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OB/GYN > EXAM #1: TROPHOBLASTIC & CERVICAL CANCER > Flashcards

EXAM #1: TROPHOBLASTIC & CERVICAL CANCER Flashcards

1
Q

What is a hydatid?

A

A cyst containing watery fluid

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2
Q

What is a mole?

A

Abnormal mass of tissue in the uterus

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3
Q

What is a Hyaditidiform Mole?

A

Abnormality of the placenta resulting from faulty fertilization

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4
Q

What are the clinical manifestations of a Hyaditidiform Mole?

A
  • 4th to 5th month gestation
  • Size of the uterus MUCH LARGER than corresponding months
  • Vaginal bleeding
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5
Q

What is the different between a complete and partial Hyaditidiform Mole?

A

Complete= fertilization of an EMPTY OVUM with one or two sperm

  • Results in 46 chromosomes
  • NO EMBRYO

Partial= OVUM is 23X, results in 69 chromosomes
- Will have FETAL DEVELOPMENT

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6
Q

How will a complete hyaditiform mole present?

A

Large, distended, bizarre, gelatinous mass

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7
Q

How does the HCG level compare between complete and partial Hyaditidiform Mole?

A 
Complete= very very high 
Partial= high
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8
Q

What US finding is pathognomonic for a complete Hyaditidiform Mole?

A

Snowstorm

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9
Q

Grossly, how is a Complete Hyaditidiform Mole described?

A

“Bunch of grapes”

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10
Q

How do the chorionic villi appear in a Complete Hyaditidiform Mole?

A

Large avascular villi

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11
Q

How do the chorionic villi for partial and complete Hyaditidiform Mole compare?

A 
Partial= slight hyperplasia 
Complete= extensive hyperplasia
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12
Q

What is an Invasive Mole?

A

Complete Hyaditidiform Mole with penetration of villi and trophoblast into the myometrium

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13
Q

What are the complications of Invasive Moles?

A

1) Uterine rupture

2) Embolization of villi to lungs

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14
Q

After D/C for complete Hyaditidiform Mole, what should you be concerned about if B-HCG remains elevated?

A

Invasive Mole

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15
Q

What is a Chroiocarcinoma?

A
  • Highly malignant neoplasm of trophoblastic cells

- Fleshy, hemorrhagic tumor with cytotrophoplast and syncytiotrophoblasts

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16
Q

How does Choriocarcinoma present?

A
  • Irregular spotting of brown, bloody, foul-smelling fluid

- Elevated B-HCG

17
Q

What is unique about Choriocarcinoma?

A

Very sensitive to chemotherapy

18
Q

What are Choriocarcinomas lacking?

A

Villi

19
Q

Where do Choriocarcinomas come from?

A

1) Normal pregnancy
2) Spontaneous abortion
3) Complete Mole*

*Most common

20
Q

What is a placental site tumor?

A

Tumor of the implantation site with intermediate trophoblasts

21
Q

What will the B-HCG levels be in a placenta site tumor?

A

Low

22
Q

What is the transformation zone?

A

Transition from columnar epithelial cells to squamous epithelial cells in the cervix (protective)

23
Q

Why is the transformation zone important?

A

Cervical intraepithelial neoplasia and carcinoma originate from the transformation zone

24
Q

What serotypes of HPV are the most oncogenic?

A

16 and 18

25
Q

How do HPV 16/18 cause cervical cancer?

A 
E6= inhibits p53
E7= inhibits p53, p21, and Rb
26
Q

How does the outcome of HPV exposure to columar vs. sqamous epithelium differ?

A 
Columnar= adenocarcinoma
Squamous= squamous carcinoma
27
Q

What morphologic feature is characteristic of CIN?

A

Nuclear atypia

28
Q

What is LSIL?

A

Low-grade Squamous Intraepithelial Lesion

29
Q

How does LSIL appear on microscopy?

A

1) Koilocytes (“empty cytoplasm”)–indicative of HPV infected cells
2) Ki-67 staining showing extension of proliferating cells from basal layer to superficial layer

30
Q

What is CIN-I?

A

Dysplasia in the lower 1/3

31
Q

What is CIN-2?

A

Dysplasia in the lower 2/3 i.e. extending into the parabasal layer

32
Q

What is CIN-3?

A

Dysplasia extending into all layers

33
Q

What is the difference between CIN-3 and CIS?

A

In CIN-3, the upper most layer is not involved, though the upper 1/3 is

34
Q

What is invasive cervical cancer?

A

Penetration of malignant cells through the basement membrane

35
Q

What is the most common type of cervical cancer?

A

Squamous cell

36
Q

What is the prognosis for Stage 1-2 cervical cancer?

A

Good

OB/GYN (19 decks)

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