Chapter 13 Flashcards
what is extramammary pagets disease?
Characterized by malignant epithelial cells in the epidermis of the vulva
Presents as erythematous, pruritic, ulcerated vulvar skin
Represents carcinoma in situ, usually with no underlying carcinoma
extramammary pagets vs. normal pagets major difference?
Paget disease of the nipple is also characterized by malignant epithelial cells in the epidermis of the nipple, but it is almost always associated with an underlying carcinoma.
what must extramammary pagets disease be distinguished from?
D. Must be distinguished from melanoma, which rarely can occur on the vulva
- Paget cells are PAS+, keratin+, and SlOO-.
- Melanoma is PAS-, keratin-, and SlOO+.
what is clear cell adenocarcinoma?
Malignant proliferation of glands with clear cytoplasm
Rare, but feared, complication of DES-associated vaginal adenosis
what is asherman syndrome?
A. Secondary amenorrhea due to loss of the basalis and scarring
B. Result of overaggressive dilation and curettage
ANOVULATORY CYCLE
A. Lack of ovulation
B. Results in an estrogen-driven proliferative phase without a subsequent progesterone-
driven secretory phase
1. Proliferative glands break down and shed resulting in uterine bleeding.
x
most common subtypes of cervical carcinoma
Most common subtypes of cervical carcinoma are squamous cell carcinoma (80% of cases) and adenocarcinoma (15% of cases). Both types are related to HPV infection.
Involvement of the uterine myometrium in endometriosis is called…
Involvement of the uterine myometrium is called adenomyosis.
what is asherman syndrome?
ASHERMAN SYNDROME
A. Secondary amenorrhea due to loss of the basalis and scarring
B. Result of overaggressive dilation and curettage (D&C)
what is the basic result an anovulatory cycle?
ANOVULATORY CYCLE
Lack of ovulation
Results in an estrogen-driven proliferative phase without a subsequent progesterone- driven secretory phase
Proliferative glands break down and shed resulting in uterine bleeding.
what are the various sites of involvement of endometriosis?
Most common site of involvement is the ovary, which classically results in formation of a ‘chocolate’ cyst
Other sites of involvement include the uterine ligaments (pelvic pain), pouch of
Douglas (pain with defecation), bladder wall (pain with urination), bowel serosa (abdominal pain and adhesions), and fallopian tube mucosa (scarring increases risk for ectopic tubal pregnancy); implants classically appear as yellow-brown ‘gun-powder’ nodules (Fig. l3.7B).
Involvement of the uterine myometrium is called…
Involvement of the uterine myometrium is called adenomyosis.
leiomyoma vs leiomysarcoma
leiomyoma
Gross exam shows multiple, well-defined, white, whorled masses that may distort the uterus and impinge on pelvic structures (Fig. 13.10).
leiomysarcoma
Malignant proliferation of smooth muscle arising from the myometrium
B. Arises de novo; leiomyosarcomas do not arise from leiomyomas.
C. Usually seen in postmenopausal women
D. Gross exam often shows a single lesion with areas of necrosis and hemorrhage;
I.
histological features include necrosis, mitotic activity, and cellular atypia
endometrial carcinoma arises via what two pathways…
Arises via two distinct pathways: hyperplasia and sporadic
D. In the hyperplasia pathway (75% of cases), carcinoma arises from endometrial
hyperplasia .
the hyperplasia pathway of endometrial carcinoma
what are the risk factors?
In the hyperplasia pathway (75% of cases), carcinoma arises from endometrial
hyperplasia
l. Risk factors are related to estrogen exposure and include early menarche/late
menopause, nulliparity, infertility with anovulatory cycles, and obesity.
2. Average age of presentation is 60 years.
- Histology is endometrioid (i.e., normal endometrium-like, Fig. 13.9B).
