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MBBS II ERS > L30 - PATHOLOGY OF THE FEMALE GENITAL TRACT > Flashcards

L30 - PATHOLOGY OF THE FEMALE GENITAL TRACT Flashcards

1
Q

List 2 causes inflammation of vulva, vagina?

A

UTI e.g. Candida albicans

STD infection

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2
Q

List 2 non-neoplastic epithelial disorders of vulva and mucosa?

A

Lichen Sclerosis

Squamous hyperplasia

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3
Q

List 3 major types of neoplasm of the Vulva and vagina? ***

A

Adenocarcinoma

Invasive squamous cell carcinoma (SCC)

Vulvar and Vaginal Squamous Intraepithelial Lesion (SIL)

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4
Q

List 2 diseases of cervix caused by low-risk HPV?

A

 Condyloma accuminata (anogenital warts)

 Condyloma planum (flat)

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5
Q

List 4 Risk factors of cervical carcinoma?**

A
  • HPV infection: High risk ***
  • Early marriage and pregnancy
  • Sexual promiscuity and STD
  • Smoking
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6
Q

1 test for HPV status of cervical cancers?**

A

HPV molecular testing

Genotype + detection of HPV

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7
Q

Define the 2 types of Vulvar intra-epithelial neoplasia (VIN) or Vulvar Squamous Intraepithelial Lesion (SIL)?

A

Classic type: asso. with HPV infection

Differentiated type: asso. with chronic irritation such as lichen sclerosis or squamous hyperplasia, NO HPV INFECTION

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8
Q

3 causes of Invasive squamous cell carcinoma at vulva, vagina and cervix?

A

1) High-risk HPV infection&raquo_space; Classic VIN/HSIL&raquo_space; Basaloid or warty SCC
2) Differentiated VIN/SIL&raquo_space; Keratinizing SCC
3) Second malignancy: cervical origin (LSIL/ invasive)

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9
Q

High risk, Low risk HPV genotypes?

A

High risk oncogenic: cause HSIL or CA: genotype 16,18…

Low risk non-ongenic: cause Anogenital warts or LSIL: genotype 6,11

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10
Q

What type of cervical cancer do most HSIL progress to ?

A

Carcinoma&raquo_space; SCC of cervix

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11
Q

Prevention of cervical cancer? (2)

A

Avoid risk factors

HPV Bivalent, Tetravalent, Nonavalent vaccines

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12
Q

How to tell HSIL from invasive cervical cancer?

A

HSIL = No stromal invasion and dissemination

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13
Q

List 4 reasons for the success of cervical cancer screening? exam

A
  • Cervix easily accessible to cytological screening
  • Long period of progression from precursor lesion to invasive cancer
  • Cost-effective cytology test
  • Effective early treatment
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14
Q

List 2 main forms of Adenocarcinoma of Vulva and Vagina?

A

Extramammary Paget’s disease

Primary Adenocarcinoma (asso. w/ DES exposure + Vaginal adenosis)

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15
Q

2 detection technique for cervix carcinoma?

A
  1. Exfoliative cytology “Pap smear”: scraping the squamo-columnar junction
  2. Colposcopy and biopsy: identify cervical neoplasia
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16
Q

Endocervical polyp: presentation?

A

Single polyp

Usually asymptomatic/ vaginal bleeding or discharge

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17
Q

Histological features of SIL in the Cervix? Location?

A

@ Transformation zone of Cervix

Malignant features:
increase in N:C ratio, nuclear pleomorphism, increased and abnormal mitotic figures

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18
Q

List 4 common diseases of Cervix? (3 = major types of cervical neoplasia)

A

Endocervical polyp

Squamous Intra-epithelial Lesion (SIL)

Invasive SCC

Adenocarcinoma

19
Q

Gross feature, 2 spread + 2 complication of Invasive SCC in cervix?

A

Ulcerative, indurated

Local invasion of pelvic structures + LN spread

Ureter obstruction + Renal failure

20
Q

Cervical Adenocarcinoma Location in cervix? Ddx from SIL, SCC?

A

endocervical epithelium = Adenocarcinoma

Ddx: Transformation zone = SIL, SCC

21
Q

3 Causes of Endometrial hyperplasia? progression to which cancer?

A

Hyper-estrogen stimulation:

1) Functioning ovarian tumours
2) Repeated anovulatory cycles
3) Prolonged exogenous estrogen use (e.g. Tamoxifen)

Atypical hyperplasia&raquo_space; Endometrial ADENOCARCINOMA

22
Q

5 Risk factors not causes of endometrial hyperplasia and endometrial carcinoma?

A

obesity, diabetes, hypertension, infertility

Genetic: Hereditary nonpolyposis colorectal cancer (HNPCC)

23
Q

Compare the 2 major types of endometrium carcinoma?

A

Type I: endometrioid, hyper-estrogen stimulation, indolent

Type II: serous, clear cell, not high oestrogen, aggressive with poor prognosis

24
Q

Spread of endometrium carcinoma?

A

Local: myometrium, parametrium, fallopian tubes, ovaries, vagina and pelvis

Para-aortic LN involvement

25
Q

List 2 examples of endometrial stroma tumours?

A

Stromal Sarcoma

Mixed mullerian tumours

26
Q

Cell origin of Gestational Trophoblastic Diseases? List some examples of GTDs?

A

origin = placental trophoblasts

hydatidiform mole, invasive mole, choriocarcinoma, PSTT, ETT

27
Q

List 3 major neoplasms arising from Myometrium of uterus? **

A

-Adenomyosis

Smooth muscle tumours:

  • Leiomyoma common
  • Leiomyosarcoma
28
Q

Gross morphology of Myometrium Adenomyosis?

Presentation?

A

nests of endometrial glands and stroma

Enlarged uterus with whorled surface + cystic space with blood

menorrhagia or dysmenorrhoea

29
Q

Myometrium Leiomyoma: number, sites and extent of involvement, gross morphology?

A

multiple, @ smooth muscle

white, whorled, Well-circumscribed spherical nodules

30
Q

Compare the gross morphology of Leiomyosarcoma with Leiomyoma of Myometrium?

A

Leiomyosarcoma = less well-demarcated with more necrosis and hemorrhage + malignant cell features

31
Q

Cause and Complications of Fallopian tube inflammation?

A

Infection-caused inflammation: Acute, Chronic, Granulomatous

Impair fertility
Ectopic pregnancy

32
Q

List the spectrum of diseases at the Fallopian tube? (4) **

A

Inflammation (Infective)

Ectopic pregnancy (rupture = emergency)

Endometriosis

Tumours

33
Q

Most common primary fallopian tube tumour?

A

Papillary adenocarcinoma

34
Q

Most common cause of ovarian enlargement? Presentation?

A

Non-neoplastic cysts:

e.g. follicular cysts, corpus luteum cysts

Asymptomatic/ Torsion, Hemoperitoneum, Pain, Infarct

35
Q

Divide Ovarian neoplasms into 5 types?

A
  • Surface Epithelial Tumours
  • Germ Cell Tumours
  • Sex Cord Stromal Tumours
  • Metastatic tumours
  • Miscellaneous - e.g. Lymphoma
36
Q

Genetic risk factors of ovarian surface epithelial tumours?

Presentation?

A
  • Breast and Ovarian Cancer syndrome
  • HNPCC

Pelvic mass, Malignant ascites, Metastatic symptoms

37
Q

List 5 surface epithelial tumours of ovary?

A 
Serous tumour 
Mucinous t 
Endometrioid t 
Brenner t 
Clear cell t
38
Q

List 5 types of germ cell tumours of the ovaries?

A
  • Dysgeminoma (=seminoma)
  • Embryonal carcinoma
  • Teratoma
  • Yolk sac tumour
  • Choriocarcinoma
39
Q

Epidemiology of ovarian germ cell tumours?

A

Children = >60% of all ovarian neoplasms, 1/3 malignant

Adult = rare, mature cystic teratoma, all benign

40
Q

How to tell borderline ovarian surface epithelial tumour from benign/ malignant?

A

Borderline = low malignant potential

Different from the benign tumour:

  • presence of epithelial budding
  • increased mitotic activity
  • nuclear atypia

Different from malignant:
- no destructive stromal invasion

41
Q

List 3 major sex cord stromal tumours?

A

a) Granulosa cell tumour
b) Thecoma -Fibroma
c) Sertoli -Leydig cell tumour

42
Q

3 subtypes of teratoma of ovaries?

A

(i) Mature Cystic teratoma
(ii) Immature teratoma
(iii) Teratoma with malignant transformation eg. SCC

43
Q

List 2 germ cell tumours of ovaries that occurs in young women?

A

Dysgerminoma

Yolk Sac Tumour

44
Q

Which malignant cancers commonly metastasize to ovaries?

A

carcinoma of breast, lower genital tract and gastrointestinal tract

MBBS II ERS (37 decks)

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