Histopathology 5 - Gynaecological pathology Flashcards
What is salpingitis?
Infection of fallopian tubes
What are the possible complications of untreated salpingitis?
Adhesions
Abscesses
Peritonitis
Ectopic pregnancy
What are the high risk forms of HPV for cervical cancer?
16 and 18
Recall the stages of progression from normal cervical cells to cervical carcinoma
Normal T positive HPV (abnormal cells) CIN 1 (lower 1/3 of cells neoplastic) CIN 2 (2/3 of cells neoplastic) CIN 3 (full thickness neoplastic) Carcinoma
What do CIN and CGIN stand for, and what is the main difference between them?
CIN = cervical intraepithelial neoplasia
CGIN = cervical glandular intraepithelial neoplasia
CIN progresses to squamous cell carcinoma
CGIN progresses to adenocarcinoma
How does HPV lead to neoplatic transformation of cervical cells?
E6 and E7 viral proteins deactivate p53 and Retinoblastoma (tumour suppressor genes)
What age range is invited to cervical screening?
25-64
Which HPV strains are included in the quadrivalent vaccine?
6,11,16,18
What is leiomyoma of the uterus?
Smooth muscle cell tumour of the uterus
What is a fibroid?
Leiomyoma
How are fibroids classified?
As either intramural, submucosal or subserosal
What is the biggest risk factor for endometrial hyperplasia?
Persistent oestrogen
What is the difference between type 1 and 2 endometrial carcinomas?
Type 1: adenocarcinomas
Type 2: Serous/ clear cell carcinoma
What is the relative prevelance of type 1 vs type 2 endometrial carcinoma?
Type 1 = 80-85%
Type 2 = 10-15%
Recall the genetic associations of serous and clear cell endometrial carcinomas
Serous: p53 mutation
Clear cell: PTEN mutation
Which type of endometrial carcinoma is high grade and which is low grade?
Type 1 = low grade
Type 2 = high grade
Which type of endometrial carcinoma is most likely to arise in atrophic endometrium?
Type 2
Recall the FIGO stages of endometrial cancer
Stage 1: Confined to uterus
Stage 2: Spread to cervix
Stage 3: Spread to adnexa, vagina, local lymph nodes (pelvic/ para-aortic)
Stage 4: Distant metastases
Recall the different types of gestational trophoblastic disease
Partial/ complete mole
Invasive mole
Choriocarcinoma
How does gestational trophoblastic disease usually present?
As spontaneous abortion
What is the cause of gestational trophoblastic disease?
Fertilisation of one egg by 2 sperm
Describe the prognosis of choriocarcinoma
Very aggressive but also very responsive to treatment
What is endometriosis?
Presence of endometrial glands and stroma outside of the uterus - bleeding of ectopic material is painful
What is adenomyosis?
Ectopic endometrial tissue within the myometrium
What is the main symptom of adenomyosis?
Dysmennorhoea
What type of tumour are 95% of ovarian neoplasms?
Epithelial tumours
Describe the 2 different types of ovarian carcinoma
Type 1 (low grade, has precursors) Type 2 (high grade, associated with p53 mutations)
What type of epithelium are most ovarian carcinomas derived from?
Serous
Which types of ovarian carcinoma are associated with endometriosis?
Endometrioid and clear cell carcinoma
Recall the 4 types of sex cord stromal tumours, and the malignant potential of each
Fibromas (from fibroblasts) = benign
Granulosa cell tumours = variable behaviour
Thecoma (thecal cells) = benign
Sertoli-Leydig cell tumours = variable behaviour
In what age group of women are germ cell tumours seen?
<20s
Recall the different types of germ cell tumour in women
Undifferentiated germ cells: dysgermioma
Tumour of extra-embryonic tissue: endodermal sinus tumour
Trophoblast tumour: choriocarcinoma
Cancer of embryonic tissue: teratoma
Recall 2 types of cancer that commonly metastasise to the ovary
Krokenburg tumours
Colon cancer
