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Path4 My Cards > Female Genital System I > Flashcards

Female Genital System I Flashcards

1
Q

Lichen Sclerosis

  • how to remember
  • what structure does it affect?
  • pathology
A

Lichen=Moss (think of the white moss that grows on rocks)

Affects the vulva

pathology:

  • white plaques (leukoplakia)
  • atrophic skin
  • parchment/crinkled appearance
  • superficial hyperkeratosis
  • Dermal fibrosis
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2
Q

Condyloma Acuminatum

  • cause
  • histopathology
  • can it coexist with something?
A

caused by low risk types of HPV (6 and 11)
rarely progresses to in situ or invasive cancers

histopathology:

  • superficial hyperkeratosis of the epithelium
  • thicker underlying epidermis

Can coexist with vulvar epithelial neoplasia

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3
Q

Vulvar Intraepithelial Neoplasm and Vulvar Cancer

-Two types

A
  1. Basaloid and Warty Carcinomas

2. Keratinizing Squamous Cell Carcinoma

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4
Q

Basaloid and Warty Carcinomas

  • cause
  • outcome
A

cause:

  • warty so HPV
  • carcinoma so dangerous types of HPV (16 and 18)

outcome:
-eventually leads to squamous cell carcinoma

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5
Q

Keratinizing squamous cell carcinoma

  • pathogenesis
  • histopathology
A

pathogenesis:

  • from lichen sclerosis or squamous cell carcinoma (if have for a long time)
  • NOT ASSOCIATED WITH HPV

histopathology:
-Keratin Pearls for keratinizing squamous cell carcinoma

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6
Q

Cervical Intraepithelial Neoplasia

  • Location
  • Causes
  • Classification
A

Location:
-cervical epithelium

causes
-strong association with HPV (the oncogenic types (16 and 18)

Classification

  • Low squamous intraepithelial lesion (LSIL): affecting immature squamous cells in lower 1/3 of the epithelium
  • High squamous intraepithelial lesion (HSIL): affecting immature squamous cells in the bottom 2/3 of epithelium
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7
Q

low squamous intraepithelial lesion (LSIL)

  • cause
  • definition
  • characteristics
A

cause: strong association with HPV 16 and 18
LSIL affects immature squamous cells in the lower 1/3 of the epithelium

  • may regress spontaneously
  • will not progress directly to invasive carcinoma

*low=lower risk

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8
Q

high squamous intraepithelial lesion (HSIL)

  • cause
  • definition
  • characteristics
A

cause: strong association with HPV 16 and 18

HSIL affects immature squamous cells in the lower 2/3 of the epithelium

  • 1/10 as common as LSIL
  • 10% will progress to carcinoma
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9
Q

LSIL and HSIL

-histopathology

A

-caused by HPV so will have koilocytic atypia

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10
Q

what is the name of the characteristic appearance of cells infected with HPV?
-what do they look like?

A

koilocyte atypia

  • nuclear enlargement
  • irregular nuclear membrane contour
  • hyperchromasia of nucleus
  • perinuclear halo (clear area around nucleus)
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11
Q

Squamous Cell Carcinoma of the Cervix

  • pathology
  • how to remember pathology
A

75% of cervical cancers are squamous cell carcinoma of the cervix

pathology

  • nests of malignant squamous epithelium
  • either keratinizing or non
  • invades underlying cervical stroma

*nests…bundles…bundles of joy…babies…babies come out of the cervix

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12
Q

Endometriosis

-what?

A
  • Benign endometrial glands and stroma outside the uterus

- These regress after natural/artificial menopause

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13
Q

Endometriosis

-Histopathology

A
  • yellow-red stains due to bleeding
  • “powder burns”: from repeated hemorrhaging that causes scarring and brown discoloration
  • fibrous adhesions
  • chocolate cysts in the ovary
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14
Q

Endometriosis

-Distribution

A

60% in the ovaries

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15
Q

Endometriosis

  • pathophysiology
  • clinical
A

pathophysiology:

  • Tissue misplaced and abnormal
  • Changes involved to allow survival in a foreign area

clinical:

  • can cause ectopic pregnancy
  • severe dysmenorrhea (extra painful menstruation)
  • Pain with intercourse
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16
Q

Endometrial Adenocarcinoma

  • what
  • Clinical
A

what:
-uterine cancer
clinical:
-Abnormal uterine bleeding (at times of the month other than expected)

17
Q

Endometrial Adenocarcinoma

-Prognosis

A

High levels of Estrogen and Progesterone receptors in tumor and lower level of proliferative activity mean better outcomes

18
Q

Endometroid Adenocarcimona

  • Pathogenesis
  • Gene Mutation
A

Pathogenesis:
-Can develop when endometrial intraepithelial neoplasia precursors experience prolonged estrogen exposure

Gene mutation:

  • mismatch repair genes
  • in 30-80% PTEN* is mutated

*ptEN = Endometroid

19
Q

Endometroid Adenocarcinoma

-Grading the pathology

A

Grade 1: well differentiated

Grade 2: moderately differentiated

  • well-formed glands
  • sheets of malignant cells

Grade 3: poorly differentiated

  • Barely recognizable glands
  • solid sheets of malignant cells
20
Q

Non-endometroid Adenocarcinoma (serous carcinoma of the endometrium)
-Pathogenesis

A
  • NOT associated with estrogen exposure

- arises in setting of endometrial atrophy (post menopause)

21
Q

non-endometroid adenocarcinoma (serous carcinoma of the endometrium)
-Pathology/Gene defect

A

All cases classified as Grade 3 (poorly differentiated) no matter the histopathology

Mutation in p53 in 90% of cases

22
Q

Leiomyoma

  • what
  • who?
A

what:

  • myoma=muscle tumor
  • leiomyoma=smooth muscle tumor
  • Estrogen promotes growth
  • Shrinkage post menopause

who?
-happens during reproductive life

23
Q

Leiomyoma

-pathology

A

sharply circumscribed

Whorling bundles of smooth muscle

24
Q

Leiomyoma

-Clinical

A
  • usually silent

- can have prolonged/excessive bleeding during period

25
Q

Leiomyosarcoma

  • Who?
  • Pathogenesis
A 
Who?:
-post-menopausal* 
Pathogenesis:
-NOT from leiomyoma
-malignant tumor from mesenchymal cells
  • To differentiate between this and non-endometroid adenocarcinoma (serous carcinoma of the endometrium): cancer arises in endometrium
    leiomyosarcoma: cancer arises from mesenchymal cells
26
Q

Salpingitis

  • What
  • Cause
A

What
-infection/inflammation of the fallopian tubes

Cause:
-develops from UTI

27
Q

Salpingitis

-Histopathology

A
  • Polys
  • Edema
  • Congestion

*Or can be chronic and have lymphocytes, less edema and less congestion

28
Q

Salpingitis

-Clinical

A
  • presents as part of PID
  • Abscesses (like UTI)
  • Ectopic Pregnancy

Path4 My Cards (6 decks)

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