Histopath - Gynae Flashcards
Which HPV strains are most associated with cervical cancer?
HPV 16 and 18
What are the 2 types of HPV vaccines?
- Cervarix: bivalent (16+18)
- Gardasil: quadrivalent (6, 11, 16, 18)
CIN and cervical Ca RFs
- Many sexual partners/sexually active early
- Smoking
- Immunosuprression
Most common direction of PID
Ascending infection
Most common cause PID in the UK
Chlamydia and Gonorrhoea
Most common cause PID in the world
TB and schistosomiasis
PID Complications
- Fitz Hugh Curtis syndrome (adhesions)
- Peritonitis
- Infertility
- Intestinal obstructions
What is CIN
Cervical intraepithelial neoplasia - dysplasia in the cervical epithelium, but membrane intact (pre-malignant, pre-invasive)
What type of cells does CIN usually occur in?
Squamous epithelium
What is CGIN?
Cervical GLANDULAR intrapithelial neoplasia
What type of cells does CGIN usually affect?
Columnar-glandular epithelium
What does CIN develop to (malignancy)?
Squamous cell carcinoma
What does CGIN develop to (malignancy)?
Adenocarcinoma
When does CIN/CGIN become malignant?
When there is invasion through the basement membrane
Which type of endometrial ca is more common?
Type 1 (85%), Type 2 (15%)
What kind of patients get type 1 endometrial cancer verus type 2?
Type 1: Younger patients
Type 2: older patients
Endometrial ca oestrogen-dependence type 1 v 2
Type 1: oestrogen-dependent
Type 2: less oestrogen-dependent
What is type 1 Endometrial Ca associated with?
Atypical endometrial hyperplasia
What is type 2 endometrial ca associated with?
Atrophic endometrium
FIGO staging 1 -4
1: Confined to uterus
2: Spread to cervix
3: Spread to anexae, vagina, local LN
4: Other pelvic organs, distant spread
What is gestational trophoblastic disease?
a spectrum of tumours and tumour-like conditions characterised by proliferation of pregnancy-associated trophoblastic tissue
What are the 3 subtypes of GTD?
- Hydatiform Moles (Complete/ Incomlpete)
- Invasive Moles
- Choriocarcinoma
GTD: complete/partial presentation
Very high HCG
Choriocarcinoma
Malignant trophoblastic cancer (usually of placenta) - rapidly invasive but responds well to chemo
What are the twp forms of pathogenesis for endometriosis?
- Retrograde menstruation
- Metaplasia of pelvic peritoneum
What can be seen histopathologically in endometriosis?
Powder burns and chocolate cysts (endometriomas)
Protective factors for Ovarian ca
- OCP
- Pregnancy
Risk factors for Ovarian ca
- Genetic predisposition (most sign)
- Nulliparity
- Early menarche & late menopause
- Infertility
3 types of ovarian tumours by histology
- Epithelial
- Germ cell tumours
- Sex cord tumours
- Most common in post-menopausal women
Serous cystadenoma histopathology
Ciliated cells
*What type of tumour is this?
Mature teratoma
Mucinous cystadenoma histopathology
Mucous secreting cells
Brenner tumour histopathology
Coffee bean nuclei
Mucinous cystadenocarcinoma histopathology
Pseudomyxoma peritonei
Serous cystadenocarcinoma histopathology
Psammoma bodies
Teratoma histopathology
Ectopic tissue types
Dysgerminoma histopathology
hCG and LDH
(And Turners syndrome)
Yolk sac histopathology
AFP
Choriocarcinoma histopathology
hCG
Fibroma histopathology
Associated with Meigs’ syndrome (ascites, pleural effusion)
What are signet ring cells associated with?
Krukenburg tumour
Most common location for Krukenberg tumour
Gastric adenocarcinoma at pylorus
(Krukenberg is 2ndry tumour)
*Most common ovarian ca
Serous adenocarcinoma
Most common ova ca
Serous cystadenoma
