EXAM #1: TROPHOBLASTIC & CERVICAL CANCER Flashcards
What is a hydatid?
A cyst containing watery fluid
What is a mole?
Abnormal mass of tissue in the uterus
What is a Hyaditidiform Mole?
Abnormality of the placenta resulting from faulty fertilization
What are the clinical manifestations of a Hyaditidiform Mole?
- 4th to 5th month gestation
- Size of the uterus MUCH LARGER than corresponding months
- Vaginal bleeding
What is the different between a complete and partial Hyaditidiform Mole?
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
How will a complete hyaditiform mole present?
Large, distended, bizarre, gelatinous mass
How does the HCG level compare between complete and partial Hyaditidiform Mole?
Complete= very very high Partial= high
What US finding is pathognomonic for a complete Hyaditidiform Mole?
Snowstorm
Grossly, how is a Complete Hyaditidiform Mole described?
“Bunch of grapes”
How do the chorionic villi appear in a Complete Hyaditidiform Mole?
Large avascular villi
How do the chorionic villi for partial and complete Hyaditidiform Mole compare?
Partial= slight hyperplasia Complete= extensive hyperplasia
What is an Invasive Mole?
Complete Hyaditidiform Mole with penetration of villi and trophoblast into the myometrium
What are the complications of Invasive Moles?
1) Uterine rupture
2) Embolization of villi to lungs
After D/C for complete Hyaditidiform Mole, what should you be concerned about if B-HCG remains elevated?
Invasive Mole
What is a Chroiocarcinoma?
- Highly malignant neoplasm of trophoblastic cells
- Fleshy, hemorrhagic tumor with cytotrophoplast and syncytiotrophoblasts
How does Choriocarcinoma present?
- Irregular spotting of brown, bloody, foul-smelling fluid
- Elevated B-HCG
What is unique about Choriocarcinoma?
Very sensitive to chemotherapy
What are Choriocarcinomas lacking?
Villi
Where do Choriocarcinomas come from?
1) Normal pregnancy
2) Spontaneous abortion
3) Complete Mole*
*Most common
What is a placental site tumor?
Tumor of the implantation site with intermediate trophoblasts
What will the B-HCG levels be in a placenta site tumor?
Low
What is the transformation zone?
Transition from columnar epithelial cells to squamous epithelial cells in the cervix (protective)
Why is the transformation zone important?
Cervical intraepithelial neoplasia and carcinoma originate from the transformation zone
What serotypes of HPV are the most oncogenic?
16 and 18
How do HPV 16/18 cause cervical cancer?
E6= inhibits p53 E7= inhibits p53, p21, and Rb
How does the outcome of HPV exposure to columar vs. sqamous epithelium differ?
Columnar= adenocarcinoma Squamous= squamous carcinoma
What morphologic feature is characteristic of CIN?
Nuclear atypia
What is LSIL?
Low-grade Squamous Intraepithelial Lesion
How does LSIL appear on microscopy?
1) Koilocytes (“empty cytoplasm”)–indicative of HPV infected cells
2) Ki-67 staining showing extension of proliferating cells from basal layer to superficial layer
What is CIN-I?
Dysplasia in the lower 1/3
What is CIN-2?
Dysplasia in the lower 2/3 i.e. extending into the parabasal layer
What is CIN-3?
Dysplasia extending into all layers
What is the difference between CIN-3 and CIS?
In CIN-3, the upper most layer is not involved, though the upper 1/3 is
What is invasive cervical cancer?
Penetration of malignant cells through the basement membrane
What is the most common type of cervical cancer?
Squamous cell
What is the prognosis for Stage 1-2 cervical cancer?
Good
