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Cardio > Histopathology - Gynaecological Pathology > Flashcards

Histopathology - Gynaecological Pathology Flashcards

1
Q

Peritoneum

A

Pelvic mesothelium

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2
Q

Fallopian tube

A

Ciliated serous epithelium

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3
Q

Endometrium

A

Endometrioid epithelium – glycogen secreting

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4
Q

Endocervix

A

Mucin secreting endocervical epithelium

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5
Q

Ectocervix

A

Squamous epithelium

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6
Q

Endometrium:

A
  1. Normal tissue
  2. Hyperplastic tissue: under hormonal stimulated more glands per unit area (more cells not bigger).
  3. Neoplasia – autonomous – cells mutated therefore don’t respond to removal of stimulation.
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7
Q

Endometrial Hyperplasia

A
  • Disease of perimenopausal women
  • Reflection of anovulatory cycles
  • May result in menorrhagia
  • Ultra scan > thickened endometrium
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8
Q

Endometrial hyperplasia types

A
  • Simple cystic hyperplasia
  • Complex hyperplasia
  • Atypical hyperplasia
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9
Q

Endometrial hyperplasia Risks/Causes

A
  • Obesity - more oestrogen
  • Anovulatory cycles
  • Prolonged exposure to oestrogen
  • Polycystic ovary disease
  • Functioning (steroid secreting) ovarian or adrenal tumours
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10
Q

Atyical Hyperplasia

A

AKA Endometrial Intraepithelial Neoplasia (EIN)

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11
Q

Atypical Hyperplasia presence of

A

Cytological abnormality (deregulation of cell division machinery)

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12
Q

Atypical Hyperplasia risk of

A

Progression of Adenocarcinoma = 25-40% (40-50 yrs)

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13
Q

Treatment

A 
Hysterectomy (older)
Progesterone therapy (young)
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14
Q

Endometrial Carcinoma epi

A

Most common malignant tumour of female genital tract in the develop world

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15
Q

Endometrial cancer risk of

A

Unopposed oestrogen treatment
Polycystic ovarian syndrome
Obesity

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16
Q

Endometrial Carcinoma: Genetic factors

A

HNPCC (Lynch Syndrome) risk 20-30%

→ Endometrial pre colorectal cancer

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17
Q

Endometrial Carcinoma: Presentation

A

Postmenopausal bleeding

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18
Q

Endometrial Carcinoma: Tumour structure

A

Low grade and low stage – good prognosis

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19
Q

Endometrial Carcinoma: Commonest morphology is

A

Endometrioid – loks like parent tissue

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20
Q

Endometrial Carcinoma:Grading on

A

Gland formation and nuclear atypia

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21
Q

Endometrial Carcinoma:Prognosis depends on

A

Grade and stage

22
Q

Endometrial Carcinoma:Spread

A

Lymphatic, direct or transtubal to peritoneum (seed into peritoneum via fallopian).

23
Q

Endometrial Carcinoma: Two types of endometrial carcinoma

A

Type 1: Oestrogen driven

Type 2: Developing de novo

24
Q

Endometrial Carcinoma: Oestrogen driven

A

Endometrioid pattern

Lesions grade according to their amount of gland formation

25
Q

Endometrial Carcinoma: Developing de novo

A

High grade serous papillary

Clear cell carcinoma

26
Q

Cervix: UK epi

A

11th most common cancer in women

27
Q

Cervical screening programme

A
  • Accessible site for exfoliative cytology
  • Pre-invasive state
  • Slow progression of disease
  • Stepwise progression of disease
  • Eradication of early cancer feasible
28
Q

Structure of cervix composed of 2 parts

A
  • Ectocervix

* Endocervix

29
Q

Ectocervix

A

• Squamous epithelium (stratified) w/ glycogen with lactobacilli which help maintain acidic environment to prevent infection

30
Q

Endocervix

A

• Columnar cells: Mucin secreting glandular epithelium

31
Q

Transformation zone

A

• Zone between original and functional squamo-columnar junction
→Metaplasia (associated with the stress from acidic ectocervix) is occurring allowing for one epithelium to change into another. The junction position varies through life according to hormonall stage e.g. menarche and menopaus

32
Q

Cervical carcinoma: Risk factors

A 
Early age at first intercourse – pick up infection early = HPV
Multiple partners
Smoking – immunomodulatory
Genital infections
Partner with multiple partners
33
Q

Cervical carcinoma: HPV and squamous neoplasia:

A
  1. Normal epithelium and Negative
  2. Low grade dysplasia and koilocytosis. Low and high risk HPV. Viral replication with or without integration.
  3. Invasive Carcinoma, High risk HPV, Viral integration and secondary chromosomal abnormalities.
  4. High grade dysplasia. High risk HPV. Viral integration
34
Q

Cervical carcinoma: Neoplasia of the cervix

A

Cervical intraepithelial neoplasia (CIN): turns into invasive squamous cell carcinoma

Cervical glandular intraepithelial neoplasia (CGIN): turns into adenocarcinoma

Carcinoma:
• Can presents with post coital bleeding
• Prevention is better than cure
• Prognosis is stage dependent

35
Q

Ovarian Neoplasia: Classification (related to anatomical compartments)

A
  1. Surface epithelial stromal tumour
  2. Sex cord stromal tumours
  3. Germ cell tumour
  4. Metastatic tumours
36
Q

Ovarian Neoplasia: Epi

A

Accounts for 30% of female genital tract cancers

37
Q

Ovarian Neoplasia: Aetiology

A

High parity and use of oral contraceptives are associated with reduced risk
7% of women with ovarian cancer have one or more relatives with disease

38
Q

Ovarian Neoplasia: Genetic factors

A

BRCA 1 and BRCA 2 – breast and ovarian

HNPCC

39
Q

Surface Epithelial Tumours: Epithelial subtypes

A

Serous, endometroid, mucinous and transitional

40
Q

Surface Epithelial Tumours: Biological behaviour is dictated by nature of epithelium

A
  1. Benign – ciliated, mucinous or columnar epithelium
  2. Borderline – papillary proliferation without invasion
  3. Malignant (adenocarcinoma) – invasive malignant epithelium – poor prognosis
41
Q

Adenocarcinoma: Epi

A
  • Commonest subtype is serous followed by endometrioid

* Primary mucinous carcinoma of the ovary are rare

42
Q

Adenocarcinoma: Clinical presentation

A

Often advanced disease and ascites (reduced albumin therefore osmotic draw)

43
Q

Adenocarcinoma: Prognosis is

A

Stage dependent

44
Q

Germ cell tumours: histo and epi

A

Histogenesis for primordial germ cells
Hetergenous group of tumours
Accoutn for 30% of ovarian tumours
95% are mature cystic teratoma/dermoid cyst

45
Q

Sex cord Stromal Tumours: Epi

A

Account 8% of all ovarian neoplasms

46
Q

Sex cord Stromal Tumours: Cell of origin

A

Include granulose cells, theca cells, sertoli cells, Leydig cells and fibroblast of stromal origin.

47
Q

Sex cord Stromal Tumours: Can produce

A

Estrogen

48
Q

Metastatic Tumours: Epi

A

Account for 5-10% of ovarian neoplasms

49
Q

Metastatic Tumours: Primary sites include

A 
Stomach
Colon
Appendix
Breast
Pancreas
→Spread as ovary has good blood supply
50
Q

Metastatic Tumours: Krukenberg

A

Metastatic tumour with signet ring forms

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