Endometrium & Cervix Pathology Flashcards
MOST COMMON cause of Abnormal Uterine Bleeding; ovarian follicles develop but DON’T ovulate, continuing to produce Estrogen; causes endometrium to stay in proliferative state, outgrowing its structural support
Anovulatory Cycles
Hyperplastic overgrowths of the endometrium; can be sessile or pedunculated
Endometrial Polyps
Increased endometrial glands:stroma ratio; precursor to Endometrial Carcinoma (especially with cytologic ATYPIA); caused by unopposed Estrogen
Endometrial Hyperplasia
Signs/Symptoms of Endometrial Adenocarcinoma
Postmenopausal Bleeding
Irregular/Heavy bleeding or discharge
Treatment for Endometrial Adenocarcinoma
Hysterectomy
Radiation
Progesterone therapy
___________________ cancer is the most common GYN malignancy
Endometrial
Risk factors for Endometrial Adenocarcinoma
Obesity Atypical Hyperplasia Unopposed Estrogen Lynch Syndrome Pelvic Irradiation
What is protective for Endometrial Adenocarcinoma
OCPs
Progesterone therapy
What are the 2 general types of Endometrial Carcinoma
Type 1: Estrogen related, LESS aggressive, younger and HEAVIER; GLANDULAR histology
Type 2: Not Estrogen related, MORE aggressive, older and THINNER; SEROUS histology
Type (1/2) Endometrial Carcinoma has a Glandular histology
Type 1
Type (1/2) Endometrial Carcinoma has a Serous histology
Type 2
Most common benign tumor of the female genital tract; smooth muscle tumor; well-circumscribed, white mass with whorled appearance; inc. risk in African Americans
Leiomyomas (“Fibroids”)
Histologic appearance of Leiomyomas
Smooth muscle in fascicles
“Cigar” shaped nuclei
Leiomyomas are precursors to Leiomyosarcomas (True or False)
False; are independent entities
Cervical cancer is commonly caused by….
HPV
____ ____________ testing can reduce a woman’s chance of dying from Cervical Cancer by almost 90%
Pap smear
Risk factors for Cervical Cancer
Smoking
Immunosuppression (AIDS)
Multiple partners
Early age of intercourse
Sexually transmitted virus; double stranded, circular DNA virus; infects epithelial cells; MOST common STD globally; most infections clear by 2 years
HPV
HPV ______ and _____ are high risk types that can cause Cervical, Anal and other genital cancers
16 and 18
HPV _____ and ____ are low risk types that may cause genital warts
6 and 11
HPV genes that affect hos regulatory proteins, such as p53 and Rb (regulate cell divisions)
E6 and E7
When should a women begin to have pap smears
age 21-65, for every 3 years
*given no risk factors or previous history
Appearance of normal Ectocervic Squamous cells on a Pap Smear
Abundant cytoplasm
Nucleus is small/dense (pyknotic)
Appearance of neoplastic Ectocervix Squamous cells on Pap Smear
Large nuclei, dark with irregular contours and coarse chromatin
Cytoplasmic clearing around nucleus (koilocytes)
Cells with the combination of nuclear atypia and cytoplasmic halos; seen with HPV
Koilocytes
________ ____________ is used in conjunction with Pap smears in the screening of women 30 years of age and older
DNA testing
Procedure to observe the inside of the Cervix with a scope; apply Acetic Acid and Lugol’s solution to dehydrate cells and measure uptake
Colposcopy
Purpose of Acetic acid and Lugol’s Solution during a Colposcopy
Acetic Acid: dehydrate cells (dec. glycogen makes white rim)
Lugol’s: iodine is not taken up if little glycogen
Most common type of Cervical Cyst; dilated endocervical glands filled with mucin; appear yellow or white
Nabothian Cysts
Focal hyperplastic protrusions of Endocervical tissue composed of epithelium and stroma; can discharge and bleed; are rounded and can be smooth or lobulated
Endocervical Polyp
Treatmetns for Cervical Intraepithelial Neoplasia (CIN)
Cryotherapy
Biopsy/Excision
Hysterectomy
When would you decide to treat vs. observe Cervical Intraepithelial Neoplasia (CIN)
Old age
Non-compliance
Abnormal colposcopy
CIN 2 and 3
What are the chances of regression for the various CIN
CIN 1: 90%
CIN 2: 50%
CIN 3: 10%
HPV Vaccines
Gardasil and Cervarix
What HPV types do Gardisil vs. Cervarix protect against
Gardisil: HPV 6, 11, 16 and 18
Cervarix: HPV 16 and 18