley-Blackwell; 2009.Google Scholar
  162. 162.
    Stang A, Merrill RM, Kuss O. Hysterectomy in Germany: a DRG-based nationwide analysis, 2005–2006. Dtsch Arztebl Int. 2011;108(30):508–14.PubMedPubMedCentralGoogle Scholar
  163. 163.
    Stany MP, Stone PJ, Felix JC, Amezcua CA, Groshen S, Ye W, Kyser KL, Howard RS, Zahn CM, Muderspach LI, Lentz SE, Chernofsky MR. Lymph node micrometastases in early-stage cervical cancer are not predictive of survival. Int J Gynecol Pathol. 2015;34(4):379–84.PubMedCrossRefGoogle Scholar
  164. 164.
    Stephan JM, Hansen J, Samuelson M, McDonald M, Chin Y, Bender D, Reyes HD, Button A, Goodheart MJ. Intra-operative frozen section results reliably predict final pathology in endometrial cancer. Gynecol Oncol. 2014;133(3):499–505.PubMedCrossRefGoogle Scholar
  165. 165.
    Stewart CJ, Leung YC, Whitehouse A. Fallopian tube metastases of non-gynaecological origin: a series of 20 cases emphasizing patterns of involvement including intra-epithelial spread. Histopathology. 2012;60(6B):E106–14.PubMedCrossRefGoogle Scholar
  166. 166.
    Stewart CJ, Little L. Immunophenotypic features of MELF pattern invasion in endometrial adenocarcinoma: evidence for epithelial-mesenchymal transition. Histopathology. 2009;55(1):91–101.PubMedCrossRefGoogle Scholar
  167. 167.
    Stoler M, Bergeron C, Colgan TJ, Ferency AS, Herrington CS, Kim KR, Loening T, Schneider A, Sherman ME, Wilbur DC, Wright T. In: Kurman RJ, Carcangiou ML, Herrington S, Young RH, editors. WHO classification of tumours of femal reproductive organs. Lyon: IARC Press; 2014. p.172–82.Google Scholar
  168. 168.
    Syed S, Reed N, Millan D. Adequacy of cervical sampling in hysterectomy specimens for endometrial cancer. Ann Diagn Pathol. 2015;19(2):43–4.PubMedCrossRefGoogle Scholar
  169. 169.
    Takano M, Ochi H, Takei Y, Miyamoto M, Hasumi Y, Kaneta Y, Nakamura K, Kurosaki A, Satoh T, Fujiwara H, Nagao S, Furuya K, Yokota H, Ito K, Minegishi T, Yoshikawa H, Fujiwara K, Suzuki M. Surgery for endometrial cancers with suspected cervical involvement: is radical hysterectomy needed (a GOTIC study)? Br J Cancer. 2013;109(7):1760–5.PubMedPubMedCentralCrossRefGoogle Scholar
  170. 170.
    Toledo G, Oliva E. Smooth muscle tumors of the uterus: a practical approach. Arch Pathol Lab Med. 2008;132(4):595–605.PubMedGoogle Scholar
  171. 171.
    Torres ML, Weaver AL, Kumar S, Uccella S, Famuyide AO, Cliby WA, Dowdy SC, Gostout BS, Mariani A. Risk factors for developing endometrial cancer after benign endometrial sampling. Obstet Gynecol. 2012;120(5):998–1004.PubMedPubMedCentralGoogle Scholar
  172. 172.
    Traiman P, Saldiva P, Haiashi A, Franco M. Criteria for the diagnosis of diffuse uterine myohypertrophy. Int J Gynaecol Obstet. 1996;54(1):31–6.PubMedCrossRefGoogle Scholar
  173. 173.
    Trimble CL, Method M, Leitao M, Lu K, Ioffe O, Hampton M, Higgins R, Zaino R, Mutter GL, Society of Gynecologic Oncology Clinical Practice Committee. Management of endometrial precancers. Obstet Gynecol. 2012;120(5):1160–75.PubMedPubMedCentralGoogle Scholar
  174. 174.
    Tulandi T, Ferenczy A. Biopsy of uterine leiomyomata and frozen sections before laparoscopic morcellation. J Minim Invasive Gynecol. 2014;21(5):963–6.PubMedCrossRefGoogle Scholar
  175. 175.
    Turan T, Oguz E, Unlubilgin E, Tulunay G, Boran N, Demir OF, Kose MF. Accuracy of frozen-section examination for myometrial invasion and grade in endometrial cancer. Eur J Obstet Gynecol Reprod Biol. 2013;167(1):90–5.PubMedCrossRefGoogle Scholar
  176. 176.
    Usubütün A, Ozseker HS, Himmetoglu C, Balci S, Ayhan A. Omentectomy for gynecologic cancer: how much sampling is adequate for microscopic examination? Arch Pathol Lab Med. 2007;131(10):1578–81.PubMedGoogle Scholar
  177. 177.
    Vidal F, Rafii A. Lymph node assessment in endometrial cancer: towards personalized medicine. Obstet Gynecol Int. 2013;2013:892465.PubMedPubMedCentralCrossRefGoogle Scholar
  178. 178.
    Wagner AE, Pappas L, Ghia AJ, Gaffney DK. Impact of tumor size on survival in cancer of the cervix and validation of stage IIA1 and IIA2 subdivisions. Gynecol Oncol. 2013;129:517–21.PubMedCrossRefGoogle Scholar
  179. 179.
    Watson P, Vasen HF, Mecklin JP, Järvinen H, Lynch HT. The risk of endometrial cancer in hereditary nonpolyposis colorectal cancer. Am J Med. 1994;96:516–20.PubMedCrossRefGoogle Scholar
  180. 180.
    Wijnen J, de Leeuw W, Vasen H, et al. Familial endometrial cancer in female carriers of MSH6 germline mutations. Nat Genet. 1999;23:142–4.PubMedCrossRefGoogle Scholar
  181. 181.
    Wilbur DC, Colgan TJ, Ferenczy AS, Hisrchowitz L, Loening T, McCluggage WG, Mikami Y, Park KJ, Ronnett BM, Schneider A, Soslow R, Wells M, Wright T. In: Kurman RJ, Carcangiou ML, Herrington S, Young RH, editors. WHO classification of tumours of femal reproductive organs. Lyon: IARC Press; 2014. p. 183–94.Google Scholar
  182. 182.
    Williams JW, Hirschowitz L. Assessment of uterine wall thickness and position of the vascular plexus in the deep myometrium: implications for the measurement of depth of myometrial invasion of endometrial carcinomas. Int J Gynecol Pathol. 2006;25(1):59–64.PubMedCrossRefGoogle Scholar
  183. 183.
    Williams KE, Waters ED, Woolas RP, Hammond IG, McCartney AJ. Mixed serous endometrioid carcinoma of the uterus: pathologic and cytopathologic analysis of a high-risk endometrial carcinoma. Int J Gynecol Cancer. 1994;4:7–18.PubMedCrossRefGoogle Scholar
  184. 184.
    Wittekind C, Compton CC, Brierley J, Sobin LH. TNM-supplement. A commentary on uniform use. Oxford: Wiley-Blackwell; 2012. p. 9–11, 21–2.Google Scholar
  185. 185.
    Wolsky RJ, Montag AG. Female genital tract. In: Taxy JB, Husain AN, Montag AG, editors. Biopsy interpretation: the frozen section. Philadelphia/Baltimore/New York/London/Buenos Aires/Hong Kong/Sydney/Tokyo: Wolters Kluwer/Lippincott Williams & Wilkin; 2014. p. 69–88.Google Scholar
  186. 186.
    Wright JD, Tergas AI, Burke WM, Cui RR, Ananth CV, Chen L, Hershman DL. Uterine pathology in women undergoing minimally invasive hysterectomy using morcellation. JAMA. 2014;312(12):1253–5.PubMedPubMedCentralCrossRefGoogle Scholar
  187. 187.
    Yin ZM, Yu AJ, Wu MJ, Zhu JQ, Zhang X, Chen JH, Yuan SH, Yu H. Prognostic factors and treatment comparison in small cell neuroendocrine cervical carcinoma. Eur J Gynaecol Oncol. 2014;35(3):259–63.PubMedGoogle Scholar
  188. 188.
    Zaino R, Carinellei SG, Ellenson LH, Eng C, Katabuchi H, Konishi I, Lax S, Matis-Guiu X, Mutter GL, Peters WA, Sherman ME, Shih IM, Soslow R. Stewart CJR. In: Kurman RJ, Carcangiou ML, Herrington S, Young RH, editors. WHO classification of tumours of femal reproductive organs. Lyon: IARC Press; 2014. p. 121–34.Google Scholar
  189. 189.
    Zaino RJ, Abendroth C, Yemelyanova A, Oliva E, Lim D, Soslow R, Delair D, Hagemann IS, Montone K, Zhu J. Endocervical involvement in endometrial adenocarcinoma is not prognostically significant and the pathologic assessment of the pattern of involvement is not reproducible. Gynecol Oncol. 2013;128(1):83–7.PubMedCrossRefGoogle Scholar
  190. 190.
    Zaino RJ. FIGO staging of endometrial adenocarcinoma: a critical review and proposal. Int J Gynecol Pathol. 2009;28:1–9.PubMedCrossRefGoogle Scholar
  191. 191.
    Zaino RJ. Unusual patterns of endometrial carcinoma including MELF and its relation to epithelial mesenchymal transition. Int J Gynecol Pathol. 2014;33(4):357–64.PubMedCrossRefGoogle Scholar
  192. 192.
    Zannoni GF, Vellone VG, Carbone A. Morphological effects of radiochemotherapy on cervical carcinoma: a morphological study of 50 cases of hysterectomy specimens after neoadjuvant treatment. Int J Gynecol Pathol. 2008;27(2):274–81.PubMedGoogle Scholar
  193. 193.
    Zarbo RJ, Schmidt WA, Bachner P, Howanitz PJ, Meier FA, Schifman RB, Boone DJ, Herron RM Jr. Indications and immediate patient outcomes of pathology intraoperative consultations. College of American Pathologists/Centers for Disease Control and Prevention Outcomes Working Group Study. Arch Pathol Lab Med. 1996;120(1):19–25.PubMedGoogle Scholar
  194. 194.
    Zaino RJ, Ward S, Delgado G, Bungy B, Gore H, Fetter G, Ganjei P, Frauenhoffer E. Histopathological predictors of the behavior of surgically treated stage Ib squamous cell carcinoma of the cervix. Cancer. 1992;69:1750–8.PubMedCrossRefGoogle Scholar

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© Springer International Publishing Switzerland 2018

Authors and Affiliations

  1. 1.Division of Breast, Perinatal & Gynecologic Pathology, Institute of PathologyUniversity Hospital of LeipzigLeipzigGermany

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