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Pathology Summaries > HISTO: Gynae and breast > Flashcards

HISTO: Gynae and breast Flashcards

1
Q

What is the most common cervical cancer type?

A

SCC

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2
Q

What are the two transforming genes in HPV and what does each target?

A

E6 and E7

P53 and Rb respectively

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3
Q

What does the HPV vaccine do?

A

Prevents progression to Ca

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4
Q

What is the most common type of endometrial cancer?

A

Endometrioid - oestrogen dependent

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5
Q

What is grade of endometrioid cancer based on?

A

%glands and cytological atypia

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6
Q

What is the most common uterine tumour?

A

Leiomyoma

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7
Q

Which endometrial cancers arise in atrophic endometrium and are high grade?

A

Serous = p53

Clear cell = PTEN

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8
Q

What are the cancer genome atlas groups?

A

Type 1 - POLE mutations (highest survival)
Type 2 - MSI
Type 3- CN low
Type 4 - CN high (lowest survival)

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9
Q

What are the epithelial subtypes of ovarian tumours? What conditions are they associated with?

A

Serous, mucinous, endometrioid, clear cell, seromucinous, Brenner, mixed

BRCA1/2 and Lynch II/HNPCC

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10
Q

What is the most common ovarian cancer subtype? What mutation is it associated with?

A

Serous P53

low grade ones have KRAS/BRAF

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11
Q

What epithelial ovarian tumour is most associated with endometriosis?

A

Clear cell - MSI/PIK3CA

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12
Q

What % of endometrioid ovarian tumours are associated with endometriosis?

A

20%

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13
Q

What age group do most sex-cord stromal ovarian tumours occur in?

A

Post-menopausal

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14
Q

What do these mixed sex cord stromal tumours release:

  • Thecoma
  • Granulosa
  • Sertoli-Leydig
  • Fibroma
A

Thecoma –> oestrogen
Granulosa –> oestrogen
Sertoli-Leydig –> androgenic
Fibromas – X none

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15
Q

Which syndromes predispose to sex-cord stromal tumours?

A 
DICER1 --> 60% of sertoli-leydig
Peutz Jeghers (STK11) --> sertoli-leydig with annular tubules
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16
Q

What are the subtypes of stromal ovarian tumours?

A

Fibroma, thecoma, microcystic stromal (CTNNB1 -beta catetin positive)

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17
Q

What is an example of an ovarian sex cord tumour?

A

Granulosa cell (FOXL2)

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18
Q

What are germ-cell ovarian tumours graded based on?

A

Primitive elements

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19
Q

Which BRCA confers survival advantage? Why?

A

BRCA2 because PARP inhibitors can ve used (compared to BRCA 1 or negative)

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20
Q

What are Krukenberg tumours?

A

Bilateral mets to ovaries from gastric or breast origin

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21
Q

What is characteristic of Krukenberg tumours on histology?

A

Signet ring cells making mucin

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22
Q

What ovarian tumour are these markers of:

  • Ca19-9
  • CA125
  • Inhibin
  • beta-HCG
  • AFP
A 
Ca19-9 = mucinous 
CA125 = epithelial 
Inhibin = granulosa (sex cord stromal)
Beta HCG = chroio or dysgerminoma 
AFP = immature teratoma, endodermal yolk sac
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23
Q

What types of tissue do Brenner tumours contain?

A

Urothelial like

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24
Q

What are the subtypes of Germ cell tumours?

A

Teratoma
Dysgerminoma
Choriocarcinoma

25
Q

Summarise the main classes of ovarian tumours.

A

Epithelial
Sex cord stromal
Germ cell
Metastatic e.g. Krukenberg

26
Q

Summarise the subtypes of sex cord-stromal tumours.

A

Sex-cord includes: granulosa
Stromal includes: fibroma, thecoma
Mixed includes: sertoli-leydig

27
Q

What are the types of ovarian cysts?

A

Physiological- follicular, corpus luteal, theca luteal
Inflammatory - endometrioid
Germ cell - dermoid
Epithelial - serous/mucinous cystadenoma, Brenner tumour
Sex-cord stromal - fibroma, thecoma

28
Q

Which cyst is Meig’s syndrome most common with?

A

Fibroma

29
Q

What is Meig’s syndrome?

A

Effusion, ascites, fibroma

30
Q

Which cyst is associated with pregnancy?

A

Theca luteal

31
Q

Which cyst looks like ground glass on USS?

A

Endometrioma aka chocolate cysts

32
Q

Which cyst can cause pseudomyxoma peritonei on rupture?

A

Mucinous cystadenoma

33
Q 
What does coding with these letters in breast pathology mean:
C
M
U
B
A 
C = cytology coding 
M = clinical coding 
U = radiology coding 
B = core biopsy coding
34
Q

Summarise the cytology coding for breast tissue.

A

C1 = inadequate; C2 = benign, C3= atypia/benign, C4 = suspicious, C5= malignant

35
Q

Summarise the core biopsy coding for breast tissue.

A

B1= normal; B2= benign; B3= uncertain; B4= suspicious; B5 = malignant

B5a=DCIS
B5b=invasive carcinoma

36
Q

What does this describe?

“Monolayer sheet of myoepithelial cells on FNA, well circumscribed”

A

Fibroadenoma = proliferation of fibrous tissue

37
Q

What is a Phyllodes tumour?

A

Malignant fibroepithelial tumour with cellular dense stroma and mitosis

38
Q

Which age group is most affected by Phyllodes tumours?

A

> 50yrs

39
Q

How are intraductal papillomas managed?

A

Should be excised

40
Q

How do intraductal carcinomas present based on location? Which age group are these seen in ?

A

Central - discharge
Peripheral - silent
Occurs in 40-60yo

41
Q

What does this describe?

“Stellate on mammogram, central scarring with peripheral glandular proliferation”

A

Radial scar

42
Q

What happens if a radial scar is left undisturbed?

A

Will progress to tubular carcinoma

43
Q

What are the two main types of proliferative breast disease? Which has the higher risk of progression to cancer?

A

Usual epithelial hyperplasia

Flat epithelial hyperplasia - higher risk of atypical ductal carcinoma

44
Q

Name 2 in-situ breast tumours. What is their risk of progression to carcinoma?

A

In situ lobular neoplasia - x10 risk

Ductal carcinoma in situ - small risk but still excised

45
Q

Which tumour is most often detected as areas of calcification on mammography or as lump/discharge/eczema of the nipple?

A

Ducal carcinoma in situ

46
Q

What is eczema of the nipple called?

A

Paget’s

47
Q

What is the most common breast carcinoma?

A

Ductal invasive carcinoma

48
Q

What breast carcinoma presents with prominent lymphocytic infiltrate and central necrosis?

A

Basal-like

49
Q

Which breast carcinoma is associated with BRCA?

A

Basal-like carcinoma

50
Q

How do basal-like carcinomas spread?

A

Vascular, often distant, spread

51
Q

What are the 3 categories used to grade basal-like carcinomas?

A

Tubule formation
Nuclear pleomorphism
Mitosis

(each is scored out of 3)

52
Q

What does ER/PR/Her2 positive/negative mean in terms of prognosis? Which is best?

A 
ER/PR+ = good
Her2 = bad
53
Q

What is the most important factor for prognosis in breast cancer?

A

Status of axillary lymph nodes

54
Q

Which breast cancer is “triple negative”?

A

Basal-like carcinoma

55
Q

What is the histopathology of gynaecomastia?

A

Epithelial hyperplasia

56
Q

Which ovarian tumours are strongly positive for beta-catetin?

A

Microcystic stromal tumours - CTNNB1

57
Q

Which breast change occurs due to imbalances in progesterone and oestrogen?

A

Fibrocystic disease - some calcification on mammogram but benign on histopathology

58
Q

Name 2 benign breast lesions that commonly mimic breast cancer on radiology.

A

Fat necrosis

Radial scar

Pathology Summaries (23 decks)

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