Female Repro Pathology Flashcards
lower abdominal pain and vaginal bleeding. In the setting of a positive pregnancy test (eg, detectable β-hCG) and an adnexal mass, her presentation is most concerning for
ectopic pregnancy
can occur in patients with a mature teratoma
Ovarian torsion
***Most common ovarian cancer *** Often bilateral ↑ CA-125 Histology: Psammoma bodies/ anaplasia/ invasion into the stroma/ papillary formations/ cellular atypia/ fibrous core
Serous cystadeno-carcinoma (epithelial) Ovarian Tumor
Pseudomyxoma peritonei Mucin-producing epithelial cells ↑ CA-125
Mucinous cystadeno-carcinoma (epithelial) Ovarian Tumor
Adolescents ↑ β-hCG, ↑ LDH Histology: “Fried egg cells”
Dysgerminoma (germ cell) Ovarian Tumor
↑ AFP Aggressive Schiller-Duval bodies resemble glomeruli
Endodermal sinus (yolk sac) Ovarian Tumor
↑ Estrogen (eg, endometrial hyperplasia, postmenopausal bleeding) ↑ Inhibin Histology: Call-Exner bodies, coffee bean nuclei
Granulosa cell Stroma (sex cord) Ovarian Tumor
↑ Androgens (eg, hirsutism, clitoromegaly) Stroma tumor
Sertoli-Leydig Stroma (sex cord) Ovarian Tumor
produce CA-125, which can be used as a serum marker for this condition.
Epithelial ovarian tumors Serous/Mucinous cystadeno-carcinoma
Typically present with a: pelvic mass, ascites, peritoneal metastasis decreased appetite, abdominal distension, bowel or bladder changes (constipation, urinary frequency)
Patients with ovarian cancer Epithelial ovarian tumors Serous/Mucinous cystadeno-carcinoma
Nulliparous women are at increased risk for ovarian cancer due to _____, resulting in continued disruption and repair of the ovarian epithelium.
frequent ovulation
Histologic findings of ______ include: anaplasia of epithelial cells with invasion into the stroma, multiple papillary formations with cellular atypia Psammoma bodies.
epithelial ovarian cancer Epithelial ovarian tumors Serous/Mucinous cystadeno-carcinoma
Sertoli-Leydig cell tumors of the ovary are rare sex cord stromal neoplasms typically appear as ____ composed of Sertoli cells with interspersed ______ Leydig cells and surrounding _____ stroma.
tubules eosinophilic fibrous stroma
Human papillomavirus infection of ______ cells can progress from premalignant (Low/High grade CIN) to cancerous lesions (cervical carcinoma.
basal cervical
Expansion of immature basal cells to the epithelial surface
high-grade CIN
Expansion of immature basal cells to the epithelial surface and breaching the basement membrane below them
Cervical Carcinoma (aka Squamous cell carcinoma (SCC)) *koilocytes do not = carcinoma
Cervical intraepithelial neoplasia refers to atypical _____ cells and is classified as Low-grade squamous intraepithelial lesions (if extending ___ of the epithelium) High-grade squamous intraepithelial lesions (if extending ___ of the epithelium) Basement membrane breach signifies _____ Typically cause by ___ infection with strains __& ___
basal squamous cells <1/3 (less than half) >1/3 (half or more) invasive disease (cervical squamous cell carcinoma) HPV 16, 18
In most cases, ____ (cervical lesion) regress spontaneously
LSILs
HPV 1-4 =
Skin warts
HPV 6, 11 =
Genital warts (Condyloma accuminata)
HPV 16, 18, 31 =
Anal, cervical, vaginal, vulvar neoplasia
the most common type of cervical cancer, arises from the squamocolumnar junction of the endocervix.
Squamous cell carcinoma (SCC)
HPV 16, 18, 31 can lead to over expression of viral oncogenes __ & __
E6 and E7
E6 binds protein ___ and increases its ____
p53 degradation
E7 binds to ____ and displaces the ___
retinoblastoma (RB1) gene transcription factors normally bound by pRB *pRB= protein made by gene RB (tumor suppressor)
What is the most significant factor that predisposed most patients to cervical abnormalities?
Lack of barrier contraception use or Immunocompromised status
Nulliparity early menarche obesity increase the risk of ______ cancer due to increased estrogen stimulation of the tissue.
endometrial cancer
Nulliparity early menarche prolonged menses (no-contraception) are risk factors for
endometriosis
_____ responds to hormonal influences of the menstrual cycle in the same way as uterine endometrium. Bleeding and shedding of extrauterine endometrium leads to formation of blood collections and induces inflammation. Inflammation is then followed by ______, which in turn distorts organ’s structure and function.
Ectopic endometrium Adhesion formation
List 4 common implant sites for ectopic endometrial tissues and adhesion formation
Uterus bladder colon uteralsacral ligament (causes thickening)
Adhesions (from Endometriosis) may interfere with ovulation and fallopian tube function, resulting in ____. Shedding of the ectopic tissue causes ____.
infertility dysmenorrhea (painful menses)