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Histopathology > Gynaecological pathology > Flashcards

Gynaecological pathology Flashcards

1
Q

Malignant signet ring cells containing mucin

A 
Krunkenburg tumour 
(ovarian tumour spreading from GI tract - classically from the stomach. Results in the formation of little signet cells containing mucin which will also be found at the primary site)
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2
Q

Benign large unilateral ovarian mass

A

Mucinous tumour

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3
Q

Germ cells mixed with lymphocytes

A

Dysgerminoma

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4
Q

Fibrous tissue containing spindle cells + lipid

A

Thecoma

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5
Q

Low-risk HPV types

A

6+11 Cause warts)

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6
Q

High-risk HPV types

A

16+18 (Cause cervical, penile, anal cancer)

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7
Q

Two types of HPV vaccine

A

Quadrivalent - 6+11, 16+18 (Yeast)

Bivalent 16+18 (Baculovirus)

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8
Q

Sub-types of endometrial carcinoma

A 
Adenocarcinomas
Type I (80-85%) - secretory, , mucinous or endometrioid) ~ oestrogen dependent, related to hyperplasia!
Type II (15-20%) - papillary, serous, clear cell ~ older + post menopausal, not oestrogen dependent
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9
Q

PTEN, PI3KCA, K-ras, CTNNB1

A

Type 1 endometrial carcinoma

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10
Q

p53, PI3KCA, HER2, PTEN, CTNNB1

A

Type II endometrial carcinoma

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11
Q

FIGO staging endometrial carcinoma

A

1 Uterus
2 Cervix
3 Adnexa / vagina / local LNs
4 Pelvic organs / distant spread

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12
Q

Most common organisms PID

A

Chlamydia trachomatis

Neisseria gonorrhoea

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13
Q

Red-blue / brown cigarette burn nodules
Chocolate cysts in ovaries
Endometrial glands + stroma outside uterus

A

Endometriosis

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14
Q

Endometriosis triad

A

Dysmenorrhoea, deep dyspareunia, subfertility

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15
Q

Endometrial tissue in myometrium

Globular ‘boggy’ uterus

A

Adenomyosis

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16
Q

Bundles of smooth muscle cells
Red-degeneration in pregnancy
Firm grey-white tumours

A

Leiomyoma

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17
Q

Endometrial cancer key difference between types

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Type I is oestrogen dependent (more common), type II is not

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18
Q

Squamous cell carcinoma

HPV-16

A

Vulval carcinoma

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19
Q

Types of VIN

A 
Usual type (warty, basaloid) - younger
Differentiated type (keratinising) - older, more likely malignant
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20
Q

Paget’s disease of the vulva

A

Adenocarcinoma in situ

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21
Q

Epithelial types at cervix

A

Inner columnar - TZ - outer squamous

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22
Q

Cytology cervical grading

A

Mild, moderate, severe dyskaryosis

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23
Q

Histology cervical grading

A

CIN1 (dysplasia in lower 1/3)
CIN2 (dysplasia in lower 2/3)
CIN3 (full thickness dysplasia)
Invasion through BM = carcinoma

24
Q

RF cervical cancer

A

Early age at first intercourse, multiple partners, smoking, immunosuppression (e.g. HIV)

25
Q

cGIN vs CIN

A

Dysplasia in columnar epithelium vs squamous epithelium (CIN more common)

26
Q

FIGO staging cervical carcinoma

A 
Stage 0 - CIN
Stage 1 - cervix
Stage 2 - < pelvic side wall or lower 1/3 vagina
Stage 3 - > above
Stage 4 - beyond pelvis
27
Q

3 main cell types in ovary

A

Surface epithelium
Germ cells (oocytes)
Sex cord / stromal cells (incl. granulosa + thecal, Sertoli + Leydig, fibrocyte (CT) cells)

28
Q

5 types of benign ovarian cysts

A
  • Functional (incl. follicular, corpus luteal, theca luteal)
  • Inflammatory (incl. tubo-ovarian abscess, endometrioma)
  • Epithelial
  • Germ cell
  • Sex cord / stromal
29
Q

Large developing primordial follicle

A

Follicular cyst (Functional cyst)

30
Q

Large CL remnant after ovulation

A

Corpus luteal cyst (Functional cyst)

31
Q

Occur in pregnancy + GTD
Caused by excessive B-hCG stimulation
Usually multiple + bilateral
Resolve after pregnancy

A

Theca luteal cyst (Functional cyst)

32
Q

Chocolate cysts
Accompanied by ‘cigarette burn’ powder lesions
Dyspareunia, dysmenorrhoea, subfertility

A

Endometrioma (Inflammatory cyst)

33
Q

Cyst of inflammatory exudate

Post PID / appendicitis

A

Tubo-ovarian abscess (Inflammatory cyst)

34
Q

PID Treatment

A

Metronidazole + Doxycycline for 14d + IM Ceftriaxone

35
Q

20% ovarian tumours, 40% become malignant
Columnar epithelium
Psammoma bodies
Small, unilateral + fluid filled

A

Serous cystadenoma (Epithelial cyst)

36
Q

Mostly benign
Mucin-secreting epithelium
Large + bilateral
Mucin-filled

A

Mucinous cystadenoma

37
Q

Rare + usually malignant
Derive from ectopic bladder transitional cells
Hobnail appearance
Abundant clear cytoplasm with intracellular glycogen

A

Transitional ‘Brenner’ clear cell cystadenoma

38
Q

Contain paste-like sebum
Derived from all 3 germ layers
Ectodermal tissue - hair, teeth etc. within Rokitansky’s protuberance

A

Mature teratoma (aka dermoid cyst) (germ cell)

39
Q

Fibrocyte cells

Ascites + pleural effusion

A

Firboma (sex cord stromal)

Ascites + pleural effusion + ovarian cyst = Meig’s syndrome

40
Q

Ascites + pleural effusion + ovarian cyst

A

Meig’s syndrome

41
Q

Malignant and solid

Secretes AFP

A

Immature teratoma (germ cell)

42
Q

Most common ovarian malignancy in young women
Central nuclei surrounded by clear cytoplasm
Very sensitive to chemo

A

Dysgerminoma (germ cell)

43
Q

Trophoblast cells

Lots of B-hCG

A

Choriocarcinoma (germ cell)

44
Q

Rings of cells around vessels (Schiller Duual bodies)

Children

A

Yolk sac tumour (germ cell)

45
Q

Meigs syndrome

No hormone production

A

Fibroma (sex cord / stromal - stromal)

46
Q

Secrete oestrogen

= Breast enlargement, endometrial hyperplasia, irregular menstruation)

A

Granulosa-thecal (sex cord / stromal - sex cord)

47
Q

Most common malignant epithelial tumour

A

High-grade serous cystadenoma

48
Q

Secrete androgens

= Defeminisation, breast atrophy, virilisation

A

Sertoli-Leydig (sex cord / stromal - sex cord)

49
Q

Infection of Fallopian tubes

Can lead to hydrosalpinx

A

Salpingitis

50
Q

What is hydrosalpinx?

A

Obstruction of ends of Fallopian tubes (e.g. from scarring in salpingitis)
Fluid collects in tube leading to swelling

51
Q

Risk factors ovarian cancer

A 
Familial risk factors - BRCA1/2 (breast, colon, endometrial), Lynch (also HNPCC), PJS
Increased ovulation (nulliparity, late menopause, early menarche)
52
Q

Endometrial cancer
Breast cancer
Colon cancer
Ovarian cancer

A

BRCA1/2

53
Q

Most common ovarian cancer

A

90% epithelial

70-80% high-grade serous epithelial

54
Q

Ovarian cancer

HNPCC

A

Lynch syndrome

55
Q

Benign hamartomatous polyps GI tract
Ovarian cancer
Hyperpigmented macular on lips / oral mucosa
AD inheritance

A

Peutz-Jeughers syndrome

Histopathology (19 decks)

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