212/215/216 - Histology, Pathology of Female Reproductive System Flashcards
Vulvar Lichen simplex chornicus
- Cause
- Pathologic changes:
- Prognosis:
- Cause: Chronic irritation (ex: itching)
- Pathologic changes: Squamous cell hyperplasia; hyperkeratosis in reaction to itching
- Prognosis: benign; resolves when the irritating agent is taken away
- Note: Lichen sclerosus IS itchy, SCC may arise*
- Lichen simplex chronicus is CAUSED BY itching; no cancer risk*
What is histologic difference between endometrial hyperlasia with atypia vs. atypical hyperplasia?
How do their prognoses differ?
- Hyperplasia without atypia
- No nuclear changes
- Stroma present between glands
- May rarely progress to carcinoma
- Atypical hyperplasia
- Nuclear changes: round, clear chromatin, prominent nucleolus
- May progress to carcinoma up to 48% of the time
Is the following characteristic of usual or differentiated vulvar squamous cell carcinoma?
p53 Mutation
Differentiated
What kind of lesion does this describe:
“Crusted, red vulvar or perianal lesion”
What are to possible processes that it may represent?
Vulvar paget’s disease
- Usually a neoplasm of sweat glands or skin adenexae
- Somtimes represents an internal malignancy
- Colon cancer, urothelial carcinoma
What makes the “high-risk” HPV serotypes so high risk?
They integrate into the host chormosome
High risk = 16, 18, 31, 33
Low-risk serotypes (6, 11) do NOT integrate into the host chromosome, will cause warts
Is the following characteristic of usual or differentiated vulvar squamous cell carcinoma?
HPV-driven
Usual
What is the histological marker of chronic endometritis?
Plasma cells
Not normally in the endometrium; if they are there, implies chronic endometritis
Acute endometritis is less common, will see neutrophils
List the 4 theories for the origin of endometriosis
-
Regurgitation
- Retrograde menstruation
-
Benign metastases
- Lymph/vascular spread
- Metaplasia
- Extrauterine stem-progenitor cells
Most likely a combination of some or all of these
Is the following characteristic of usual or differentiated vulvar squamous cell carcinoma?
Arises from lichen sclerosus
Differentiated
Characteristic of Endometroid (type 1) or Serous (type 2) enometrial carcinoma?
PTEN mutation
Endometroid
What is the defining cell type present in a Syphilis chancer?
Plasma cells
Inactivation of which tumor suppressor is associated with endometrial hyperplasia?
PTEN
- And this is associated with endometroid (type 1) endometrial carcioma
What kind of epithelium is found in the fallopian tube?
Simple collumnar epithelium
What are the characteristic histological findings of endometriosis?
How many are needed for diangosis?
2/3 of the following in an ectopic location
- Endometrial glands
- Endometrial stroma
- Hemosiderin-laden macrophages (evidence of hemorrhage)
What is the most common type of cancer in the cervix?
Squamous cell carcinoma
Develops in the transformation zone in the background of dysplasia
What is the major function of the simple cuboidal epithelium (germinal epithelium) of the ovary?
- Projects inward to form glands
- Forms the capsule of the ovary
- Is a serous, peritoneal membrane
- Is the source of primordial oocytes
c. Is a serous, peritoneal membrane
* Stupid name - turns out eggs come from the hindgut, not the germinal epithelium lmao*
What is the histologic feature of vaginal epithelium?
Pyknotic nuclei
- Small, focal, condensed
- Spaces in between = cells swelling with glycogen in response to rising estrogen (before menstruation)
What in which stage of meiosis are oocytes arrested during fetal development?
Prophase I
As the follicle matures, continues until Mataphase II; only progresses from here if fertilized
Characteristic of Endometroid (type 1) or Serous (type 2) enometrial carcinoma?
Papillary or glandular growth pattern
Serous
Histologic differences between leiomyosarcoma and leiomyoma? (3)
Leiomyosarcomas may have:
- Nuclear atypia
- Mitoses
- Necrosis
Need 2/3 to diagnose
If none are present = leiomyoma (fibroid)
If 1 is present it falls into some weird category - if we are ever tested on it may the power of Dr. Wolniak be with us all <3
What is the difference between the corpus albicans vs. atretic follicles?
-
Corpus albicans comes from a mature follicle
- After ovulation, follicul becums corpus luteum
- No pregnancy -> corpus luteum dies, becomes corpus albicans
- Atretic follicle = all follicles that were never selected to become mature follicles
Which cells does HPV infect?
Basal cells of the transformation zone
- Transformation zone: squamous mucosa of the ectocervix -> glandular mucosa of the endocervix
- These cells ar vulnerable because they are naturally metaplastic
List 4 risk factors for cervical cancer
- Multiple sexual partners
- Early initiation of sexual activity
- There is more transformation zone epithelium during adolescent hormonal states
- High parity
- Smoking
At what stage of follicular develpent is the follicle 10mm or greater in size?
Mature follicle (ready to pop out)
Which one of the following changes the least in morphology during the menstrual cycle?
A. Uterine glands
B. Ovarian follicles
C. Uterine tube epithelium
D. Vaginal epithelium
E. Cervical histology
E. Cervical histology