The role of electron microscopy in gynecological pathology

Electron microscopy, as a diagnostic method, has been available to pathologists for about half a century. Its use in studying normal and abnormal gynecological tissues has been applied during the second half of that period, and many works on specific female genital topics have been published. Several of those subjects are worthy of citing in a review of the present type. Clear cell carcinoma has been revealed to be a mullerian, rather than a wolffian, derivative. Small cell carcinoma of the ovary with hypercalcemia is comprised of cells shown ultrastructurally to be epithelial, but unlike surface epithelial cells, germ cells, sex-cord cells, or neuroendocrine cells. Further electron microscopic studies provided evidence that these small cell tumors are not adult diffuse granulosa cell tumors, endometrioid stromal tumors, primitive neuroectodermal tumors, or numerous other primary and metastatic small cell tumors. Electron microscopy has also been useful in determining that not all signet-ring cell tumors of the ovary are stromal, and that there are multiple types of signet-ring (vacuolated) cells in ovarian tumors. Smooth muscle tumors are well known to have multiple light microscopic phenotypes, and electron microscopy has proven to be diagnostic in many of these cases, especially in epithelioid smooth muscle tumors. A number of other gynecological neoplasms that have been better defined by electron microscopic studies are described. Embryology and histogenesis are other areas of study in which electron microscopy has been a major contributor of new information at the subcellular level. Electron microscopy, solely or in harmony with clinical information, light microscopy, and immunohistochemistry, has been and is a valuable tool for the pathologist in the study of histogenesis and accurate diagnosis of gynecological lesions.