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YEAR 5: Histopathology > Histo: Gynaecological pathology Pt.2 > Flashcards

Histo: Gynaecological pathology Pt.2 Flashcards

1
Q

How is HPV detected

A

Hybridisation assay
Signal amplification
Uses long synthetic RNA probes complementary to the DNA sequence of numerous low and high risk HPV strains

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2
Q

What vaccine is protect against HPV?

A

Gardasil 9
Protects against HPV types 6, 11, 16, 18, 31, 33, 45, 52 and 58

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3
Q

At what age to children receive HPV vaccine?

A

12-13 years old:

  • First dose in year 8
  • Second dose 6-24 months later
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4
Q

Describe the structure of the uterine wall

A
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5
Q

List some diseases of the uterine body.

A
  • Congenital anomalies
  • Inflammation - endometritis
  • Adenomyosis - endometrium present within muscle wall
  • Dysfunctional uterine bleeding
  • Enodetrial atrophy/hyperplasia
  • Leiomyoma
  • Endometrial polyp
  • Tumours
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6
Q

What is endometrial hyperplasia?

A

Defined as irregular proliferation of the endometrial glands with an increase in the gland to stroma ratio when compared with proliferative endometrium.

  • Usually driven by oestrogen
  • Usually occurs in the perimenopausal period
  • May be associated with atypia
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7
Q

List some causes of endometrial hyperplasia.

A
  • Persistant anovulation (due to persistently raised oestrogen)
  • PCOS
  • Oestrogen therapy (without progesterone)
  • Obesity
  • Granuloma cell tumour of the ovary
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8
Q

List some risk factors for endometrial carcinoma.

A
  • Nulliparity
  • Early menarche, late menopause
  • PCOS
  • Obesity
  • Diabetes mellitus
  • Excessive oestrogen stimulation
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9
Q

List some prognostic factors in endometrial carcinoma.

A
  • Histological type
  • Grade
  • Stage
  • Lymphovascular invasion
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10
Q

What are the 2 subgroups of endometrial cancer and what differentiates them?

A

Type 1 and type 2

  • Type 1 are oestrogen-dependent, better prognosis
  • Type 2 are oestrogen-independent, worse prognosis
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11
Q

What subgroup is endometroid carcinoma in and what are its key features

A

Endometrioid carcinoma is a type 1 endometrial cancer
Key features:

  • MOST COMMON TYPE OF ENDOMETRIAL CANCER
  • Oestrogen dependent
  • Affects perimenopausal women
  • Associated with atypical endometrial hyperplasia
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12
Q

Which endometrial cancers are classified as type 2?

A

Serous and clear cell carcinomas

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13
Q

What are the key features of type II endometrial carcinoma?

A
  • Affect older, postmenopausal patients
  • Oestrogen-independent
  • Arise in atrophic endometrium
  • High grade, deeper invasion and higher stage
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14
Q

Which genetic mutations are associated with the two types of type II endometrial carcinoma?

A

Endometrial Serous Carcinoma

  • P53 (90%)
  • P13KCA (15%) Her2 amplification

Clear Cell Carcinoma

  • PTEN
  • CTNNB1
  • Her2 amplification
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15
Q

What criteria is the FIGO grading system based on?

A

3 tier system: grades 1,2, and 3 depending on

  • Tissue architecture: % of gland formation
  • Cytological atypia
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16
Q

Briefly describe the FIGO staging system

A
17
Q

What is a leiomyoma? Outline its key features.

A
  • A benign smooth muscle cell tumour in the uterus (MOST COMMON uterine tumour)
  • aka. Fibroid
  • Present in > 20% of women > 35 years
  • Often multiple
  • Usually asymptomatic
18
Q

What are the three types of leiomyoma?

A
  • Intramural
  • Submucosal
  • Subserosal
19
Q

What is a leiomyosarcoma?

A

Malignant counterpart of leiomyoma

  • Rare
  • Usually solitary
  • Affect mainly the postmenopausal
  • Local invasion and bloodstream spread
  • 20-30% 5 year survival
20
Q

What is endometriosis? How common is it?

A

Presence of endometrial tissue outside the uterus
Common - affects 10% of premenopausal women

21
Q

Outline the possible pathogenesis of endometriosis.

A
  • Metaplasia of pelvic peritoneum
  • Retrograde menstruation - endometrial lining travels up the fallopian tubes, into the peritoneal cavity and implants outside the uterus
22
Q

Why is endometriosis an issue?

A
  • It is functional and bleeds at the time of menstruation
  • Can lead to pain, scarring and infertility
  • May develop hyperplasia or malignancy
23
Q

What is adenomyosis?

A
  • Ectopic endometrial tissue deep within the myometrium
  • Causes dysmenorrhoea (because it bleeds into the muscle layer and causes pain)
24
Q

List two types of non-neoplastic ovarian cysts.

A
  • Follicular and luteal cysts
  • Endometriotic (chocolate) cyst
25
Q

What are some manifestations of polycystic ovarian syndrome?

A
  • Oligo/amenorrhoea
  • Polycystic ovaries
  • Hyperandrogenism

YEAR 5: Histopathology (33 decks)

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