B8-032 Uterine, Cervical, and Vulvar Pathophysiology Flashcards
progressive inflammatory vulvar disease characterized by porcelain-white plaques
lichen sclerosus
lichen sclerosus slightly increases the chance of
SCC
keratinizing
vulvar pathology that causes thinning of epithelium on path, loss of rete pegs, and inflammatory infiltrate
lichen sclerosus
vulvar pathology that causes thickening of epithelium and increased mitotic activity on path
classic vulvar intraepithelial neoplasia (VIN)
how can classic vulvar intraepithelial neoplasia (VIN) be distinguished from differentiated VIN?
classic is HPV dependent
differentiated is HPV independent
vulvar carcinoma characterized by peripheral palisading and deep basophilic staining pattern
basaloid and warty squamous cell carcinoma
vulvar carcinoma associated with HPV
basaloid and warty squamous cell carcinoma
vulvar carcinoma occurring most commonly in women with long standing-lichen sclerosus
keratinizing SCC
(unrelated to HPV)
vulvar carcinoma characterized by keratin pearls
keratinizing SCC
ectocervix is lined by
stratified squamous epithelium
endocervix is lined by
columnar mucinous epithelium
HPV independent endocervical adenocarcinoma
gastric type
type of cervical adenocarcinoma associated with Peutz-Jeghers syndrome
gastric type
HPV independent
[proliferative/secretory phase]
tubular glands
monomorphic stroma
proliferative
[proliferative/secretory phase]
coiled glands
edematous stroma
secretory
associated with infertility/recurrent implantation failure
antibiotic therapy can improve outcomes
chronic endometritis
identification of […] cells is most important criterion for the diagnosis of chronic endometritis
plasma
presence of endometrial glands within the myometrium
adenomyosis
adenomyosis is made up of the […] layer of the endometrium
endometriosis is composed of the […] layers of the endometrium
adenomyosis is made up of the [basal] layer of the endometrium (non-functional)
endometriosis is composed of the [functional] layers of the endometrium
may be a precursor to endometrioid and clear cell carcinoma
endometriosis
frequent precursor to endometrial carcinoma
associated with prolonged estrogenic stimulation
endometrial hyperplasia
increased gland-to-stroma ratio when compared to normal proliferative endometrium
endometrial hyperplasia
endometrial hyperplasia often shows inactivation of […] gene
PTEN
(PI3K/AKT pathway)
[Type 1 vs Type 2 endometrial carcinoma]
55-65 years
type I
[Type 1 vs Type 2 endometrial carcinoma]
65-75 years
type II
[Type 1 vs Type 2 endometrial carcinoma]
linked to unopposed estrogen, obesity, HTN, diabetes
type 1
[Type 1 vs Type 2 endometrial carcinoma]
linked to atrophy and thin physique
type 2
[Type 1 vs Type 2 endometrial carcinoma]
morphology is endometrioid
type 1
[Type 1 vs Type 2 endometrial carcinoma]
morphology is serous, clear cell, or mixed mullerian
type 2
[Type 1 vs Type 2 endometrial carcinoma]
precursor is hyperplasia
type 1
[Type 1 vs Type 2 endometrial carcinoma]
precursor is serous endometrial intraepithelial carcinoma
type 2
[Type 1 vs Type 2 endometrial carcinoma]
mutated gene is PTEN
type 1
[Type 1 vs Type 2 endometrial carcinoma]
mutated gene is p53
type 2
[Type 1 vs Type 2 endometrial carcinoma]
indolent
spreads via lymphatics
type 1
[Type 1 vs Type 2 endometrial carcinoma]
aggressive
intraperitoneal and lymphatic spread
type 2
endometrial adenocarcinomas with malignant mesenchymal component
mesenchymal component can take many forms
mixed mullerian tumors
(type 2 endometrial carcinoma)
squamous cell carcinoma of the vagina is usually secondary to
cervical SCC
(primary vaginal carcinoma is rare)
arises from vaginal adenosis
found in females who had exposure to DES in utero
clear cell adenocarcinoma
type 2 endometrial carcinoma
presence of endometrial tissue in the myometrium
adenomyosis
presence of endometrial tissue outside uterus
endometriosis
abnormal endometrial gland proliferation often caused by unopposed estrogen
endometrial hyperplasia
presents with uterine bleeding/dysmenorrhea
diffusely enlarged “globular”, soft “boggy” uterus on exam
adenomyosis
endometriosis presents with normal sized uterus on exam
yellow brown “powder-burn” lesions
chocolate cysts
endometriosis
presents with uterine bleeding/dysmenorrhea
normal sized uterus on exam
endometriosis
vs. adenomyosis: “globular” and “boggy” uterus on exam
inflammation of the endometrium
usually occurs after delivery due to innoculation of uterine cavity by vaginal microbiota
endometritis
(IUDs also a risk factor)
fever, purulent lochia, and uterine tenderness
endometritis
c-section is the most important risk factor for
endometritis
benign tumor of myometrium
most common GYN tumor
leiomyoma
tumor size is estrogen sensitive; increases with pregnancy and decreases with menopause
leiomyoma
whorled pattern of smooth muscle bundles and well-demarcated borders
leiomyoma
subtype of endometrial carcinoma heavily associated with unopposed estrogen
endometrioid carcinoma
type 1
confluent endometrial glands without intervening stoma on biopsy
endometrial carcinoma
more specifically, type 1 i think
are endometrial polyps associated with endometriosis?
no
predominant hormone in the secretory phase
progesterone
predominant hormone in the proliferative phase
estrogen
cystically dilated glands
fibrous stroma
thick walled vessels
endometrial polyps
increased gland-to-stroma ratio with irregular architecture
endometrial hyperplasia
[type 1 vs type 2 endometrial carcinoma]
back-to-back endometrial glands admixed with solid areas
type I endometrial carcinoma
endometrial carcinoma with papillary architecture, cytologic atypia and numerous mitoses
may have psammoma bodies
type II (serous) endometrial carcinoma
what components of a MMMT tumor are malignant?
both the epithelial and mesenchymal
does cervical intraepithelial neoplasia cause dysfunctional uterine bleeding?
no
[classical/differentiated] vulvar intraepithelial neoplasia is a precursor of keratinizing SCC
differentiated
[classical/differentiated] vulvar intraepithelial neoplasia is a precursor of basaloid/warty SCC
classical
[classical/differentiated] vulvar intraepithelial neoplasia is associated with HPV infections
classical
