Female Genital Tract Pathology Flashcards
[diagnosis]
plasma cells in endometrial stroma
chronic endometritis
[diagnosis]
lymphocytes or plasma cells in cervical stroma
chronic cervicitis
[diagnosis]
pelvic pain, adnexal tenderness, fever, vaginal discharge
PID
[diagnosis]
gross: leukoplakia of the vulva
thinning of the epidermis, basal cell degeneration, hyperkeratosis, sclerotic changes of superficial dermis, dermal lymphocytic infiltrate
lichen slerosus
[diagnosis]
gross: leukoplakia of the vulva
acanthosis, mitosis, hyperkeratosis, lymphocytic infiltrates
squamous hyperplasia
[diagnosis]
failure of mullerian duct fusion, accompanied by uterine didelphys
septate vagina
vaginal anomaly associated with DES exposure
septate vagina
[diagnosis]
___ cyst
remnant of wolffian or mesonephric duct
gartner duct cyst
most common primary vulvar CA
squamois cell CA
[diagnosis]
patient 4 years old, gross presence of grape-like clusters
sarcoma botryoides
___ term for small, with oval nuclei and tennis racket like appearance with or without striations in sarcoma botryoides
embryonal rhabdomyoblast
[diagnosis]
fibromyxoid stroma, lined by endocervical type epithelium, usually with inflammation
endocervical polyp
[HPV]
Infects: _____ (mature/immature)
Replicates in: ______ (mature/immature)
Infects immature cells
replicates in mature cells
[HPV]
E___ inactivates Rb leading to cell proliferation
E7
[HPV]
E___ inactivates p53 leading to cellular immortality
E6
[diagnosis: CIN]
nuclear atypia with cytoplasmic “halos”, confined to lower third of epithelium
LSIL
[diagnosis: CIN]
nuclear atypia with cytoplasmic “halos”, expansion to upper two-thirds of epithelium
HSIL
[diagnosis]
CIN + invasion beyond the basement membrane
cervical CA
[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
[diagnosis]
chocolate cyst
endometriosis
[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
[diagnosis]
due to retrograde menstruation
endometriosis
[diagnosis]
exophytic mass that project into endometrial cavity, clinically silent AUB, seen in patient on tamoxifen
endometrial polyp
[diagnosis]
precursor to endometrial CA type I, important cause of AUB
endometrial hyperplasia
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