The role of electron microscopy in gynecological pathology

Electron microscopy, as a diagnostic method, has been available to patholog ists for about half a century. Its use in studying normal and abnormal gyne cological tissues has been applied during the second half of that period, a nd many works on specific female genital topics have been published. Severa l of those subjects are worthy of citing in a review of the present type. C lear cell carcinoma has been revealed to be a mullerian, rather than a wolf fian, derivative. Small cell carcinoma of the ovary with hypercalcemia is c omprised of cells shown ultrastructurally to be epithelial, but unlike surf ace epithelial cells, germ cells, sex-cord cells, or neuroendocrine cells. Further electron microscopic studies provided evidence that these small cel l tumors are not adult diffuse granulosa cell tumors, endometrioid stromal tumors, primitive neuroectodermal tumors, or numerous other primary and met astatic small cell tumors. Electron microscopy has also been useful in dete rmining that not all signer-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 microsco pic phenotypes, and electron microscopy has proven to be diagnostic in many of these cases, especially in epithelioid smooth muscle tumors. A number o f other gynecological neoplasms that have been better defined by electron m icroscopic studies are described. Embryology and histogenesis are other are as of study in which electron microscopy has been a major contributor of ne w information at the subcellular level. Electron microscopy, solely or in h armony with clinical information, light microscopy, and immunohistochemistr y, has been and is a valuable tool for the pathologist in the study of hist ogenesis and accurate diagnosis of gynecological lesions.