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Path4 My Cards > Female Genital System II > Flashcards

Female Genital System II Flashcards

1
Q

Ovarian Neoplasms are called (umbrella term for all three)

A

Surface Epithelial-Stroma Cell Tumors

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2
Q

Surface Epithelial-Stroma Cell Tumors

-What?

A

-Ovarian neoplasm that arises especially in cases of never giving birth or family Hx

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3
Q

Surface Epithelial-Stroma Cell Tumors

-Types (3)

A
  1. Serous tumors of the ovary
  2. Cystadenoma
  3. Cystadenocarcinoma
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4
Q

Surface Epithelial-Stroma Cell Tumors

-Genes

A
  • Familial types associated with BRCA
  • BRCA only in 10% of sporadic cases
  • Overexpression of HER2/NEU will lead to a poor prognosis
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5
Q

Serous tumors of the ovary

A
  • A type of Surface Epithelial-Stroma Cell Tumor
  • Most frequent ovarian tumor
  • Large and round
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6
Q

Cystadenoma

A

A type of Surface Epithelial-Stroma Cell Tumor

  • Benign
  • Cystic lesions
  • single layer of tall columnar epithelium lining cysts
  • younger age (30-40)
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7
Q

Cystadenocarcinoma

  • What
  • Who does it affect
A

A type of Surface Epithelial-Stroma Cell Tumor
-Malignant

-Affects older women (45-65)

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8
Q

Cystadenocarcinoma

  • Dx
  • Histo
  • Metastasis
A

Dx:
-CA-125 used as a marker

Histo:
-cyst lined with anaplastic epithelium (as opposed to cystadenoma which is lined with___?)

Mets:
-spread by seeding

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9
Q

Breast Cancer

-Gene factors

A

BRCA1*:
-involved in 20% of breast cancer cases

BRCA2*

  • involved in 20% of breast cancer cases
  • common in ashkenazi jewish women
  • Men who have BRCA2 at increased risk of breast cancer

*These mutations not detected frequently in sporadic breast cancers

p53

  • Li Fraumeni syndrome: all young women will develop breast cancer
  • Germline mutations involved in 1% of breast cancer cases for women <40 yrs old
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10
Q

Breast Cancer

-Hormonal/other factors

A

Women who never give birth or who have their first pregnancy at >35 yrs have 2-3X the risk of those who have first baby at <25 yrs of age

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11
Q

Breast cancer

-Genetic changes

A

overexpression of HER2/NEU IN 30% of invasive breast cancers

HER2/NEU is involved in epidermal growth factor receptors, and overexpression is associated with poor prognosis

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12
Q

Ductal Carcinoma in Situ (DCIS)

-Histopathology

A

DCIS is the most common form of in situ breast cancer

histopathology:

  • arises from terminal duct lobular units
  • involves ductlike spaces
  • wont penetrate basement membrane
  • Calcifications are associated with DCIS (ducts=milk=Calcium)
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13
Q

Ductal Carcinoma in Situ (DCIS)

-Clinical

A
  • Rarely presents as palpable or radiologically detectable mass
  • if develops into carcinoma, will develop in the same breast and quadrant
  • Non-comedo subtype unlikely to produce desmoplastic (hardening) response
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14
Q

Ductal Carcinoma in Situ (DCIS)

-Comedo High-Grade Subtype

A
  • Gross appearance is a duct-like structure with white, necrotic material that looks like comedos (a clogged hair follicle)
  • Induces desmoplastic (hardening) response
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15
Q

Lobular Carcinoma in Situ (LCIS)

-histopathology

A
  • arises in terminal duct lobular units
  • wont penetrate basement membrane
  • these lobules produce mucus
  • mucin vacuoles that produce signet ring cells are common
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16
Q

Lobular Carcinoma in Situ (LCIS)

-Clinical

A
  • Always found incidentally
  • Does not form masses or calcifications
  • 1/3 of women with LCIS will have an invasive carcinoma, appearing in either breast at a significant frequency
  • Thus, LCIS is used as a marker for breast cancer
17
Q

Invasive Ductal Carcinoma

-What

A
  • Breast cancers that cant be categorized into any particular specialized subtype
  • Associated with DCIS
18
Q

Invasive Ductal Carcinoma

-histopathology

A
  • may see dimpling of the skin
  • irregular margins
  • Invades tissues (nerves and/or lymph-vascular spaces)
19
Q

Invasive Ductal Carcinoma

-Clinical

A

Hard palpable mass because normal breast fat is replaced due to a desmoplastic response

20
Q

Breast Cancer: clinical manifestations

-nodules

A
  • small nodules can be felt through palpation
  • 2-3 cm diameter means regional lymph nodes in 50% of cases
  • 1 cm diameter means nodal metastasis in 15% of cases
21
Q

Breast Cancer: clinical manifestations

-Superficial signs

A
  • nipple retraction
  • nipple discharge
  • breast inflammation
  • lymph node enlargement
  • maybe some paraneoplastic syndrome like hypercalcemia
22
Q

Breast cancer: clinical manifestations

-radiologic findings

A

Calcification from the hypercalcemia

23
Q

Breast Cancer: prognosis

  • Size
  • Lymph node involvement
A

Size:

- 12 involved, survival rate decreases to <50%

24
Q

Breast Cancer: prognosis

  • Histologic type
  • Hormone receptor status
A

histologic type:
-specialized types of breast carcinomas are better than no special type (invasive ductal carcinoma)

Hormone receptor status:

  • overexpression of HER2/NEU is not good
  • on the other hand, the anti-tumor antibody, Herceptin, which targets the HER2/NEU gene product, is good

Path4 My Cards (6 decks)

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