Histopath - Gynae Flashcards
HPV - most common high risk types?
Most common low risk types?
High risk: HPV 16 +18
Low risk: HPV 6+11
How does HPV cause cervical dysplasia?? with proteins are involved?
Proteins E6 + E7 inactivate 2 TS genes:
Rb gene + p53 gene
Risk factors for HPV infection
Early age of first intercourse, multiple partners, smoking, HIV, immunosuppression
Smear test - what results are seen?
Mild/moderate/severe dyskaryosis
If smear test shows dyskaryosis, what is the next test done? what results can it find?
Biopsy to undergo histology
Results –> CIN1/2/3
CIN1/2/3 =?
CIN1 = dysplasia confined to lower 1/3 of epic CIN2 = confined to 2/3 CIN3 = full thickness but BASEMENT MEMBRANE INTACT
Cervical cancer: 2 types?
How do you differentiate between CIN and cancer?
SqCC and adenocarcinoma
CIN progresses to carcinoma if BM is compromised
How is Cervical cancer staged?
FIGO system
1 = confined to cervix
2 = involves uterus but NOT lower 1/3 of vagina nor pelvic wall
3 = involves pelvic wall or lower 1/3 vagina or hydronephrosis of kidney
4 = involves bladder/rectal mucosa or beyond true pelvis
Key Sx seen in endometrial cancer
Post menopausal bleeding
System of staging for endometrial cancer? Describe it?
FIGO system
1) uterus alone
2) cervix involved
3) adnexae/vagina/LNs involved
4) other pelvic organs/distant LNs involved
2 types of endometrial cancer? Which one is more common?
Type I, Endometrioid = more common(80%)
Type II, Non-endometrioid
pathophysiology of endometrial cancer - what is the difference between the 2 types?
Endometrioid type = OESTROGEN DEPENDENT, assoc with endometrial hyperplasia
Non-endometrioid type = unrelated to oestrogen, assoc with endometrial atrophy
Endometrioid type endometrial cancer = what kinda cells are usually seen?
85% are adenocarcinomas
Gene mutations seen in the 2 types of endometrial cancer
Endometrioid: all pts have at least 4 mutations, eg K-Ras, PTEN, CTNNB1, p63, Pl3KCa
Non-endometrioid: p53 in 90%, Her2 amplification
3 main groups of ovarian tumours? Most common?
Epithelial - most common
Stromal/sex cord
Germ cell
Most common type of epithelial ovarian tumour? what 2 cells are seen on cytology?
Serous cyst adenoma
- columnar epithelium
- Psammoma bodies
Psammoma bodies?
Serous epithelial ovarian tumour
Mucinous cystadenoma
- 2 types? What do they secrete?
- endocervical or intestinal type
- Mucin and oestrogen secreting tumour
What familial syndrome is mucinous ovarian carcinoma assoc with?
HNPCC
What familial syndrome is serous ovarian carcinoma assoc with?
BRCA1
Tubular glands seen in epithelial ovarian tumour… what type is it?
Endometrioid
which epithelial ovarian cancer has the best prognosis?
Endometrioid
Histology of an ovarian mass shows:
- Intracellular glycogen
- Hobnail appearance
Clear cell
Which female tumour is the counterpart for testicular seminoma?
Dysgerminoma
2 types of teratoma - what are their differences? (Benign or malignant, structure, tissues)
Mature(dermoid) or immature
Mature = benign, cystic, lots of mature tissues
Immature = malignant, usually solid, immature embryonal tissues
Origin of choriocarcinomas?
50% arise in moles
25% from previous abortions
Choriocarcinomas and immature teratomas - what do they secrete?
Choriocarcinomas - b-hCG
Immature teratomas - AFP
3 types of stromal ovarian tumours. Which one doesn’t secrete hormones?
Fibromas - no hormone production
Granulosa-thecal cell tumours
Sertoli-Leydig cell tumours
Meig’s syndrome
ascites, pleural effusion, fibroma
Krukenberg tumours
bilateral ovarian mets (from GI/breast)
mucin-secreting, signet ring cells
3 familial syndromes of ovarian cancer
- Familial breast-ovarian cancer syndrome
- Site specific ovarian ca
- HNPCC
