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PATHPROS > FEMALE GENITAL TRACT > Flashcards

FEMALE GENITAL TRACT Flashcards

1
Q

Occurs in women with intrauterine exposure to DES

Cells have distinct cell membranes,

large

moderate to abundant clear cytoplasm

cuboidal and sometimes hobnail type with nuclei protruding into the lumen

Nuclei are round to irregular, hyperchromatic with conspicuous nucleoli

A

Clear cell adenocarcinoma

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2
Q

Proliferative/ secretory endometrium?

Gland architecture: straight, tubular

  • Gland lining: regular, tall, pseudostratified columnar
  • Secretory activity: no evidence of mucus secretion or vacuolation.
  • Compact stroma
A

Proliferative Endometrium

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3
Q
  1. Diagnosis?

vaginal bleeding, adnexal pain, adnexal mass

  1. List 2 complications
  2. Confirmatory test
A
  1. Ectopic pregnancy
  2. a. Hypovolemic shock
  3. b. Hematosalpinx
  4. Vaginal USG
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4
Q

Type of cellular adaptation seen in the image

A

Squamous Metaplasia

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5
Q
  1. See attached image and name the Tumor marker
  2. What category of ovarian tumors does it belong to?
A
  1. Inhibin
  2. Sex cord stromal tumors
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6
Q

Morphology of HSV 2 on Tzanck smear

A

squamous cells containing eosinophilic to basophilic viral inclusions with ground glass appearance.

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7
Q

Bilateral ovarian masses

Microscopy of the ovarian masses show findings seen in the attached image.

Diagnosis?

Most likely primary?

A

Krukenberg tumor- bilateral metastases

Gastric origin

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8
Q

second most common malignant tumor of germ cell origin

See attached image

What tumor is this?

Marker?

A

Yolk Sac

Alpha-feto protein

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9
Q

Ovarian neoplasm assoc with the syndrome described below:

Widely spaced nipples, webbed neck, lack of secondary sex charcateristics

A

Dysgerminoma assoc with Turner Syndrome

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10
Q

1. See the image provided and the clues below and formulate a diagnosis

38 year old female

dysmenorrhea

painful defecation at the time of menstruation

2. What findings would you expect to see in the ovary?

A
  1. Endometriosis
  2. large cystic masses filled with brown fluid
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11
Q

1. Pre eclampsia / eclampsia?

New onset hypertension+ proteinuria + seizures in a primipara in the last trimester

  1. 2 complications of this condition
A
  1. Eclampsia
  2. HELLP Syndrome; DIC

Know the expansion of HELLP:

Hemolysis

Elevated Liver enzymes

Low Platelets

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12
Q

right upper quadrant pain following the transabdominal spread of infection from pelvic inflammatory disease

violin string adhesions of anterior liver capsule to anterior abdominal wall or diaphragm

liver capsular infection without affecting hepatic parenchyma

A

Fitz Hugh Curtis Syndrome

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13
Q

painful vaginal bleeding, abdominal or back pain, and fetal compromise

Premature separation of the placenta caused by formation of a retroplacental clot

Diagnosis?

Greatest risk factor?

A
  1. Abruptio placenta
  2. Maternal hypertension
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14
Q

1. Gestational(Placental) /Non gestational(Ovarian) choriocarcinoma?

  • Øunresponsive to chemotherapy

Øoften fatal

  • Øexists in combination with other germ cell tumors

2. Marker for choriocarcinomas?

A
  1. Non gestational choriocarcinoma
  2. human chorionic gonadotropin
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15
Q

mcc of death in patients with advanced cervical carcinoma

A

local invasion of ureter, pyelonephritis and renal failure

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16
Q

large, flagellated ovoid protozoan

transmitted by sexual contact

yellow, frothy vaginal discharge

Colposcopy finding: strawberry cervix

A

Trichomonas vaginalis

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17
Q

Microscopy findings in ovarian dysgerminoma

A
  • large vesicular cells, clear cytoplasm, well-defined cell boundaries, central regular nuclei.
  • grow in sheets or cords
  • scant fibrous stroma , infiltrated by mature lymphocytes
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18
Q

What’s your diagnosis?

56 year old female with post coital vaginal bleeding assoc with malodorous discharge

Colposcopy shows a fungating mass

Microscopy shown in the attached image.

A

Cervical Squamous cell carcinoma

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19
Q

WHAT’S THE DIAGNOSIS?

TEMP >101 DEGREE FARENHEIT

ABNORMAL VAGINAL DISCHARGE

CERVICAL MOTION TENDERNESS

ADNEXAL TENDERNESS

A

PID

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20
Q

Mechanism of carcinogenesis by HPV E6 AND E7?

A

Learn this till you go blue in the face!

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21
Q
  1. Describe the microscopic findings seen in this benin condition caused by HPV 6 and 11.
  2. What’s the diagnosis?
A
  1. Papillary, exophytic, treelike cores of stroma covered by thickened squamous epithelium with koilocytic atypia
  2. Condyloma acuminatum
22
Q
  1. Painless vaginal bleeding 2nd or 3rd trimester
  2. Uterus soft/nontender
  3. No fetal distress

Øplacenta implants in the lower uterine segment or cervix

A

Placenta praevia

23
Q

1. Diagnosis?

32 year old woman

menometrorrhagia

•Enlarged globular uterus, c/s trabeculated appearance

2. What finding do you see on microscopy?

A
  1. Adenomyosis
  2. presence of endometrial tissue within the uterine wall (myometrium)
24
Q

TREATMENT OF THIS CONDITION IS BY MARSUPIALIZATION

TENDS TO GET INFECTED

LINING OF TRANSITIONAL/SQUAMOUS EPITHELIUM

A

Bartholin Cyst

25
Q
  1. Presenting symptoms of an ovarian mass
  2. mc site for seeding of malignant surface derived ovarian tumors
A
  1. Lower Abdominal pain and distention
  2. Omentum
26
Q

placental villi adhere to the myometrium as a result of a partial or complete absence of the decidua basalis

A

§Placenta accreta

27
Q

1. What is this condition termed as?

Bilateral ovarian masses

Extensive mucinous ascites

2. Most likely primary tumor of origin?

A

1. pseudomyxoma per­itonei

2. Appendix

28
Q

Unilateral ovarian mass

No palpable thyroid

Thyroid function tests suggestive of hyperthyroidism

A

Struma Ovarii

29
Q

45 year old female

H/O pruritus, dyspareunia

M/E pf vulval area shows marked thinning of epidermis, sclerotic changes in the dermis with hyalinization and bandlike lymphocytic infiltrate

A

Lichen sclerosus

30
Q

Origin of this tumor?

<5 years of age

Gross: polypoid, round, bulky grapelike masses

A

Origin of the tumor is from Skeletal muscle cells

The tumor is embryonal Rhabdomyosarcoma.

31
Q

Gross appearance: sharply circumscribed, discrete, round, firm, gray-white

characteristic whorled pattern of smooth muscle bundles on cut section

Microscopic appearance: see attached image

What’s your diagnosis?

A

Leiomyoma

32
Q

1. DIagnosis?

20 year old female

unilocular cyst

cyst wall lined by stratified squamous epithelium

Microscopy : Image attached

2. mc type of carcinoma that may rarely develop from this benign tumor?

A
  1. Mature teratoma
  2. Squamous cell carcinoma
33
Q

52 year old female

abdominal distension

unilateral ovarian mass

Gross: Larger cystic masses,Multiloculated,sticky, gelatinous fluid

What would you see on microscopy?

A

Tall columnar cells with apical mucin

(Mucinous tumor)

34
Q

1. Diagnosis?

52 year old female , distended abdomen and low back ache

elevated CA-125

gross and microscopic images attached

2. Which type of calcification would you expect to see?

A
  1. Malignant surface epithelial tumor- papillary serous cystadenocarcinoma
  2. Dystrophic calcification in psammoma bodies
35
Q

List 6 morphologic lesions seen in the tubes and ovaries following PID

A

ACUTE SUPPURATIVE SALPINGITIS

SALPINGO-OOPHORITIS

TUBO OVARIAN ABSCESS

PYOSALPINX

CHRONIC SALPINGITIS

HYDROSALPINX

36
Q

1. Diagnosis?

  • ovarian counterpart of testicular seminoma
  • MC malignant germ cell tumor
  • soft and fleshy
  • see attached microscopic image

2. Markers?

A
  1. Dysgerminoma

2.

  • serum LDH
  • hcG
  • OCT-3, OCT4, and NANOG
37
Q

irregular vaginal spotting of a bloody, brown fluid

rising titer of hCG after a molar pregnancy, abortion, or ectopic pregnancy.

Xray findings attached

What is the origin of these tumor cells?

A

trophoblastic cells

38
Q

Differences between a partial mole and a complete mole

A
39
Q

1. Diagnosis?

Pruritic, red, crusted , maplike area over the labia majora

lateral spread of cells in singles/clusters within epidermis, the cell are large rthan normal keratinocytes

pale cytoplasm conatining mucopolysaccharide

2. Special stain?

A
  1. Extramammary Paget Disease
  2. PAS/Alcian Blue/Mucicarmine
40
Q

Functional ovarian tumors

  1. Estrogen secreting
  2. Androgen secreting
A
  1. Granulosa cell, thecomas
  2. Sertoli Leydig cell tumor
41
Q
  1. Name the most frequent precursor to endometrial carcinoma

2. Which syndrome is this?

Clustering of endometrial, colorectal and ovarian carcinomas in a family

A
  1. Endometrial hyperplasia
  2. Lynch Syndrome
42
Q

20 year old female

Bulky, solid; Hair, sebaceous material, cartilage, bone, and calcification may be present, along with areas of necrosis and hemorrhage

Microsocpy image attached

Diagnosis?

A

Immature teratoma

43
Q

Proliferative endometrium / secretory endometrium?

  • Gland architecture: tortuous, serrated or “saw-toothed
  • Gland lining: shows subnuclear secretory basal vacuoles that move progressively to the apex
  • Secretory activity: prominent
  • Loose stroma
A

secretory endometrium

44
Q

Diagnosis?

60 year old female

bulky, fleshy masses that invade the uterine wall

Tumor cells- irregular, hyperchromatic nuclei, Atypical mitoses and Foci of necrosis

A

Leiomyosarcoma

45
Q

ØPrimipara

last trimester

new-onset hypertension (≥140 mm Hg systolic or ≥90 mm Hg diastolic) accompanied by proteinuria (>300 mg in 24-hr urine collection or 30 mg/dL [1+ dipstick])

A

Pre-eclampsia

46
Q

Give one word that best describes this image:

Atypical, enlarged hyperchromatic nuclei with wrinkled, raisinoid appearance with perinucelar halo

A

Koilocytic atypia

47
Q
  1. mc cause of ectopic pregnancy
  2. mc site of ectopic pregnancy in the ft?
A
  1. Scarring from previous PID
  2. broad ampullary portion below the fimbriae
48
Q

Lab findings in PCOD

A

LH/FSH ratio >3

Increase in serum FT and androstenedione

Decrease in serum sex hormone binding globulin (SHBG)

Normal to decreased serum FSH

Increased insulin

49
Q

most common mechanism of formation of this subtype of benign mole

A

The image shows a complete mole - mc mechansim is fertilization of an empty ovum by a single sperm that undergoes duplication of its chromosomes.

50
Q

Estrogen secreting tumor

adult female

M/E: small, cuboidal to polygonal cells may grow in anastomosing cords, sheets, or strands; with small, distinctive, glandlike structures filled with an acidophilic material

A

Granulosa cell tumor

PATHPROS (36 decks)

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