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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

A

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
cGIN vs CIN
Dysplasia in columnar epithelium vs squamous epithelium (CIN more common)
26
FIGO staging cervical carcinoma
``` Stage 0 - CIN Stage 1 - cervix Stage 2 - < pelvic side wall or lower 1/3 vagina Stage 3 - > above Stage 4 - beyond pelvis ```
27
3 main cell types in ovary
Surface epithelium Germ cells (oocytes) Sex cord / stromal cells (incl. granulosa + thecal, Sertoli + Leydig, fibrocyte (CT) cells)
28
5 types of benign ovarian cysts
- Functional (incl. follicular, corpus luteal, theca luteal) - Inflammatory (incl. tubo-ovarian abscess, endometrioma) - Epithelial - Germ cell - Sex cord / stromal
29
Large developing primordial follicle
Follicular cyst (Functional cyst)
30
Large CL remnant after ovulation
Corpus luteal cyst (Functional cyst)
31
Occur in pregnancy + GTD Caused by excessive B-hCG stimulation Usually multiple + bilateral Resolve after pregnancy
Theca luteal cyst (Functional cyst)
32
Chocolate cysts Accompanied by 'cigarette burn' powder lesions Dyspareunia, dysmenorrhoea, subfertility
Endometrioma (Inflammatory cyst)
33
Cyst of inflammatory exudate | Post PID / appendicitis
Tubo-ovarian abscess (Inflammatory cyst)
34
PID Treatment
Metronidazole + Doxycycline for 14d + IM Ceftriaxone
35
20% ovarian tumours, 40% become malignant Columnar epithelium Psammoma bodies Small, unilateral + fluid filled
Serous cystadenoma (Epithelial cyst)
36
Mostly benign Mucin-secreting epithelium Large + bilateral Mucin-filled
Mucinous cystadenoma
37
Rare + usually malignant Derive from ectopic bladder transitional cells Hobnail appearance Abundant clear cytoplasm with intracellular glycogen
Transitional 'Brenner' clear cell cystadenoma
38
Contain paste-like sebum Derived from all 3 germ layers Ectodermal tissue - hair, teeth etc. within Rokitansky's protuberance
Mature teratoma (aka dermoid cyst) (germ cell)
39
Fibrocyte cells | Ascites + pleural effusion
Firboma (sex cord stromal) | Ascites + pleural effusion + ovarian cyst = Meig's syndrome
40
Ascites + pleural effusion + ovarian cyst
Meig's syndrome
41
Malignant and solid | Secretes AFP
Immature teratoma (germ cell)
42
Most common ovarian malignancy in young women Central nuclei surrounded by clear cytoplasm Very sensitive to chemo
Dysgerminoma (germ cell)
43
Trophoblast cells | Lots of B-hCG
Choriocarcinoma (germ cell)
44
Rings of cells around vessels (Schiller Duual bodies) | Children
Yolk sac tumour (germ cell)
45
Meigs syndrome | No hormone production
Fibroma (sex cord / stromal - stromal)
46
Secrete oestrogen | = Breast enlargement, endometrial hyperplasia, irregular menstruation)
Granulosa-thecal (sex cord / stromal - sex cord)
47
Most common malignant epithelial tumour
High-grade serous cystadenoma
48
Secrete androgens | = Defeminisation, breast atrophy, virilisation
Sertoli-Leydig (sex cord / stromal - sex cord)
49
Infection of Fallopian tubes | Can lead to hydrosalpinx
Salpingitis
50
What is hydrosalpinx?
Obstruction of ends of Fallopian tubes (e.g. from scarring in salpingitis) Fluid collects in tube leading to swelling
51
Risk factors ovarian cancer
``` Familial risk factors - BRCA1/2 (breast, colon, endometrial), Lynch (also HNPCC), PJS Increased ovulation (nulliparity, late menopause, early menarche) ```
52
Endometrial cancer Breast cancer Colon cancer Ovarian cancer
BRCA1/2
53
Most common ovarian cancer
90% epithelial | 70-80% high-grade serous epithelial
54
Ovarian cancer | HNPCC
Lynch syndrome
55
Benign hamartomatous polyps GI tract Ovarian cancer Hyperpigmented macular on lips / oral mucosa AD inheritance
Peutz-Jeughers syndrome

Histopathology (19 decks)

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