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Path Y > Histopathology - Gynaecological pathology > Flashcards

Histopathology - Gynaecological pathology Flashcards

1
Q

What is salpingitis?

A

Infection of fallopian tubes

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2
Q

What are the possible complications of untreated salpingitis?

A

Adhesions
Abscesses
Peritonitis
Ectopic pregnancy

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3
Q

What are the high risk forms of HPV for cervical cancer?

A

16 and 18

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4
Q

Recall the stages of progression from normal cervical cells to cervical carcinoma

A

Normal
T positive HPV (abnormal cells)
CIN 1 (lower 1/3 cells dysplasia)
CIN 2 (2/3 of cells )
CIN 3 (full thickness neoplastic)
Carcinoma

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5
Q

What do CIN and CGIN stand for, and what is the main difference between them?

A

CIN = cervical intraepithelial neoplasia
CGIN = cervical glandular intraepithelial neoplasia
CIN progresses to squamous cell carcinoma
CGIN progresses to adenocarcinoma

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6
Q

How does HPV lead to neoplatic transformation of cervical cells?

A

E6 (deactivates p53) and E7 (deactivates retinoblastoma) (tumour suppressor genes)

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7
Q

What age range is invited to cervical screening?

A

25-64

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8
Q

Which HPV strains are included in the quadrivalent vaccine?

A

6,11,16,18

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9
Q

What is leiomyoma of the uterus?

A

Smooth muscle cell tumour of the uterus

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10
Q

What is a fibroid?

A

Leiomyoma

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11
Q

How are fibroids classified?

A

As either intramural, submucosal or subserosal

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12
Q

What is the biggest risk factor for endometrial hyperplasia?

A

Persistent oestrogen

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13
Q

What is the difference between type 1 and 2 endometrial carcinomas?

A

Type 1: adenocarcinomas, mucinous, secretory
Type 2: Serous/ clear cell carcinoma

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14
Q

What is the relative prevelance of type 1 vs type 2 endometrial carcinoma?

A

Type 1 = 80-85%
Type 2 = 10-15%

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15
Q

Recall the genetic associations of serous and clear cell endometrial carcinomas

A

Serous: p53 mutation
Clear cell: PTEN mutation

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16
Q

Which type of endometrial carcinoma is high grade and which is low grade?

A

Type 1 = low grade
Type 2 = high grade

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17
Q

Which type of endometrial carcinoma is most likely to arise in atrophic endometrium?

A

Type 2

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18
Q

Recall the FIGO stages of endometrial cancer

A

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

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19
Q

Recall the different types of gestational trophoblastic disease

A

Partial/ complete mole
Invasive mole
Choriocarcinoma

20
Q

How does gestational trophoblastic disease usually present?

A

As spontaneous abortion

21
Q

What is the cause of gestational trophoblastic disease?

A

Fertilisation of one egg by 2 sperm

22
Q

Describe the prognosis of choriocarcinoma

A

Very aggressive but also very responsive to treatment

23
Q

What is endometriosis?

A

Presence of endometrial glands and stroma outside of the uterus - bleeding of ectopic material is painful

24
Q

What is adenomyosis?

A

Ectopic endometrial tissue within the myometrium

25
Q

What is the main symptom of adenomyosis?

A

Dysmennorhoea

26
Q

What type of tumour are 70% of ovarian neoplasms? outline their key findings

A

epithelial tumours
=
serous - psammoma bodies, most common
mucinous - mucin producing, K- ras mutation in 75%
endometroid - endometriosis risk factors
clear cell - clear cytoplasm & hobnail appearance, strong association w endometriosis

27
Q

Describe the 2 different types of ovarian carcinoma

A 
Type 1 (low grade, has precursors) 
Type 2 (high grade, associated with p53 mutations)
28
Q

What type of epithelium are most ovarian carcinomas derived from?

A

Serous

29
Q

Which types of ovarian carcinoma are associated with endometriosis?

A

Endometrioid and clear cell carcinoma

30
Q

Recall the 3 types of sex cord stromal tumours, outline their key aspects

A

sex cord stromal tumours = 10% of ovarian tumours

fibromas = associated w Meig’s syndrome (ascites + pleural effusion)

granulosa theca cell tumours = produce E2, cause oestrogenic effects

sertoli-leydig cell tumours = secrete androgens (look for defeminsation)

31
Q

In what age group of women are germ cell tumours seen?

A

<20s

32
Q

what are the other 20% of ovarian tumours?

A

germ cell tumours (of which 95% are benign)

dysgermioma = undifferentiated germ cells
teratoma (mature = most common = benign, immature = malignant)
choriocarcinoma - secrete hCG

33
Q

Recall 2 types of cancer that commonly metastasise to the ovary

A

Krukenburg tumours mets grom gastric adenocarcinoma
Colon cancer

34
Q

2 macroscopic findings of endometriosis

A

red-blue to brown nodules - “powder burns”
“chocolate cysts” in ovaries (endometriomas)

35
Q

what’s the transformation zone

A

squamocolumnar junction

36
Q

malignant version of a fibroid =

A

leiomyosarcoma

37
Q

which subtype of endometrial carcinoma are oestrogen dependent & linked to endometrial hyperplasia

A

type 1 -85%
endometrioid, mucinous and secretory adenocarcinoma

-younger patients, usually lower grade,

38
Q

which subtype of endometrial carcinoma are not oestrogen dependent

A

type 2-15%
serous and clear cell tumours
- older patients, higher grade

39
Q

differentiate between complete mole and partial mole

A

complete = empty egg fertilised by 2 sperm (or 1 which duplicates DNA)
46 XY or 46 XX (paternal origin only)

partial = normal egg fertilised by 2 sperm (or 1 which duplicates DNA)
69 XXX or 69 XXY (1x maternal and 2x paternal origin)

40
Q

what’s an important secondary ovarian tumour

A

Krukenberg Tumour:

Bilateral metastases from gastric or breast cancer composed of mucin-producing signet ring cells

41
Q

outline the FIGO staging for ovarian cancer

A

Stage I: limited to ovaries (75-90%)
• Stage II: limited to pelvis (45-60%)
• Stage III: limited to abdomen (including regional LN metastases) (30-40%)
• Stage IV: distance metastases outside abdominal cavity (<20%)

42
Q

what type of cervical carcinoma is most common

A

squamous cell carcinoma (70-80%)

43
Q

outline the FIGO staging of cervical cancer

A

Stage0:CIN
1 - limited to cervix
2- beyond uterus but not to pelvic side wall or lower 1/3 of vagina
3- extension to pelvic side wall or lower 1/3 vagins
4- extension beyond true pelvis or involvement of bladder/bowel

44
Q

what marks the change from CIN to cervical carcinoma

A

Invasion through the basement membrane

45
Q

which gynae cancer accounts for most deaths in UK

A

ovarian carcinoma

Path Y (81 decks)

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