Female Genital Tract Pathology Flashcards by Clyde Silverio

[diagnosis]

plasma cells in endometrial stroma

chronic endometritis

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[diagnosis]

lymphocytes or plasma cells in cervical stroma

chronic cervicitis

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[diagnosis]

pelvic pain, adnexal tenderness, fever, vaginal discharge

PID

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[diagnosis]

gross: leukoplakia of the vulva

thinning of the epidermis, basal cell degeneration, hyperkeratosis, sclerotic changes of superficial dermis, dermal lymphocytic infiltrate

lichen slerosus

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[diagnosis]

gross: leukoplakia of the vulva

acanthosis, mitosis, hyperkeratosis, lymphocytic infiltrates

squamous hyperplasia

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[diagnosis]

failure of mullerian duct fusion, accompanied by uterine didelphys

septate vagina

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vaginal anomaly associated with DES exposure

septate vagina

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[diagnosis]

___ cyst

remnant of wolffian or mesonephric duct

gartner duct cyst

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most common primary vulvar CA

squamois cell CA

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[diagnosis]

patient 4 years old, gross presence of grape-like clusters

sarcoma botryoides

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___ term for small, with oval nuclei and tennis racket like appearance with or without striations in sarcoma botryoides

embryonal rhabdomyoblast

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[diagnosis]

fibromyxoid stroma, lined by endocervical type epithelium, usually with inflammation

endocervical polyp

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[HPV]

Infects: _____ (mature/immature)

Replicates in: ______ (mature/immature)

Infects immature cells

replicates in mature cells

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[HPV]

E___ inactivates Rb leading to cell proliferation

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[HPV]

E___ inactivates p53 leading to cellular immortality

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[diagnosis: CIN]

nuclear atypia with cytoplasmic “halos”, confined to lower third of epithelium

LSIL

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[diagnosis: CIN]

nuclear atypia with cytoplasmic “halos”, expansion to upper two-thirds of epithelium

HSIL

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[diagnosis]

CIN + invasion beyond the basement membrane

cervical CA

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[diagnosis]

infertility, dysmenorrhea, chronic pelvic pain

Gross: subserosal red-blue to yellow brown nodules on sites of involvement, ovaries may be converted to cyst

Histology: endometrial glands and stroma

Cyst lining: hemosiderin-laden macrophages in old hemorrhage, fibrosis

endometriosis

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[diagnosis]

chocolate cyst

endometriosis

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[diagnosis]

menometorrhagia, colicky dysmenorrhea, dyspareunia, premenstrual pelvic pain

gross: symmetrically enlarged corpus, with multiple blood lakes within the myometrium
histo: (+) endometrial stroma, with or without glands, within the myometrium, separated from the decidual basalis by 2 to 3 mm

adenomyosis

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[diagnosis]

due to retrograde menstruation

endometriosis

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[diagnosis]

exophytic mass that project into endometrial cavity, clinically silent AUB, seen in patient on tamoxifen

endometrial polyp

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[diagnosis]

precursor to endometrial CA type I, important cause of AUB

endometrial hyperplasia

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most common malignancy of the female genital tract

endometrial carcinoma

[diagnosis] postmenopausal bleeding, increased exposure to estrogen

endometrial CA

inactivation of this tumor suppressor gene can lead to atypical hyperplasia leading to endometrial CA

PTEN

precursor lesion to Type II endometrial CA

serous endometrial intraepithelial CA

a tumor suppressor gene that is associated with endomterial CA microsatellite instability

KRAS

[diagnosis: endometrial CA type] localized polypoid tumor, has three grades, glandular and solid; mild to moderate atypia

type I endometriod

[diagnosis: endometrial CA type] atrophic uterus with large bulky, infiltrative mass presence of papillary fronds, marked atypia

Type II serous

most common tumor in women

leiomyoma

[diagnosis] not encapsulated, well circumscribed, grayish-white tumor, intramural absent necrosis, scarce to low mitotic figure, absent to mild atypia

leiomyoma

[diagnosis] bulky, fleshy mass invading the uterine wall or polypoid mass projecting to the uterine lumen atypia is present, necrosis is present

leiomyosarcoma

[diagnosis] uterine mass wherein the glands are benign, stroma is malignant

adenosarcoma

[diagnosis] uterine mass wherein the glands are malignant, stroma are malignant

malignant mixed mullerian tumor

fallopian tube epithelium that is related to high-grade serous carcinoma

serous tubal intraepithelial carcinoma

[diagnosis: ovarian cyst] ovarian cyst 2cm

cystic follicle

[diagnosis: ovarian cyst] ovarian cyst > 2cm

follicle cyst

rupture of this ovarian cyst can lead to peritoneal reaction

luteal cyst

Stein-Leventhal Syndrome is also called

PCOS

most common ovarian tumors

mullerian epithelium (germ cell, sex cord-stromal, metastatic)

most common surface epithelial tumors of the ovary

serous

tumor marker for ovarian CA used to monitor recurrence and progression

CA 125

presence of _____ in surface epithelial tumors distinguish borderline from benign tumors

stromal invasion

presence of ____ in surface epithelial tumors distinguishes borderline tumors from benign tumors

atypia and complex architecture

[diagnosis: type of serous ovarian tumor] mutation of TP53, KRAS, BRAF Mucinous, low grade

Type I

[diagnosis: type of serous ovarian tumor] mutation of TP53, BRCA, PIK3CA Serous, high grade

Type II

[diagnosis: ovarian tumor] non-ciliated, tall columnar, usually unilateral, can produce large mass associated with pseudomyxoma peritoni

mucinous tumor

most common site of mucinous tumor in pseudmyxoma peritoni

appendix

most common germ cell tumor

mature cystic teratoma

[diagnosis] presence of tubular glands resembling benign or malignant endometrium; squamous differentiation

endometriod tumors

most common MALIGNANT germ cell tumor

dysgerminoma

[diagnosis: germ cell tumor] nest of large, vesicular cells with clear cytoplasm, centrally located nuclei with lymphocytic infiltration tumor marker: KIT

dysgerminoma

[diagnosis: germ cell tumor] central blood vessels enveloped by tumor cells within a space lined by tumor cells (+) hyaline bodies Tumor marker: AFP

Yolk sac tumor/endodermal sinus tumor

[diagnosis: germ cell tumor] schiller-duval bodies

Yolk sac tumor/endodermal sinus tumor

[diagnosis: germ cell tumor] tumor marker: HCG

ovarian choriocarcinoma

[diagnosis: sex-cord stromal tumors] hyperestrenism, presence of call exner bodies Tumor marker: estrogen, inhibin

granulosa cell tumor

[diagnosis: sex-cord stromal tumors] defemination, virilization tumor marker: androgen

Sertoli-leydig cell tumor

[diagnosis: sex-cord stromal tumors] mass effect, associated with Meigs syndrome fibroblast-like cells or plump spindle cells tumor marker: none

Thecoma/Fibroma

[diagnosis] Hydrothorax ascites ovarian tumor

Meigs Syndrome

[diagnosis: sex-cord stromal tumors] small, cuboidal to polygona cells in sheets, cords, may recapitulate with central acidophilic material

granulosa cell tumor

[diagnosis] cystic swelling of the chorionic villi with trophoblastic invasion

Hydatidiform mole

[diagnosis: H. mole] 46XX, most common

complete mole

[diagnosis: H. mole] 69XXX or 69 XXY

partial mole

[diagnosis: H. mole] missed abortion, small for dates uterine size, initial hCg <100,000 embyo-fetus, Amnion, fetal erythrocyte present, focal villous edema, mild trophoblastic atypia

partial mole

[diagnosis: H. mole] molar gestation, large for dates uterine size, initial hCg >100,000, absent fetal parts, absent amnion widespread villous edema, marked trophoblastic proliferation and atypia

complete mole

[diagnosis] proliferation of syncitiotrophoblast and cytotrophoblast without villi formation rapidly invasive, metastasizing but responsive to chemo

choriocarcinoma

[diagnosis] proliferation of syncitiotrophoblast and cytotrophoblast WITH villi formation rapidly invasive, metastasizing but responsive to chemo

invasive mole