Cervical and vulval pathology Flashcards
What is neoplasia?
the presence or formation of new, abnormal growth of tissue.
What is dysplasia?
the presence of cells of an abnormal type within a tissue, which may signify a stage preceding the development of cancer.
Difference between neoplasia and dysplasia?
Dysplasia does not mean that it is definately cancerous. Whereas neoplasia is the development of cancerous tissue
What are vulval and cervical neoplasia driven by?
Human papilloma virus
What is Human Papilloma Virus (HPV)
Human papilloma virus (HPV) is the name for a group of viruses that affect your skin and the moist membranes lining your body. Examples of this include your: -cervix -anus -mouth and throat
They can cause cervical cancer
How is HPV spread?
Sexual contact and skin to skin contact
How are genital HPVs grouped?
- High oncogenic risk
- Low oncogenic risk
What do low risk HPV cause?
They cannot cause cervical cancer. They can cause genital warts or minor cell changes on the cervix.
What can high risk HPV cause?
cancer of the cervix, vagina, vulva, anus, penis and throat.
Which type of HPV is the most common in low risk?
6 and 11
What is the mode of action of oncogenic virus?
They integrate into host chromosomes and upregulate E6,E7 expression
What is the most common vulval cancer?
Squamous cell carcinoma
Where can vulval squamous cell carcinoma spread to?
Lymph nodes
What are the clinical features of paget’s disease?
The presence of a pink or red lesion on the vulva Rash and itchiness The presence of scaly skin on the lesions Formation of ulcers in the infected area Bleeding in the affected area Burning sensation Increased sensitivity Pain and discomfort
What is the pathogenesis of paget’s disease?
In-situ adenocarcinoma of squamous mucosa
What is the transformation zone of the cervix?
Columnar cells are constantly changing into squamous cells in an area of the cervix called the transformation (transitional) zone. The transformation zone is an area of changing cells, and it is the most common place on the cervix for abnormal cells to develop. These abnormal cells can be detected on a Pap smear.
Physiological area of squamous metaplasia. The TZ is what we sample in taking a cervical cytology sample.
What is cervical intraepithelial neoplasia?
Cervical intra-epithelial neoplasia (CIN) is a term that describes changes in the squamous cells of the cervix.
CIN is not cancer, but you may need treatment to stop cervical cancer developing. You may hear doctors call CIN a pre-cancerous condition.
What is the cervical screening programme?
Cervical screening is a method of preventing cancer by detecting and treating abnormalities of the cervix.
Uses liquid based cytology
starts off every 3 years, then every 5 years.
What is colonoscopy?
Examination of the cervix with a low powered stereoscopic microscope.
What is the biggest cause of cervical squamous cell carcinoma?
High risk HPV
What staging system is used in cervical carcinoma?
FIGO staging
What is vulval intraepithelial neoplasia (VIN)?
Vulval intraepithelial neoplasia (VIN) is a condition where there are pre-cancerous cells in the skin of the vulva.
In VIN, the pre-cancer cells are located within the epidermis or the very top layer and are only a millimetre or so thick. The abnormal cells do not penetrate deep down into the dermis so as a consequence, it is easy to see on the surface of the skin with the naked eye the affected areas. We use the word pre-cancer, NOT because the cells are cancerous or you have cancer, but because the cells MAY (or MAY NOT) develop into cancer over a period of years.
