Grading / Staging Flashcards

1
Q

Metaplasia

A
  • The reversible replacement of one differentiated cell type by another mature differentiated cell type
  • Cervical metaplasia occurs physiologically with changes in hormone levels and pH levels
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2
Q

Dysplasia

A
  • Anomylous growth and differentiation of cells
  • Expansion of immature cell with a decrease in the number and location of mature cell types
  • Cervical dysplasia - CIN
  • Seen as 4 microscopic changes:
    • Anisocytosis - irregular cell sizes
    • Poikilocytosis - irregular cell shapes
    • Hyperchromatism - excessive pigmentation
    • Mitotic figures - Unusually high number of dividing cells
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3
Q

CIN 1

A
  • Cervical intraepithelial neoplasia grade 1
  • Mild dysplasia confined to the basal 1/3 of the epithelium
  • Diagnosis on biopsy / pathology
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4
Q

CIN 2

A
  • Cervical itraepithelial neoplasia grade 2
  • Moderate dysplasia confined to the basal 2/3 of the epithelium
  • Diagnosis on biopsy / pathology
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5
Q

CIN 3

A
  • Cervical intraepithelial neoplasia grade 3
  • Severe dysplasia involving more than 2/3 of the epithelium, and may be full thickness
  • Diagnosis on biopsy / pathology
  • Also referred to as Carcinoma in situ (CIS)
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6
Q

Cervical CIS

A
  • Cervical Carcinoma in situ
  • Also known as CIN 3
  • Sever dysplasia involving more than 2/3 of the epithelium and may be full thickness
  • Diagnosis on biopsy / pathology
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7
Q

ASC-US

A
  • Atypical squamous cells of unknown significance
  • Finding on pap smear
  • Follow up with HPV DNA testing or repeat cytology
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8
Q

ASC-H

A
  • Abnormal squamous cells, cannot exclude high grade squamous intraepithelial lesion
  • Finding on pap smear
  • Follow up with colposcopy
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9
Q

LSIL

A
  • Low-grade squamous intraepithelial lesion of the cervix
  • Diagnosed on pap smear
  • Generally correlates with CIN1
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10
Q

HSIL

A
  • High-grade squamous intraepithelial lesion
  • Diagnosed on pap smear
  • Biopsy will be consistent with CIN 2 or CIN 3
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11
Q

Stage I SCC of the Cervix

A
  • FIGO staging system
  • Can only be staged upon surgical resection
  • Carcinoma strictly confined to the uterus. Extension to the corpus of the uterus may be disregarded
  • Divided into Stages IA and IB
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12
Q

Stage IA SCC of the Cervix

A
  • FIGO staging system
  • Can only be staged upon surgical resection
  • Can only be detected microscopically (no macroscopic lesions)
  • Invasion limited to the stroma
  • Depth no > than 5.0mm
  • length no > than 7.0mm
  • Subdivided into stages IA1 and IA2
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13
Q

Stage IA1 SCC of the Cervix

A
  • FIGO staging system
  • Can only be staged upon surgical resection
  • Can only be detected microscopically (no macroscopic lesions)
  • Invasion limited to the stroma
  • Depth no > than 3.0mm
  • length no > than 7.0mm
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14
Q

Stage IA2 SCC of the Cervix

A
  • FIGO staging system
  • Can only be staged upon surgical resection
  • Can only be detected microscopically (no macroscopic lesions)
  • Invasion limited to the stroma
  • Depth > than 3.0mm but no > than 5.0mm
  • length no > than 7.0mm
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15
Q

Stage IB SCC of the Cervix

A
  • FIGO staging system
  • Can only be staged upon surgical resection
  • Clinically visible lesions limited to the cervix or preclinical cancers with dimensions exceeding stage IA.
  • Subdivided into stages IB1 and IB2
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16
Q

Stage IB1 SCC of the Cervix

A
  • FIGO staging system
  • Can only be staged upon surgical resection
  • Clinically visible lesion confined to the cervix no greater than 4.0cm
17
Q

Stage IB2 SCC of the Cervix

A
  • FIGO staging system
  • Can only be staged upon surgical resection
  • Clinically visible lesion confined to the cervix > 4.0cm
18
Q

Stage II SCC of the Cervix

A
  • FIGO staging system
  • Can only be staged upon surgical resection
  • Cervical carcinoma invading beyond the uterus, but not to the pelvic wall or lower 1/3 of the vagina
  • Divided into stages IIA and IIB
19
Q

Stage IIA SCC of the Cervix

A
  • FIGO staging system
  • Can only be staged upon surgical resection
  • Cervical carcinoma invading beyond the uterus, but not to the pelvic wall or lower 1/3 of the vagina
  • No obvious parametrial involvement
20
Q

Stage IIB SCC of the Cervix

A
  • FIGO staging system
  • Can only be staged upon surgical resection
  • Cervical carcinoma invading beyond the uterus, but not to the pelvic wall or lower 1/3 of the vagina
  • Obvious parametrial involvement
21
Q

Stage III SCC of the Cervix

A
  • FIGO staging system
  • Can only be staged upon surgical resection
  • Extension to pelvic wall, lower 1/3 of vagina, or causing hydronephrosis / non-functioning kidney
  • Divided into stages IIIA and IIIB
22
Q

Stage IIIA SCC of the Cervix

A
  • FIGO staging system
  • Can only be staged upon surgical resection
  • Extension to lower 1/3 of vagina, no extension to pelvic wall
23
Q

Stage IIIB SCC of the Cervix

A
  • FIGO staging system
  • Can only be staged upon surgical resection
  • Extension to pelvic wall, or causing hydronephrosis / non-functioning kidney
24
Q

Stage IV SCC of the Cervix

A
  • FIGO staging system
  • Can only be staged upon surgical resection
  • Extension beyond true pelvis, or biopsy proven involvement of bladder or rectum mucosa
  • Divided into stages IVA and IVB
25
Q

Stage IVB SCC of the Cervix

A
  • FIGO staging system
  • Can only be staged upon surgical resection
  • Extension beyond true pelvis, or biopsy proven involvement of bladder or rectum mucosa
  • Spread to distant organs
26
Q

Stage IVA SCC of the Cervix

A
  • FIGO staging system
  • Can only be staged upon surgical resection
  • Extension beyond true pelvis, or biopsy proven involvement of bladder or rectum mucosa
  • Spread to adjacent organs
27
Q

Stage I Endometrial Carcinoma

A
  • FIGO staging system
  • Can only be staged upon surgical resection
  • Carcinoma confined to the corpus uteri
  • Divided into stages IA and IB
  • Stage I should also be subgrouped with regard to histological grade (1-3)
28
Q

Stage IA Endometrial Carcinoma

A
  • FIGO staging system
  • Can only be staged upon surgical resection
  • Carcinoma confined to the corpus uteri
  • Length of the uterine cavity is no longer than 8.0cm
  • Stage I should also be subgrouped with regard to histological grade (1-3)
29
Q

Stage IB Endometrial Carcinoma

A
  • FIGO staging system
  • Can only be staged upon surgical resection
  • Carcinoma confined to the corpus uteri
  • Length of the uterine cavity > 8.0cm
  • Stage I should also be subgrouped with regard to histological grade (1-3)
30
Q

Stage II Endometrial Carcinoma

A
  • FIGO staging system
  • Can only be staged upon surgical resection
  • Carcinoma involves corpus and cervix but does not extend beyond uterus
31
Q

Stage III Endometrial Carcinoma

A
  • FIGO staging system
  • Can only be staged upon surgical resection
  • Local and/or regional spread
  • Divided into stages IIIA, IIIB, IIIC1, IIIC2
32
Q

Stage IIIA Endometrial Carcinoma

A
  • FIGO staging system
  • Can only be staged upon surgical resection
  • Tumor invades serosa and/or adnexa
33
Q

Stage IIIB Endometrial Carcinoma

A
  • FIGO staging system
  • Can only be staged upon surgical resection
  • Tumor spreads to vagina or next to the uterus
34
Q

Stage IIIC1 Endometrial Carcinoma

A
  • FIGO staging system
  • Can only be staged upon surgical resection
  • Metastases to pelvic lymph nodes
35
Q

Stage IIIC2 Endometrial Carcinoma

A
  • FIGO staging system
  • Can only be staged upon surgical resection
  • Metastases to para-aortic lymph nodes
36
Q

Stage IVA Endometrial Carcinoma

A
  • FIGO staging system
  • Can only be staged upon surgical resection
  • Distant metastasis including inguinal lymph nodes, intraperitoneal disease, lung, liver, or bone.
37
Q

Stage IVA Endometrial Carcinoma

A
  • FIGO staging system
  • Can only be staged upon surgical resection
  • Tumor invasion of bowel or bladder mucosa