FGT Path

Question 1

Gartner’s Duct Cyst

Answer 1

Etiology: remnants of mesonephric duct (Wolffian duct)
ROS: 1-2cm cyst on anterolateral wall of vagina

Question 2

Vaginal Adenosis

Answer 2

Etiology: pt whose mother received diethylstilbesterol (DES) during pregnancy to prevent abortion
ROS: endocervical glands present in vaginal wall
Complication: clear cell adenocarcinoma

Question 3

Sarcoma Botryoides aka Embryonal Rhabdomyosarcoma

Answer 3

Etiology: <5yo
Morphology: semi-translucent soft polyploid masses (clusters of grapes)
ROS: sometimes mistaken for inflammatory pseudopolyps
Complication: highly malignant, invade locally

Question 4

Bartholinitis

Answer 4

Etiology: inflammation of the inferior part of the labium major
Pathogenesis: Strep, Staph, Gonococci, E.coli
ROS: abscess formation

Question 5

Bartholin Cyst

Answer 5

Etiology: common @ any ge
Pathogenesis: obstruction of glands secondary to infection
ROS: pain/discomfort

Question 6

Leukoplakia

Answer 6

Morphology: white/scaly mucosal thickening
ROS: puritis
Diagnosis: biopsy is mandatory

Question 7

Extramammary Paget’s Dz

Answer 7

Etiology: grossly and microscopically identical to breast counterpart
Morphology: puritic/red labia majors
Diagnosis: PAS +ve (differentiates it from melanoma), CK7+ve

Question 8

Tubal Pregnancy

Answer 8

Etiology: fertilized ovum in Fallopian tube
Risk factors: PID w/ tubal adhesions or endometriosis w/ fibrosis
Morphology: lack of space, poor vasculature, limited placental size
ROS: ruptures 2wks s/p fertilization, acute and pn, may mimic appendicitis if right side, shock/hemorhage
Diagnosis: US, rise and fall of bHCG, no chorionic villi

Question 9

Abortion

Answer 9

Etiology: delivery of embryo or fetus up to 20 weeks (20-40wks = premature delivery)
Morphology: contains chorionic villi or embryo
ROS: rapid, severe VB (shock), and pn d/t uterine contraction

Question 10

Pre-Eclampsia

Answer 10

Etiology: gestational edema w/ proteinuria and HTN (3rd trimester)
Risk factors: primigravida (>35yo), multiple pregnancies, hydramnios, preexisting HTN, hydatidiform mole
Pathogenesis: placental ischemia (autoimmune rxn), decraeased PgE and NO production by placenta (increased RAAS), remodeling of spinal arteries and utero-placental vascular bed
ROS: proteinuria, endothelial dysfunction, increased permeability, DIC

Question 11

Complete Mole

Answer 11

Etiology: empty egg fertilized by 2 sperm or single diploid sperm (46XX or 46XY)
Morphology: dilated villi
*No fetal parts seen
Complication: Gestational choriocarcinoma (HTN or hyperthyroid)
Marker: β-hCG

Question 12

Partial Mole

Answer 12

Etiology: ovum fertilized by 2 sperm (69XXY)
Morphology: fetal parts seen
Complication: can invade myometrium (HTN or hyperthyroid)

Question 13

Gestational Choriocarcinoma

Answer 13

Preceded by complete mole (abortion/ectopic too)
Gross: necrotic, hemorrhagic, friable mass
Biopsy: cytotrophoblasts, syncytiotrophoblasts but NO chorionic villi
ROS: brownish vaginal d/c, hyperemesis
Marker: β-hCG
Tx: chemotherapy (responds d/t paternal ag)

Question 14

Sarcoma Botryoides

Answer 14

female < 5yo
Gross: bunch of grapes hanging in the vagina
*highly malignant,