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ENRP Exam 1 > Female Reproductive Tract Pathology Part 2 > Flashcards

Female Reproductive Tract Pathology Part 2 Flashcards

1
Q

What is the overall appearance of the proliferative endometrium?

A

cellular blue stroma with many round to tubular glands
glands are relatively straight in cross section and show pseudostratification of nuclei with readily identifiable mitotic figures

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2
Q

What is the overall histologic appearance of the secretory phase endometrium?

A

the glands of secretory endometrium are much more tortuous and serrated

in early secretory endometrium: subnuclear vacuoles are present which mimic an appearance of piano keys

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3
Q

what is the overall histologic appearance of the menstrual phase endometrium?

A

the endometrial stroma breaks down into tight blue clusters

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4
Q

what is the most common subtype of abnormal uterine bleeding?

A

dysfunctional uterine bleeding, which is uterine bleeding that lacks an underlying structural basis

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5
Q

of the causes of dysfunctional uterine bleeding, what is the most common?

A

hormonal disturbances which result in lack of ovulation (termed an anovulatory cycle)

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6
Q

what is acute endometritis?
What are the histological findings?
What is it caused by?

A

an acute infection of the endometrium
neutrophils infiltrating and destroying endometrial epithelium +/- microabscesses
caused by: bacterial infection (group A strep, staphylococci) after delivery

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7
Q

What is chronic endometritis?
What is it caused by?
What is the histologic hallmark?
What is the clinical presentation?

A

Caused by: retained products of conception
chronic PID
IUD (actinomyces)

the histologic hallmark is plasma cells within the stroma

clinical presentation: often asymptomatic but can see abnormal bleeding, crampy lower abdominal pain

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8
Q

what is endometriosis?

A

“ectopic” endometrial tissue outside of the uterus

commonly affects the ovaries and pelvic tissue

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9
Q

What are the clinical findings associated with endometriosis?

A

severe dysmenorrhea, ovarian mass, dyspareunia, also infertility

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10
Q

What are the morphologic gross features of endometriosis?

A

gross findings: endometriosis appears as red-brown to blue-black lesions termed “powder-burn” lesions which often are seen involving a serosal or peritoneal surface

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11
Q

what is it called when endometriosis involves the ovary?

A

it can create a large blood filled cyst called a chocolate cyst

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12
Q

what are the histologic findings associated with endometriosis?

A

endometrial glands
endometrial stroma
hemosiderin laden macrophages (evidence of hemorrhage)

*need 2 of 3 for diagnosis

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13
Q

what is adenomyosis?

what are the clinical findings?

A

endometriotic tissue in the muscle of the uterus (myometrium)
can be identical to those seen in endometriosis

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14
Q

what are endometrial polyps?

A

benign exophytic hyperplastic polypoid neoplastic-like masses

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15
Q

The growth and formation of endometrial polyps is promoted by?

A

certain proestrogenic factors, the most important being tamoxifen

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16
Q

What is endometrial hyperplasia?

A

increase in the number of endometrial glands relative to the stroma, premalignant condition

17
Q

what are the two types of endometrial hyperplasia?

A

typical hyperplasia and atypical hyperplasia

18
Q

what do the nuclei look like in atypical hyperplasia?

A

they show enlargement with rounding and identifiable nucleoli

19
Q

what are some risk factors for endometrial hyperplasia and carcinoma?

A

chronic, unopposed estrogen
obesity
PCOS

20
Q

There are estrogen producing tumors, which can increase risk for endometrial hyperplasia and carcinoma. Which are they?

A

granulosa cell tumor and thecoma of the ovary

21
Q

what is the most common type of endometrial carcinoma?

A

endometroid carcinoma of the uterus

22
Q

what are the histologic characteristics of endometrioid carcinoma of the uterus?

A

it histologically mimics normal endometrium

23
Q

which endometrial cancer typically has a papillary growth pattern with marked cytologic atypia?

A

serous carcinoma of the uterus

24
Q

what is serous carcinoma of the uterus strongly associated with?

A

TP53

25
Q

what is malignant mixed mullerian tumor?

A

MMMT
rare, aggressive, same demographic group as serous carcinoma
comprised of both malignant glands and malignant stroma

26
Q

What is lynch syndrome?

A

an autosomal dominant disorder which runs in families in which there is a mutation in a mismatch repair gene

27
Q

which mismatch repair gene is the most important in lynch syndrome and why?

A

MLH1 and MSH2

they give the highest risk for colorectal carcinoma

28
Q

mutation in mismatch repair gene (including MLH1 and MSH2) leads to what?

A

microsatellite instability (MSI)

29
Q

what are the major molecular abnormalities associated with type I endometrial carcinoma?

A

PTEN
P13K/AKT
MSI

30
Q

what is adenosarcoma of the uterus?

A

rare, low grade malignancy

consists of benign glands and malignant stroma (sarcoma)

31
Q

what is low grade endometrial stromal sarcoma?

A

relatively rare malignant tumor of endometrial stroma

invades myometrium and/or has lymph/vascular invasion

32
Q

what is low grade endometrial stromal sarcoma associated with?

A

JAZF1 gene translocation

33
Q

unlike leiomyoma, leiomyosarcoma presents with what 3 histological findings?

A
  1. atypia
  2. increased mitoses
  3. tumor necrosis
34
Q

the two benign cysts of the ovary are?

A

the follicular cyst

the luteal cyst

35
Q

what is the follicular cyst derived from?

What lines it?

A

derived from ovarian follicle

lined by inner layer of granulosa cells, outer layer of follicular cells

36
Q

what is the luteal cyst derived from?

what is it lined by?

A

occurs when corpus luteum fails to regress

lined by: luteinized inner granulosa cells, outer theca cells

37
Q

what is an adenomatoid tumor?

A

rare, benign tumor of mesothelial origin

most common tumor of the fallopian tube

38
Q

PCOS is a complex syndrome characterized by what 4 things?

A

hyperandrogenism
hormonal imbalance (increased LH, decreased FSH)
insulin resistance
polycystic ovaries

ENRP Exam 1 (30 decks)

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