Female Genital Pathology Flashcards
Molluscum contagiosum:
- Gross description
- Infectious agent
- Small cluster of 2mm papules with central umbilication
- Molluscum Contagiosum Virus (a DNA poxvirus)
Psoriasis:
- Gross appearance
- Micro appearance
- MC areas
- Silvery plaques on an erythematous base
- Hyperkeratosis, loss of granular layer, elongation of rete pegs
- Scalp, elbows, knees, gluteal cleft
Lichen Simplex Chronicus:
- Description
- Micro appearance
- Keywords: ___ - ____ cycle
- Epithelial thickening dt chronic scratching
- Elongation, widening, and thickening of rete pegs
- Scratch-itch cycle
Lichen planus:
- Gross appearance
- Micro appearance
- Red, sore, raw areas of skin w/ scarring
- Saw-tooth rete pegs **pathognomonic
Lichen sclerosus:
- Gross appearance
- Micro appearance
- Inc risk of …?
- White/pale thickening of skin of vulva
- Edema of basal layer, collagen deposition, disappearance of rete pegs
- Vulvar carcinoma
What happens with the epithelial rete pegs in the following conditions:
Psoriasis, LSC, Lichen Planus, Lichen Sclerosus
Psoriasis: elongation
Lichen Simplex Chronicus: elongation, thickening, widening
Lichen Planus: saw-tooth
Lichen Sclerosus: disappearance
A cyst found in the vulva is probably a…
Bartholin’s duct cyst
Genital Herpes
- Gross description
- Micro description
- Shallow, painful ulcers
- Tzanck smears reveal multinucleated giant cells. Nuclei have ground glass appearance.
Condyloma acuminata
- MC infectious agent–be specific
- Gross appearance
- Micro appearance
- HPV types 6 & 11
- nontender nonpruritic lesions, cauliflowery
- acanthosis, hyperkeratosis, cytoplasmic vacuoles
Condyloma lata
- Infx agent
- Gross apperance
- Treponema pallidum (syphilis)
- Pale or gray flat warts (not cauliflowery)
What are the three MC vaginal infx in order of prevalence?
- Bacterial vaginosis
- Candida
- Trichomonas
Differentiate BV, candida, and trich on the basis of discharge, odor and pH.
BV + Trich: fishy odor, high vaginal pH
Candida: no odor, low pH, cottage cheese d/c”
What wet mount finding indicates BV?
Clue cells = epithelial cells covered in bacteria
Why is chlamydia difficult to find in the lab?
Because it lives inside human cells.
Characteristic histological finding for Neisseria gonorrhea
Neutrophils with Gram (-) intracellular diplocci
Vulvar intraepithlial neoplasia
- Gross appearance
- Micro apperance
- Assoc w/ which infx agent
- Inc risk of…?
- Presence of multicolored hyperpigmented skin plaques
- Diffuse cellular atypia, nuclear crowding, mitotic figures
- High-risk HPV
- Vulvar carcinoma
Vulvar carcinoma
- MC cell type
- Tumor marker
- When is HPV assoc?
- SCC (85%)
- p53 protein
- Poorly differentiated, positive for HPV; highly differentiated + keratinizing, HPV negative
Cancer assoc w/ DES exposure
Clear cell adenocarcinoma of the vagina/vulva
Cellular changes in which nuclei are enlarged and stain with a halo-like appearance (relates to cervical cancer)
Koilocytosis
Which grade of cervical dysplasia is characterized by koilocytosis?
Low-grade SIL/ASC-US
Which HPV strains are considered high-risk for cervical cancer?
16 & 18
Give the main risk factor for cervical cancer, along with at least 3 other risk factors.
Main: presence of HPV
Others: younger at first intercourse, multiple partners, OCP, tobacco, hx genital infx, multiple births
Endometriosis
- Definition
- MC ectopic site
- MC age group
- Gross appearance
- Micro appearance
- Endometrial tissue located outside the lining of uterus
- Ovaries
- Reproductive age
- Black/brown specks on tissues in the abdomen
- Endometrial glands and stroma
Endometrioma
- Common name
- Definition”
- Chocolate cyst
- Ovarian cyst that forms dt ectopic endometrial tissue bleeding inside the ovary
Adenomyosis
- Definition
- Micro appearance
- Ectopic endometrial tissue within the myometrium
- Thickened, spongy myometrium
Endometritis
- Cause usu related to…?
- Acute is characterized by…?
- Chronic is characterized by…?
- childbirth (e.g. retained placental fragments)
- microabscesses (neutrophils within endometrial glands)
- plasma cells in stroma
PID
- Definition
- Scary sequela
- Infx of upper genital tract not assoc w/ pregnancy or surgery
- Infertility (save the tubes!)
What group are the most common gyn cancers in the US?
Endometrial cancers
Most common endometrial cancer?
Adenocarcinoma
Tumor marker for papillary serous carcionma
p53 protein
Leiomyoma
- Definition
- Gross appearance
- Micro appearance
- Benign smooth muscle tumor of uterus (fibroid)
- Round, firm, well-circumscribed tumors
- Cells have uniform size and shape with oval nuclei, characteristic whorled pattern
MC endocrine d/o in women AND MC cause of female infertility
PCOS
PCOS
- Direct cause
- Assoc w/… (other endocrine dz)
- Lab finding
- US finding
- Ovaries producing androgens
- Insulin resistance
- LH>FSH 1:3
- string of pearls
“Ovarian cancer:
- MC cell of origin
- Characteristic spread
- Bx of cystadenocarcinoma”
- “epithelial” (adenocarcinoma)
- seeding along peritoneum
- psamomma bodies
Three characteristic findings in psoriasis
Koebner phenomenon (new lesion at site of injury) Woronoff's ring (ring of blanching around plaque) Auspitz's sign (point bleeding on lifting of scale)
