Cervical Cancer

Question 1

How many cell layers line the normal endocervix?

Answer 1

One

Question 2

What is the most common site of neoplasia in the cervix?

Answer 2

Transformation zone

Question 3

The transformation zone is a junction between which epithelia?

Answer 3

Squamous (ectocervical)

Columnar (endocervical)

Question 4

What occurs in cervical erosion?

Answer 4

Exposure of endocervical epithelium to acid environment causes physiological metaplasia

Question 5

Give some causes of inflammatory pathology in the cervix

Answer 5

Cervicitis

Cervical polyp

Question 6

Give some causes of neoplastic pathology in the cervix

Answer 6

Cervical intraepithelial neoplasia (CIN)
Squamous carcinoma
Adenocarcinoma

Question 7

Which virus serotypes are the main cause of cervical cancer?

Answer 7

HPV 16 and 18

Question 8

Give some risk factors for CIN/cervical cancer

Answer 8

Presence of high risk HPV (multiple sexual partners)
Long term OCP use
Smoking
Immunosupression

Question 9

Which histological feature shows HPV infection in the cervix?

Answer 9

Koilocytosis

Question 10

Histopathologically, when does cervical cancer occur?

Answer 10

When squamous cells have invaded the basement membrane

Question 11

Give some histological features of CIN

Answer 11

Delay in maturation/differentiation
Nuclear abnormalities (increased nucleocytoplasmic ratio)
Excess mitotic activity

Question 12

What occurs in CIN stage I?

Answer 12

The basal 1/3 of the epithelium is occupied by abnormal cells

Question 13

What occurs in CIN stage II?

Answer 13

Abnormal cells extend to middle 1/3

Question 14

What occurs in CIN stage III?

Answer 14

Abnormal cells occupy full thickness of epithelium

Question 15

How is squamous cervical carcinoma staged?

Answer 15

Stage 1 - confined to cervix
Stage 2 - spread to adjacent organs
Stage 3 - involves pelvic wall
Stage 4 - distant mets or involvement or rectum/bladder

Question 16

Give some symptoms of squamous cervical carcinoma

Answer 16

Abnormal bleeding (post-coital/menopausal)
Pelvic pain
Haematuria
Ureteric obstruction

Question 17

In squamous cervical carcinoma, lymphatic spread is early and haematogenous is late. True/false?

Answer 17

True

Question 18

What is the preinvasive phase of endocervical adenocarcinoma?

Answer 18

Cervical glandular intraepithelial neoplasia (CGIN)

Question 19

Give some risk factors for endocervical adenocarcinoma

Answer 19

Higher social class
Later onset of sexual activity
Smoking
HPV

Question 20

Which women commonly get vulvar invasive squamous carcinoma?

Answer 20

Elderly women

Question 21

Which lymph nodes are most commonly affected by VISC?

Answer 21

Inguinal

Question 22

How does vulvar Paget’s disease present?

Answer 22

Crusting rash