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Repro 2 Midterm > Dobson: Vulvar, Vaginal, Cervical, Uterine, and Endometrial pathology > Flashcards

Dobson: Vulvar, Vaginal, Cervical, Uterine, and Endometrial pathology Flashcards

1
Q

What is Mayer-Rokitansky-Kuster-Hauser syndrome?

A
  • causes vagina and uterus to be underdeveloped or absent
  • no periods
  • first sign is no menstruation by 16
  • kidneys may be screwed up too
  • may have hearing loss or heart defects
  • normal 46, XX karyotype
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2
Q

What hormone drops to cause shedding of the functionalis layer?

A

-progesterone

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3
Q

in proliferative phase, what do the glands look like?

A
  • straight, tubular

- no mucus secretion or vacuolization

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4
Q

in the secretory pphase, what is it marked by?

A
  • subnuclear vaculoles

- tortuous and serated or saw toothed

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5
Q

What are the causes of abnormal uterine bleeding in prepubertal group?

A

-precocious puberty

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6
Q

Causes of AUB in adolescence?

A
  • anovulatory cycle

- coag disorders

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7
Q

causes of AUB in reproductive age?

A
  • complications of preggo
  • anatomic lesions
  • dysfunctional uterine bleeding
  • anovulatory cycle
  • ovulatory dysfunctional bleeding
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8
Q

causes of AUB in perimenopausal women?

A

-dyfunctional uterin bleeding
-anovulatory cycle
-anatomic lesions
-

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9
Q

Causes of AUB in postmenopausal women?

A
  • endometrial atrophy

- anatomic lesions

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10
Q

bolded thing as a presentation of chronic endometritis?

A

-abnormal bleeding

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11
Q

if there is plasma cells in biopsy of endometrium, what is it until proven otherwise?

A

-chronic endometritis

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12
Q

What is endometriosis?

A

-endometrial tissues outside of the uterus

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13
Q

What is adenomyosis

A

-presence of endometrial tissue withing the myometrium 2-3 mm below the basalis layer

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14
Q

most common sites of endometriosis?

A
  • ovaries!
  • uterine ligaments
  • rectovaginal septum
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15
Q

what is the enzyme that makes a lot of estrogen and makes stromal cells in ectopic endometrial tissue go nuts?

A

-aromatase

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16
Q

When extensive, what can endometriosis cause?

A

-fibrous adhesions!

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17
Q

What color are the nodules in endometriosis?

A
  • brown material

- hemosiderin… breakdown of blood

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18
Q

can endometrial polyps be malignant?

A

hell yes!

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19
Q

what will endometrial hyperplasia and malignancy lead to?

A

-endometrial carcinoma

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20
Q

What is the first gene thing to be weird with endometrial hyperplasia?

21
Q

What can give us increased estrogen?

A
  • anovulation
  • obesity
  • prolonged administration of estrogenic substances
22
Q

What is Cowden syndrome?

A

-germline PREN mutation and high incidence of endometrial and breast cancer

23
Q

What does the loss of PTEN lead to?

A

-overactivation of the PI3K/AKT pathway

24
Q

What is the cardinal feature of Non atypical hyperplasia?

A
  • increased gland to stroma ratio

- rarely progresses to cancer

25
Atypical hyperplasia in uterus... what does it look like?
- complex patterns of proliferating glands displaying nuclear atypia - glands back to back and branching - overlap with well differentiated cancer
26
What is the treatment for the hyperplasia?
- if reproductive age, place on progesterone and follow up | - otherwise hysterectomy
27
What are the two malignant endometrial tumors?
- Carcinoma of the endometrium | - malignant mixed mullerian tumors
28
What is the most common invasive cancer of the female genital tract?
-Endometrial carcinoma
29
What age is EC at?
- -55-65 | - uncommon under 40
30
What is the early sign for EC
-bleeding
31
Type 1 endometrial carcinoma
- 55-65 - unopposed estrogen, obesity, htn, diabetes - endometrioid morphology - hyperplasia precursor - PTEN mutation at first, ends with TP53 - indolent behavior - spreads via lymphatics
32
Type 2 endometrial carcinoma
- 65-75 yo - endometrial Atrophy, thin physique - serous, clear cell, mixed mullerian tumor morphology - seour endometrial intraepithelial carcinoma precursor - TP53 is first gene mutated - AGGRESSIVE - intraperitoneal and lymphatic spread
33
What are the risk factors for endometrial carcinoma?
- obesity - diabetes - htn - infertility - unopposed estrogen * **high estrogen seems to be the common demoninator****
34
which type of endometrial cancer was more common in african americans?
- type 2 - that serous kind - arises in endometrial atrophy
35
What staining do we use for type 2 endometrial carcinoma?
-p53!
36
How is the staging done form both type 1 and 2 endometrial adenocarcinoma and malignant mixed mullerian tumors?
- 1: carcinoma is confined to the corpus uteri itself - 2: involves the corpus and the cervix - 3: extends outside the uterus but not outside the true pelvis - 4: extends outside the true pelvis or involves the mucosa of the bladder or the rectum
37
What are malignant mixed mullerian tumors (MMMT's)?
- carcinosarcoma= malignant glandular and mesenchymal elements - mutations similar to endometrial carcinomas in the epithelial component (TP53, PTEN, PIK3CA)
38
how does MMMT's present?
-postmenopausal with bleeding
39
Are stromal tumors rare or common in the uterus?
-rare
40
Adenosarcoma
-benign glands and malignant appearing stroma
41
Leiomyoma basic facts
- Leiomyoma: most common tumor in women - HMGIC and HMGIY genes - MED12 gene encodes component of mediator which allows cells to divide in an uncontrolled way
42
What are the gross features of leiomyoma
- sharply circumscribed - single or multiple - small or large - firm grey-white masses - subserosal, myometrial, submucosal - rarely uterine ligaments, LUS, or cervix
43
Microscopic features of leiomyoma
- bundles of smooth muscle cells (whorled) - uniform in size and shape, oval nucleus, long bipolar processes - RARE mitosis - can degenerate
44
Clinical presentation of leiomyomas?
- abnormal bleeding - urinary frequency due to compression of bladder - impaired fertility - problems with preggo - malignant transformation is very rare
45
Leiomyosarcoma (be able to tell this apart from leiomyoma)
- uncommon (peak age 40-60) - arise from a stromal precursor cell - complex karyotypes that include deletions - recurrence common - MORE THAN HALF METASTASIZE
46
Gross features of leiomyosarcoma?
- 2 patterns - Bulky fleshy invasive masses - Polypoid intraluminal masses
47
Microscopic features of leiomyosarcoma
- Nuclear atypia - mitotic index 10 or >10= MALIGNANT - zonal necrosis
48
What does STUMP stand for?
-smooth muscle tumor of uncertain malignant potential
49
Where does a metastatic leiomyosarcoma spread most often?
- lung - peritoneum - bones - liver - muscles

Repro 2 Midterm (9 decks)

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