Cervical, vulva & vagina pathology Flashcards
What is the transformation zone?
Squamo-columnar junction between ecto (squam) and endocervical (colum) epithelia
What is cervical erosion?
Exposure of delicate endocervical epithelium to acid of vagina - squamous metaplasia
What infections can cause cervicitis?
Chlamydia
HSV
Are cervical polyps premalignant?
No
Which 2 types of HPV tend to cause cervical cancer?
16 & 18
What is the pathogenesis of cervical cancer?
HPV 16 & 18 produce oncogenes E6 & E7
E6 inhibits p53 tumour suppressor gene
E7 inhibits RB suppressor gene
What is CIN?
Delay in maturation/differentiation of cells
Nuclear abnormalities
Excess mitotic activity
How are the 3 stages of CIN defined?
CIN I = basal 1/3rd occupied
CIN II = Abnormality extends to middle 1/3rd
CIN III = Abnormality is full thickness
How is invasive squamous carcinoma (cervical) staged?
Stage 1 = low risk in cervix
Stage 2 = In adjacent organs
Stage 3 = pelvic wall
Stage 4 = distant metastases
How does invasive squamous carcinoma (cervical) present?
Abnormal bleeding
Pelvic pain
Haematuria/TI
Ureteric obstruction/renal failure
What is the origin of CGIN?
endocervical columnar epithelium
What is CGIN?
Pre-invasive phase of endocervical adenocarcinoma (screening is less effective)
Which type of cervical cancer has the worse prognosis?
Endocervical carcinoma
Is vulvar intraepithelial neoplasia precancerous?
Can progress to vulvar invasive squamous carcinoma
What is the most important prognostic factor in VISC?
Spread to inguinal lymph nodes
