Histopathology 6: Gynaecological pathology

Question 1

What is the most common site of ectopic pregnancy ?

Answer 1

Ampulla of the fallopian tube

Question 2

List 2 high risk HPV serotypes for cervical cancer ?

Answer 2

HPV 16

HPV 18

Question 3

Which cells are characteristic of HPV on histology and appear to have a halo around the nucleus

Answer 3

Koilocytes

Question 4

Describe CIN 1, CIN2, CIN 3, carcinoma?

Answer 4

CIN 1: Mild dyskaryosis limited to 1/3 of epithelium
CIN 2: Moderate dyskaryosis limited to 2/3 of epithelium
CIN 3: Severe dyskaryosis affecting entire epithelium
Carcinoma: Evidence of invasion through the basement membrane

Question 5

At what age do girls receive the HPV vaccine ?

Answer 5

12-13

Question 6

List 3 causes of PID ?

Answer 6

Chlamydia
Gonorrhoea
TB

Question 7

What happens to the position of the uterus in severe endometriosis ?

Answer 7

It becomes retroverted

Question 8

What is meant by chocolate cyst of the ovary?

Answer 8

Endometrioma

Question 9

List 2 complications of Fibroids around pregnancy ?

Answer 9

Red degeneration

Post-partum torsion

Question 10

What is the most common type of endometrial cancer ?

Answer 10

Endometroid adenocarcinoma

Question 11

Which mutation is most commonly associated with Serous adenocarcinoma of the endometrium ?

Answer 11

P53

Question 12

Define FIGO stage 1 of endometrial cancer

Answer 12

Confined to the endometrium

Question 13

Define FIGO stage 2 of endometrial cancer

Answer 13

Spread to the cervix

Question 14

Define FIGO stage 3 of endometrial cancer

Answer 14

Spread to adnexa, vagina or local lymph nodes

Question 15

Define FIGO stage 4 of endometrial cancer

Answer 15

Distal metastasis or other pelvic organ spread

Question 16

Into which 3 categories are ovarian tumour often subdivided ?

Answer 16

• Epithelial
• Germ cell
• Sex cord/ stromal

Question 17

Which bilateral ovarian tumour is likely if Signet ring cells are present ?

Answer 17

Kreukenberg tumour

Question 18

List 4 epithelial cell Ovarian tumours ?

Answer 18

Serous cystadenoma
Mucinous cystadenoma
Endometroid
Clear cell

Question 19

Which ovarian tumour has Psamomma bodies ?

Answer 19

Serous cystadenocarcinoma

Question 20

Which ovarian tumour is associated with pseudomyxoma peritonei ?

Answer 20

Mucinous cystadenocarcinoma

Question 21

Which ovarian tumour has Walthard cell rests and “coffee bean” nuclei ?

Answer 21

Brenner tumour

Question 22

Which ovarian tumours contain ectodermal, endodermal and mesodermal cell lines ?

Answer 22

Teratoma (dermoid cyst)

Question 23

Which Ovarian tumour is histologicaly similar to a testicular seminoma and associated with Turner’s syndrome ?(Typically secrete hCG and LDH)

Answer 23

Dysgerminoma

Question 24

Which Ovarian germ cell tumour is associated with high levels of beta HCG ?

Answer 24

Choriocarcinoma

Question 25

Which germ cell ovarian tumours typically secrete AFP and show Schiller-Duval bodies on histology ?

Answer 25

Yolk sac tumours

Question 26

Which sex cord/ Stromal Ovarian tumour produces oestrogen leading to precocious puberty if in children or endometrial hyperplasia in adult? (Histology shows Call-Exner bodies)

Answer 26

Granulosa (theca) cell tumour

Question 27

Which sex cord/ Stromal Ovarian tumour produces androgens leading to masculinizing effects? Which syndrome is this tumour associated with ?

Answer 27

Sertoli-Leydig cell tumour Peutz-Jegher syndrome

Question 28

Which ovarian tumour is associated with Peutz-Jegher syndrome

Answer 28

Sertoli-Leydig cell tumour

Question 29

Which ovarian tumour is associated with Meigs' syndrome and tends to occur around the menopause ? (histology shows bundles of spindle-shaped fibroblasts)

Answer 29

Fibroma

Question 30

List the triad of features seen in Meig's syndrome ?

Answer 30

Fibromas Ascites Pleural effusions

Question 31

Describe FIGO stage 1 of Ovarian cancer ?

Answer 31

Limited to the ovaries

Question 32

Describe FIGO stage 2 of Ovarian cancer ?

Answer 32

Limited to the pelvis

Question 33

Describe FIGO stage 3 of Ovarian cancer ?

Answer 33

Limited to the abdomen

Question 34

Describe FIGO stage 4 of Ovarian cancer ?

Answer 34

Distant metastases outside of the abdominal cavity

Question 35

which vaginal cancer are children of women who were treated with diethyl stilbosterol for threatened abortion at increased risk of?

Answer 35

Clear cell carcinoma