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Human Development 2 > Microanatomy > Flashcards

Microanatomy Flashcards

1
Q

What does CIN refer to

A
  • this refers to the spectrum of epithelial changes the take place in the squamous epithelium as the precursors of invasive squamous carcinoma
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2
Q

how is CIN graded

A
  • severity of the lesion is graded as 1, 2 and 3, this is according to the level in the epithelium at which the cytoplasmic maturation is taking place
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3
Q

what is squamous neoplasia of the cervix associated with

A

Sexual activity

  • early age of first intercourse
  • frequency of intercourse
  • number of sexual patterns
  • sexual behaviour of male partner
  • HPV infection
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4
Q

what increases the risk of probability of HPV infection

A
  • family history of cervical neoplasia
  • wives of men with carcinoma of the penis
  • urban areas
  • cigarette smoking
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5
Q

How many different types of HPV are there

A

greater than 100

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6
Q

what types of HPV are associated with genital warts

A

HPV 6 and 11

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7
Q

what HPV types are associated with carcinoma

A

HPV 16, 18, 31, 33,

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8
Q

How does HPV cause cancer

A
  • Papillomavirus DNA is incorporated into the host genome
  • this produces the proteins E6 and E7 which form complexes with anti-oncogenes such as p53 and retinoblastoma thereby inactivating the normal cellular response to DNA damage
  • this results in accumulation of genetic abnormalities
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9
Q

what type of cancer does HPV cause

A

vulval and vaginal intraepithelial neoplasia

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10
Q

what investigations should be carried out in breast cancer diagnosis

A
  • mammogram
  • ultrasound
  • fine needle aspiration cytology
  • core biopsy
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11
Q

How do negating Masses differ in appeared from malignant ones

  • growth rate
  • shape
  • edge/border
  • relation to neighbouring structures
  • resemblance to normal
  • morphology
  • invasion
  • metastasis
A

Benign

  • growth rate = slow
  • shape = rounded/ovoid
  • edge/border = smooth
  • relation to neighbouring structures = pushing growth, easy to shell out
  • resemblance to normal = close
  • morphology = no, atypia/necrosis, low mitotic activity
  • invasion= no
  • metastasis = never

malignant

  • growth rate = rapid
  • shape = irregular
  • edge/border = infiltrative
  • relation to neighbouring structures = tethered to surrounding structures
  • resemblance to normal = variable can be good to poor
  • morphology = atypia, necrosis, high mitotic activity
  • invasion = yes
  • metastasis = frequent
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12
Q

What are the different types of benign and malignant tumours

  • squamous epithelium
  • glandular epithelium
  • transitional epithelium
  • smooth muscle
  • striated muscle
  • adipose tissue
  • cartilage
  • bone
  • blood vessels
A

Benign

  • squamous epithelium = squamous cell papilloma
  • glandular epithelium = adenoma
  • transitional epithelium = transitional cell papilloma
  • smooth muscle = leiomyoma
  • striated muscle = rhabdomyoma
  • adipose tissue = lipoma
  • cartilage = chondroma
  • bone = osteoma
  • blood vessels = angioma

Malignant

  • squamous epithelium = squamous cell carcinoma
  • glandular epithelium = adenocarcinoma
  • transitional epithelium = transitional cell carcinoma
  • smooth muscle = leiomyosarcoma
  • striated muscle = rhabomosacroma
  • adipose tissue = liposarcoma
  • cartilage = chondrosarcoma
  • bone = osteosarcoma
  • blood vessels = angiosarcoma
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13
Q

what is breast cancer common age

A

before age of 30

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14
Q

what is the most commonest being tumour of the breast and where does it arise

A

Fibroadenoma

- arises in the breast lobule

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15
Q

what are the clinical features of a breast tumour/ fibroadenoma

A
  • present as a mobile mass in the breast

- multiple in 20% of cases

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16
Q

what is the treatment of a fibroadenoma

A
  • no Treatment in some cases if it is small

- surgical excision this can usually be shelled out easily

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17
Q

what does a fibroadenoma look like

A

circumscribed tumour

lobulated appearance

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18
Q

what is the prognosis of an ovarian adenocarcinoma

A
  • very poor

- 5 year survival of about 25%

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19
Q

describe adenocarcinoma facts

A
  • 90% of all ovarian malignancy s
  • 6th in frequency of cancer in women, disproportionate number of fatal malignancies
  • asymptomatic until they have reached a large size
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20
Q

where does the adenocarcinoma come from

A

fallopian tube origin is most of ovarian carcinoma

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21
Q

what is the function of the ovary

A

To produce gametes or ova

  • develop from special sperm germ cells called oocytes
  • present within the ovary from birth

To produce the female sex hormones oestrogen and progesterone

  • causes development of female sexual characteristics
  • support development of the early embryo in early pregnancy
  • produced by the specialises stomal cells of the ovary
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22
Q

how do you classify ovarian tumours

A

– three major types are classified according to their cell of origin

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23
Q

what are the three major categories of ovarian tumours

A

Epithelial tumours

germ cell tumours

sex cord stromal tumors

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24
Q

give example of epithelial tumours in the ovary

A
  • serous
  • mutinous
  • endometroid
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25
Q

give example of germ cell tumours in the ovary

A
  • teratoma
  • yolk sac tumour
  • dysgerminoma
  • embryonal carcinoma
  • choriocarcinoma
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26
Q

give example of sex cord stomal tumours in the ovary

A
  • granulose cell tumour
  • thecoma-fibroma
  • sertoli-leydig cell tumour
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27
Q

what type of epithelium lines the cervix

A
  • simple columnar epithelium with deep invagination called cervical glands
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28
Q

What is the part of the cervix that projects into the vaginal cavity

A

ectocervix

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29
Q

what is the epithelium of the ecotcervix

A
  • striated squamous epithelium
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30
Q

what epithelium is in the vagina

A
  • striated squamous epithelium
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31
Q

the cervical epithelium responds….

A

differently to sex steroids than that of the uterine body (the endometrium) and is not shed at menstruation

32
Q

what do the hormonal factors do to the shape and volume of the cervix

A
  • they alter the shape and volume of the cervix
33
Q

what happens to the cervix at puberty and pregnancy

A
  • changes occur with the eversion (turning inside out) of then endocervical columnar epithelium onto the ectocervix
  • the protrusion of the endocervical epithelium forms what is referred to as the endocervical columnar ectropion
  • thus at punters the original squamous-columnar junction becomes relocated outside the external os
  • in response to the acidic conditions of the vaginal vault areas of ectropion are replaced with stratified squamous epithelium by metaplasia involving stages of reverse cell hyperplasia and immature metaplastic epithelium
34
Q

what is the region of metaplastic epithelium called

A

transformation zone

35
Q

where do the majority of cervical cancers arise

A

the transformation zone of the cervix

36
Q

how do you screen for cervical cancer

A
  • take a sample of epithelial cells at the transformation zone using a brush or spatular
  • apply the to a slide
  • stain with papanicolaou stain followed by microscopy for cellular abnormalities
37
Q

how does liquid base cytology work for cervical cancer screening

A
  • it improves the effectiveness of analysis
  • LBC involves transferring the collected cells into a liquid preservative and centrifuging to remove obscuring materials such as pus or blood before reconstituting the cells
  • deposit them thinly onto a slide for staining and analysis
38
Q

what are the types of cervical cancers

A

80% of being squamous cell carcinoma
15% adenocarcinoma
- the remainder are Aden-squamous and neuroendocrine carcinomas and these are caused by high oncogenic risk GPV

39
Q

what HPV is the most common in squamous cell carcinomas and adenocarcinomas

A

Squamous cell carcinomas HPV16

adenocarcinomas HPV18

40
Q

how does HPV infects

A

HPV infect immature basal cells through epithelial breaks caused by damage
- this can directly infect metaplastic squamous epithelium but it cannot infect mature superficial squamous epithelial cells

41
Q

what occurs in the mature superficial squamous epithelial cells

A
  • infection does not occur in maturing cells but replication does
  • virus needs to activate cellular mitosis to accomplish DNA synthesis
42
Q

what are the characteristic signs of HPV

A
  • nuclear atypia

- pronounced clearing of cell cytoplasm forming a perinuclear halo = cells showing this effect are called koilocytes

43
Q

what do dyskaryotic changes to the nucleus consist of

A
  • disproportionate nuclear enlargement
  • irregularity in form and contour
  • hyperchromasia
  • irregular chromatin condensation
  • abnormalities in number, for, and size of nucleoli
  • multinucleate
  • nucleus to cytopaslm ratio increases as dyskaryosib prowesses so exfoliated cells with severe dysplasia most resemble immature basal cells
44
Q

describe the grading system to cancers in epithelum

A

Dyplasia limited to lower third of epithelium

  • mild dysplasia
  • CNI
  • mild dykaryosis
  • Low grade SIL

dysplasia limited to lower 2/3 of epithelium

  • moderate dysplasia
  • CIN 2
  • moderate dsykaryosis
  • high grade SIL

Dysplasia extend into upper third of the epithelium

  • severe dysplasia
  • CIN3
  • severe dyskaryosis
  • High grade SIL
45
Q

what do invading cells have an appearance of

A

typically they have an appearance of squamous cell carcinoma instead of a overlying dysplastic epithelium

46
Q

what is HPV 2 and 7 associated with

A

common warts

47
Q

where do most of the breast cancers originate from

A

the terminal duct lobular unit (TDLU)

48
Q

within the breast how many glands form lobes

A

15-25 compound areolar mammary glands form lobes

49
Q

what is the functional secretory unit of the breast

A

Terminal duct lobular unit

- comprised of lobules with an secretory acing arising from an extra lobular terminal duct

50
Q

describe anatomy of the breast

A

15-25 compound areolar mammary glands form lobes

distally large lactiferous ducts dilate forming the lactiferous sinuses before exiting at the nipple

Terminal duct lobular unit
- comprised of lobules with an secretory acing arising from an extra lobular terminal duct

51
Q

what two types of connective tissue is the storm of the breast made up of

A

1, interlobular stroma = this is comprised of a dense fibrocollagenous tissue mixed with adipose tissue
2, intra lobular stroma - this is comprised of a looser fibrocollagneous tissue contains hormonally responsive breast-specific fibroblasts important in mammary gland remodelling for example in pregnancy

52
Q

what is the difference between interlobular stroma and intra lobular stroma

A

1, interlobular stroma = this is comprised of a dense fibrocollagenous tissue mixed with adipose tissue

2, intra lobular stroma - this is comprised of a looser fibrocollagneous tissue
- contains hormonally breast specific fibroblasts

53
Q

What two types of cells line the ducts and lobules

A
  • secretory and duct epithelium

- myopeithelial cell

54
Q

what do the secretory and duct epithelium produce

A
  • they produce milk which is transported to larger excretory ducts
55
Q

what to the myoepthelial cells do

A
  • they are on the same basement membrane as the epithelial cells
  • form a mesh like complex
  • stimulated to contract by oxytocin released from the posterior pituitary gland as a result of suckling
  • milk is propelled through the duct system and released
56
Q

what stimulates the development of the breast at puberty

A
  • oestrogen
57
Q

what happens to the breast in the follicular phase and then after ovulation

A
  • oestrongen stimulates growth of ductule components
  • after ovulation progesterone causes growth of secretory alveoli and the interlobular stroma which becomes oedematous
  • then epithelial apoptosis ensues at the end of the cycle
58
Q

when do women experience an increase in breast massive

A
  • they experience a progressive increase in breast mass during the luteal paste and tenderness about 7-14 days after ovulation
59
Q

what happens to TDLUs in pregnancy

A
  • oestrogen and progesterone cause a dramatic increase in TDLUs
  • prolactin, human placenta lactose and adrenal steroids are also important hormones in this growth
    falling levels of estrange and progesterone following birth enable prolactin to stimautle milk production
60
Q

what happens to the breast tissue with ageing

A
  • with ageing from approximately age 30 and through menopause the breast lobules involute and can nearly complete atrophy in the elderly
  • adipose is more prominent
  • lobules decrease in size and in number
61
Q

where do benign tumours originate from

A

specialised fibroblasts of the TDLU

- looks liked specialised stream fibroma with entrapped glands

62
Q

what is the ovary a common site for

A

it is a common site for metastatic carcinoma arising from the gut or other parts of the reproductive system

63
Q

where do epithelial tumours of the ovary arise from

A
  • they arise from the mesothelial cell layer covering the peritoneal surface of the ovary and associated inclusion cysts
  • there is incorporation of these overlying cells at ovulation when the surface rupture heals and the cells are believed to de-differentiate toward fetal precursor coelomic epithelium
64
Q

describe what epithelial tumours of the ovaries can resemble

A

differentiate to resemble tubal mucosa(serous tumours), endocervical mucosa(mutinous tumours) or endometrium(endometriosis tumours)

65
Q

describe what epithelial tumours are like and where they project

A
  • cystic with solid components
  • smooth surface or be covered in papillary projections
  • spread is often into the peritoneal cavity
66
Q

what are ovarian epithelial tumours divided into

A

Benign
boderline
malignant

67
Q

what distinguished between the different types of ovarian epithelial tumours

A
  • extend of epithelial proliferation distinguishes between benign and borderline ( borderline tumours also exhibit nuclear atypia)
  • cells in malignant tumours have marked nuclear atypia, loss of glandular architecture and differentiation
68
Q

what are malignant tumours by definition

A

tumours that show invasion of the underlying stroma

69
Q

what makes up 40% of ovarian carcinomas

A
  • serous adenocarcinoma

- most common malignant ovarian tumour

70
Q

what are most germ cell tumours

A
  • most are benign mature cystic teratomas

- remainder are malignancy

71
Q

describe what mature teratomas look like

A
  • Cystic structure
  • contains well differentiated ectodermal components (skin and appendanges including hair_
  • sebaceous glands
  • teeth
  • neural tissue
72
Q

What are dysgerminomas

A

these are germ cell tumours that resemble seminomas in the male testis

73
Q

Describe the anatomy of a dysgerminoma

A
  • these undifferentiated germ cell tumour is composed of sheet or cords of cells separated by a scant fibrous stroma that shows inflammatory infiltration by lymphocytes
74
Q

where are sex cord stroma tumours derived form

A

they are derived from ovarian stroma that originates from the sex cords of the embryonic gonad

  • tumours may diffenriate towards sertoli and Leydig structures int he male
  • or granulose and theca cells in the female
75
Q

what do sex cord stomal tumours produce

A
  • they produce hormones including excessive oestrogen in the case of thecfmas and grnaulosa cell tumours
  • or androgen in sertoli-leydig cell tumours
76
Q

what is the most common type of sex cord stomal tumour

A

thecomas (Benign) most common class

- cells show a foray cytoplasm due to large number of lipids droplets in their cytoplasm

77
Q

what are Granulose cell tumours composed of

A
  • grnaulosa cell tumours are composed of cells with morphology like normal grnaulosa cells
  • sometimes look like clusters that resemble immature follicles
  • granulose cell tumours have distinct potential for malignancy and make up about 5% of malignant ovarian tumours

Human Development 2 (34 decks)

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