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ENRP II > female reproductive tract part 4 endometrium cont. > Flashcards

female reproductive tract part 4 endometrium cont. Flashcards

1
Q

what is endometrial hyperplasia?

A

increase in the number of endometrial glands relative to the stoma

it is a premalignant condition

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2
Q

what are the two types of endometrial hyperplasia?

A

typical - slight risk to progress to carcinoma

atypical - substantial risk to progress to carcinoma

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3
Q

what does typical endometrial hyperplasia look like?

A

glandular crowding +/- cystic change with no atypia

glands are more cyctic appearing

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4
Q

what does atypical hyperplasia look like

A

complex glandular proliferation with nuclear atypia

crowding increases, scant amount of stroma between glands

nuclei show hyperplasia and enlargement

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5
Q

risk factors for endometrial hyperplasia

A

unapposed estrogen increases risk

-obesity
- PCOS
- estrogen replacement therapy
- tamoxifen therapy
- estrogen producing tumors
- no children
- early period late menopause

unapposed- no progesterone

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6
Q

tamoxifen is proestrogenic in the _ but is antiestrogenic in the _

A

uterus

breasts (used for breast cancer)

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7
Q

endometrial cancer is most seen in _ (premenopausal/post menopausal) women

A

postmenopausal

75%

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8
Q

what is the most common symptoms of endometrial cancer

A

abnormal uterine bleeding

90%

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9
Q

what is the most common type of endometrial carcinoma

A

endometrial endometroid carcinoma

80-85 % of all endometrial carcinomas

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10
Q

endometrial endometroid carcinoma is driven by the _ pathway

A

hyperplasia pathway

typical hyperplasia to atypical hyperplasia and finally carcinoma

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11
Q

typical hyperplasia is a mutation in ?

A

PTEN

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12
Q

atypical hyperplasia is a mutation in ?

A

KRAS

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13
Q

how does endometriod carcinoma progess (slow, fast)

A

slow/indolent

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14
Q

serous carcinoma of the uterus is the second most common endometrial carcinoma they arise for then _ pathway and have an increased incidence in _ (race)

A

atrophic pathway- atrophic noncyclic endometrial tissue

african american (postmenopasual)

15& of all endometrial carcinomas

occur 10 years later than endometroid cancer

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15
Q

pathogenesis of serous carcinoma of the uterus

A

atrophic endometrium
TP53 aneuploidy
serous endometrial intraepithelial carcinoma
serous carcinoma

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16
Q

what is the main risk factor for serous carcinoma of the uterus?

A

Age which drives TP53 mutations

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17
Q

histology of a serous carcinoma of the uterus

A

papillary growth pattern with cytologic atypia

papillary growth has papillary projections with a fibrovascular core

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18
Q

histology of an endometrial endometroid carcinoma

A

like regular endometrium but very little to know stroma

can form a mass

19
Q

unlike endometroid carcinoma of the uterus which is graded by the degree of _ , serous carcinomas are uniformly considered _ grade

A

solid component- endometroid

high grade- serous

20
Q

what is a malignant mixed mullerian tumor (MMMT)

A

a rare, aggressive endometrial tumor that is found in african americans in the post menopausal sate

21
Q

MMMT are comrpised of ?

A

malignant glands and malignant stroma

the malignant glands can be that of serous type of endometroid type

malignant stroma can be differentiated or diffentiated into things like cartilage, muscle, etc. - heterologous

22
Q

what does heterologous mean?

A

this meains that the malignant stroma does not for sarcomatous elements found in other uterine sarcomas (chondrosarcoma, rhabdomyosarcoma)

poor prognositc feature- more aggressive

23
Q

what are 2 examples of heterologous components in a malignant mixed mullerian tumor

A

chondrosarcoma (cartilage)
rhabdomyosarcoma (primitive muscle cells usually seen in the embryo)

must have malignant glands and malignant stroma

24
Q

Lynch syndrome is inheritied in a _ _ fashion

A

autosomal dominant

25
Q

what is the mutation in lynch syndrome

A

mutation in mismatch repair genes (MLH1 and MSH2) leading to microsatillite instability

***cant repair DNA mismatches which occur in repetitive sequences to form microsatilites

26
Q

the microsatillite instability in lynch syndrome leads to an increased risk for?

A

colorectal cancers

endometrial (uterine ) and ovarian cancers of the endometroid type

27
Q

endometroid carcinoma are type _

A

1

28
Q

serous and malignant mixed mullerian tumors are type _

A

2

29
Q

are the endometrial cancer in lynch syndrome type 1 or type 2

A

type 1

30
Q

what is an adenosarcoma

A

this is a combination tumor of benign endometrial glands and malignant stroma

may be mistaken for a endometrial polyp on histology

31
Q

what is a low grade endometrial stromal sarcoma

A

a malignant tumor that is comprised of small blue tumor cells recapitulating normal endometrial stromal cells

32
Q

low grade endometrial stromal sarcomas invade where?

A

myometrium and lymph/vascular spaces

33
Q

symptoms of low grade endometrial stromal sarcoma

A

abdominal pain, AUB

34
Q

what is the key chromosomal abnormality associated with low grade endometrial stromal sarcoma

A

JAZF1 translocation that results in the fusion of SUZ12 gene

35
Q

what is a leiomyoma?

A

a fibroid that is a tumor of the myometrium it is benign and is composed of smooth muscle and spindled cells

most common gynecological tumor in women

36
Q

how do leiomyomas look

A

singular or more likely to be joined together

circumscribed
whte to white tan whorled sufraces

37
Q

what does the histology of a leiomyoma look like?

A

intersecting fasciles of spindled shaped smooth muscle cells with pink eosinophillic cytoplasm

cigar chaped nuceli

38
Q

common symtpoms of leiomyoma

A

uterine bleeding and infertility

39
Q

leiomyomas may have a _ mutation

A

med 12

a lot of uterine smooth muscle tumors have a med12 mutation

40
Q

what is a leiomyosarcoma

A

an uncommon malignant neoplasm of uterine smooth muscle

41
Q

some leiomyosarcomas have a _ mutation similar to leiomyoma

A

med 12

usually not a direct progression though

42
Q

are leiomyosarcomas aggresive?

A

yes, 50% of them metastasize to the lung, brain, bone etc.

43
Q

on histology unline leiomyomas: leiomyosarcomas have what?

A

atypia, mitoses, and tumor necrosis

44
Q

grossly what does a leiomyosarcoma look like ?

A

bulky, fleshy mass

ENRP II (25 decks)

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