Female genital tract pathology

Question 1

Main classifications of a mass

Answer 1

Neoplastic

Non-neoplastic

Question 2

Classifications of neoplastic mass

Answer 2

Benign

Malignant (can be primary or secondary)

Question 3

Classifications of primary malignant tumours. I.e. what tissues can they arise in?

Answer 3

Epithelial, mesenchymal, lymphoid, melanocytic, germ cell, other.

Question 4

Classification of non neoplastic growths

Answer 4

Infections, inflammation, deposits, hamartomas, congenital. Neuroendocrine,fibrous

Question 5

Classification of tumours:
Name based on cell of origin-
Epithelial
Glandular epithelium
Squamous epithelium
Lymphiod
Melanocytic
Mesenchymal (fat, nerve, bones, muscle)

Answer 5

Carcinoma
adenocarcinoma
Squamous cell carcinoma
Lymphoma
Melanoma
Sarcoma

Question 6

At birth how many primordial follicles are there

Answer 6

400 000

Question 7

How many follicles develop each month and under what influence

Answer 7

20 FSH,LH

Question 8

What supports the follicles in the ovary

Answer 8

Stroma

Question 9

What are the tumours of the ovary

Answer 9

Germ cell tumours (teratomas)
Stromal tumours (e.g. fibroma)
Epithelial tumours (near fimbra)
Metastases

Question 10

What are some non neoplastic growths in the ovary

Answer 10

PCOS, functional ovarian cysts, follicular cysts, corpus luteum cyst

Question 11

What are some benign tumours of the ovary

Answer 11

Epithelial, germ cell or stream tumours (fibromas)

Question 12

What are the two kinds of epithelial ovarian tumours

Answer 12

Mucinous (glandular epithelium with mucous in cytoplasm)

Serous (columnar epithelia that is ciliated)

Question 13

Layers of fallopian tube

Answer 13

delicate smooth muscle layer, covered in serous epithelium, columnar, cilliated

Question 14

Two non neoplastic mass in fallopian tube

Answer 14

Salpingitis

Ectopic pregnancy

Question 15

Malignant tumours of fallopian tubes

Answer 15

Primary carcinoma

Secondary metastatic carcinoma (often from local tumours)

Question 16

What happens with excess oestrogen

Answer 16

Excess proliferation and increased risk of neoplasia

Question 17

Non neoplastic masses in endometrium

Answer 17

Endometritis
Endometriosis (chronic endometritis)

Question 18

Malignant tumours of endometrium

Answer 18

Endometrial adenocarcinoma

Question 19

Non neoplastic masses in cervix

Answer 19

Cervicitis

Candida

Question 20

Non neoplastic masses in myometrium

Answer 20

Adenomyosis

Question 21

Benign tumours in the myometrium

Answer 21

Leiomyoma (fibroid)

Question 22

Malignant tumour of myometrium

Answer 22

Leiomyosarcoma (a malignant smooth muscle tumour)

Question 23

Pre malignant lesions in cervix

Answer 23

Squamous intraepithelial lesion (SIL)

Adenocarcinoma in situ

Question 24

Malignant tumours of the cervix

Answer 24

Squamous cell carcinoma

Adenocarcinoma

Question 25

What do we detect when cervical screening

Answer 25

Pre malignant lesions of squamous intraepithelial. Three stages CIN I,CIN II, CIN III

Question 26

Define metaplasia, dysplasi, neoplasia

Answer 26

Metaplasia- change from cell types Dysplasia genetic alterations to the DNA of cell which cause it to proliferate/ reproduce more (always above BM never invasive) Neoplasia- When the tumour invades beyond BM

Question 27

What does CIN stand for

Answer 27

Cervical Intraepithelial Lesion

Question 28

Why are pre cancerous cells confined to the epithelium

Answer 28

Because there are no blood vessels above the BM an intraepithelial lesion can't metastatasize

Question 29

How can precancerous cells become neoplastic

Answer 29

If the pre-cancerous cells undergo further mutations that allow invasions through the BM. Once through the BM the cells can invade lymphatics/ blood vessels

Question 30

Name four cancers that relate to HPV

Answer 30

Cervical cancer Cancer of the vagina/cervix Cancer of the penis Cancer of the oro-pharynx

Question 31

What is the transmission rate of HPV

Answer 31

70% without a condom | 30% with a condom

Question 32

Describe the progression of cervical cancer

Answer 32

Precancerous intraepithelial lesion- CIN I to CIN III depending on amount of epithelial cells effected. This is whereby dysplastic cells are confined to the epithelium and there is no invasion beyond the basement membrane. As the epithelium does not have blood vessels these cells cannot metastasise. Neoplastic cells can then undergo further mutations that allow invasion through the BM where they can now invade lymphatics/ blood vessels and metastasize.

Question 33

What strains of HPV most commonly cause cervical cancer

Answer 33

16 and 18

Question 34

Who is most at risk of cervical cancer?

Answer 34

WOMEN WHO DONT GET REGULAR SMEARS. People who have contracted high and intermediate risk strains of HPV whereby the infection has not been cleared. Co factors include sexual promiscuity, smoking, low SES, and immune deficiency.

Question 35

What is the main kind of endometrial cancer

Answer 35

Endometrial adenocarcinoma

Question 36

Risk factor for endometrial adenocarcinoma

Answer 36

Excessive oestrogenic state. Obesity, PCOS, nulliparity, early monarch/late menopause, HRT, hormone secreting tumours

Question 37

What is the technical term for fibroids and describe

Answer 37

Leiomyoma | Circumscribed nodules within the myometrium, creamy, benign tumour of smooth muscle.

Question 38

What is endometriosis and why is it a concern

Answer 38

Endometrial tissue occurring outside of the uterus. Responds to hormones in the menstrual cycle and can cause bleeding, cysts, pain, tissue inflammation, infertility and ectopic pregnancy. Can give rise to malignancy.

Question 39

What is the most common ovarian tumour

Answer 39

Serous epithelial

Question 40

What is a teratoma

Answer 40

A dermoid cyst in the ovary derived from germ cells

Question 41

What is the malignant cancer of the fallopian tube

Answer 41

Primary carcinoma of the fallopian tube

Question 42

What is salpingitis

Answer 42

Inflammation of the fallopian tube (PID)