Genital System Flashcards
Explain and differentiate between Bowen’s disease and Bowenoid papulosis.
Both are in-situ penile cancers. (PeIN)
Both are associated with high risk HPV (maily HPV 16)
1) Bowens is seen in elderly while Bowenoid is seen around 35 years of age (in sexually active males)
2) Bowens shows grey-white plaques while Bowenoid shows red velvety papular lesions
3) Bowens lesions are solitary while in Bowenoid they are multiple
4) Bowens has 10% risk of progressing to Squamous Cell Carcinoma while Bowenoid almost never progresses,
Choriocarcinoma.
It is a highly malignant tumor of testis which tends to metastasize aggressively.
Age > 60 years
It does NOT produce testicular enlargement
Morphology
Gross: Small <5cm. Large areas of hemorrhage and necrosis found
Microscopy: Two types of cells are seen: 1) Synciotrophoblast cells (Multinucleated with eosinophilic cytoplasm containing hCG)
2) Cytoptrophoblastic cells (Uninucleated, well defined borders)
IHC: hCG
Metastasis: Widespread and causes hemorrhage in the sites if metastasis.
Commonly occurs in the lungs- canonball metastasis.
Reinke’s crystals are seen in which tumor?
Describe the tumor.
Leydig cell tumor.
It is a Sex cord stromal tumor of testes.
Morphology
Gross: Golden yellow color due to lipofuschin
Microscopy: 1) Round cells with eosinophilic cytoplasm
2) Vacuoles and lipids in cytoplasm
3) Reinke’s crystals
Prostatic adenocarcinoma— risk factors, genetics, morphology.
Risk Factors:
1) High fat western diet
2) Increased exposure to androgens
3) Family history
Age>50 years
Genetics:
- BRCA2 gene mutation
- Hypermethylation of Glutathione S Transferase gene
- Chromosomal rearrangement, juxtaposing ETS gene next to TMPRSS2 Gene
- Loss of Echadherin
Morphology:
Gross-
1) Arises from posterior zones of prostate, palpable on rectal examn.
2) Grey white, firm and gritty
Microscopy-
1) Small back to back glands
2) Loss of basal cuboidal layer of cells linung the glads
3) No branching or papillary infoldings of the glands
4) Scanty stroma
5) Perineural invasion seen
Precursors lesion: Postatic Intraepithelial Neoplasia (PIN)
Name the important vaginal tumors.
- Squamous Cell Carcinoma of Vagina
- Embryonal Rhabdomyosarcoma
- Clear Cell Carcinoma of Vagina
Markers of Embryonal Rhabdomyosarcoma of vagina
Desmin
Myogenin
Myo D1
What are the risk factors of Cervical cancer.
- HPV
- Multiple sexual partners
- Early age at first intercourse
- High parity
What is the most common site of cervical cancer?
Transformation Zone (squamocolumnar junction)
Cervical carcinoma— Incidence, age, types
It is the 2nd m/c carcinoma in women
Age: 45-50 years
Types
1) Squamous cell carcinoma (m/c)
2) Adenocarcinoma (2nd m/c)
3) Adenosquamous carcinoma
4) Neuroendocrine cancer
Staging of cervical cancer.
Stage 0: Carcinoma in situ
Stage 1: Carcinoma confined to cervix
1a1: Depth <3m and Width <7mm
1a2: Depth <5 and Width <7m
1b: Exceeds 1a
Stage 2: Carcinoma spreads beyind cervix but does not reach pelvic wall + No involvement of lower 1/3rd of vagina
Stage 3: Reaches pelvic wall and involves lower 1/3rd of vagina
Stage 4: Extends beyond true pelvis, may metastasize.
What is endometrial hyperplasia?
Pathogenesis.
Abnormal proliferation of endometrial glands relativeto the stroma resulting in high Gland:Stroma ratio.
Pathogenesis:
Due to prolonged estrogenic stimulation.
May be due to anovulation.
The source of estrogen may be exogenous or endogenous.
Associated with: Obesity Menopause PCOS Ovarian tumors Prolonged administration of estrogenic drugs
Genetics: PTEN mutation (Often a part of Cowden syndrome)
What are the genetics associated with leiomyoma?
Most have normal karyotype
Rest have:
- Rearrangement in Chromosome 12q14 or 6p
- MED12 gene mutation
What do you mean by Pseudomyxoma Peritonei?
It is a clinical condition characterized by
- Mucinous ascites
- Cystic epithelial implants on peritoneal surface
- Adhesions of peritoneal
- Usually associated with Mucinous tumor of ovary
May lead to intestinal obstruction and death
What is Transitional Cell tumor of the ovary? What are its features?
Brenner’s tumor is aka transitional cell tumor.
Usually benign and unilateral. (Rarely borderline or malignant)
Gross: Small to massive in size
Microscopy:
1) Nests of epithelial cells resembling transitional epithelium of bladder
2) Dense fibrous stroma
3) Coffee bean nuclei : Grooves present on nuclei
Coffee bean nuclei seen in which tumors?
1) Papillary carcinoma of thyroid
2) Langerhans cell histiocytosis
3) Brenner’s tumor
4) Granulosa Cell tumors
