Gynaecological pathology Flashcards
Common causes of PID
Chlamydia trocho and N Gonorrhoea = most common in uk
others = TB, schistosomiosis
how will PID present
lower abdo pain, dyspareunia, vaginal bleeding/discharge, fever, tenderness, cervical excitation
complications of PID
peritonitis, bacteremia, adhesions -> intestinal obs, ectopic preg, infertility
histo findings in endometriosis
powder burns - red/brown nodules
chocolate cysts in ovaries (endometriomas)
what adenomyosis
presence of ectopic endomet tissue in myometrium
how will adenomyosis present
heavy menstrual bleeding, dysmenorrhagia, deep dyspareunia, globular uterus
histo of leiomyoma
(fibroid)
sharply circumscribed discrete bundles of smooth muscle cells (grey-white tumours)
first diagnosis for post menopausal bleeding
endometrial carcinoma till proven otherwise
types of endometrial carcinoma
T1 (85%) - endometriod
T2 (15%) - non endometriod - serous carcinoma/clear cell carcinoma
associations and risk factors for endometriod carcinoma
related to oestrogen excess
RF = oestrogen, Dm ,HTN
asso with atypical endometrial hyperplasia
what mut is associated with endometriod carcinoma
PTEN
epidemiology of non endometriod carcinoma
unrelated to oestrogen excess
older women with endomet hyperplasia
what is associated with VIN and how many progress to invasive disease
asso with HPV-16
<5% progress
types of ovarian carcinoma
70% = epithelial
20% = germ cell
sex cord stromal tumours
metastatic tumours
types of epithelial ovarian carcinomas and defining features
most common = serous cystadenoma - psammoma bodies
mucinous cystadenoma - mucin sec cells, K-Ras mut
endometrial tumours - form tubular glands, endomet is RF
clear cell tumour - clear cytoplasm, strong asso with endomet, hobnail appearance
types of germ cell ovarian tumour
dysgermioma
teratoma - most common ov tumour in young women
choriocarcinoma - malig , sec hcG
histo of mature teratoma
mature teratoma = benign dermoid cyst. tissue differentiates into mature tissue (teeth hair etc)
histo of immature teratoma
malig, solid, contains immature embryonic tissue
types of sex cord stromal tumours
fibroma - benign, non sec
granulosa-thecal cell tumour - prod E2
sertoli leydig cell tumour - sec androgens
common metastatic ovarian tumour
krukenberg tumour - mets from gastric/breasyt cancer
signet ring cells
staging for ovarian cancer
1 = lim to ov 2 = lim to pelvis 3 = lim to abdo (+LN mets) 4 = distant mets outside abdo cavity
typical age range for cervical carcinoma
45-50
risk factors for cervical carcinoma
HPV exposure (16 and 18) cocp, lots of sexual partners, non barrier contraception
what are the types of cervical carcinomas
70-80% = sq cell carcinoma 20 = adenocarcinoma
staging for cervical carcinoma
0 = CIN 1 = lim to cervix 2 = extended beyond uterus 3 = extends to pelvic wall/lower 1/3 of vagina 4 = extension beyond pelvis
epithelial changes in the cervix
cervix = sq epi
squamocolumnar junc
endocervical canal= columnar glandular epi
what is the transformation zone
area in cervix when columnar epi transforms to squamous cells
how is CIn staged
1 = lower 1/3 of epi 2 = lower 2/3 3 = full thickness but BM intact
when does CIN become cervical cancer
when it breaks through the Basement membrane
progression of CIN
60-90% CIN1 will revert to normal
30% CIN3 prog to cancer
what are the risk factors for CIN
early first sex multi partners HIV immunocomp multiparity
