Neoplastic Female Flashcards
What would CIN III look like with a thin prep?
Small cells with very high nuclear:cytoplasmic ratio
(Unusual b/c neoplastic cells are usually larger than their non-neoplastic counterparts)
70% of cervical lesions like the one below are caused by:
HPV 16 & 18
(Note the nests of squamous cells + keratin invading the stroma = invasive squamous cell carcinoma)
How might this lesion present?
Asymptomatic or bleeding/cramping
(White, well-defined mass in uterine cavity = think leiomyoma; this one is submucosal, which can cause the above sx)
Dx?
HPV, possibly flat condyloma due to retention of the basal layer
(Cytomegaly + clear cytoplasm = koilocytes)
Most common presenting symptom?
Infertility
(Chocolate cyst of ovary = endometriosis, which causes adhesions/strictures of Fallopian tube)
Management of this patient?
Screen regularly for progression to squamous cell carcinoma
(White vulva = lichen sclerosus)
Most common cause of this lesion?
Unopposed estrogen causing hyperplasia progressing to endometrioid adenocarcinoma
What caused this finding?
Seeding of ovarian carcinoma
(Omental caking)
Dx?
Yolk sac tumor
(Schiller-Duval body = glomeruloid appearance)
Dx?
CIN II
(Big cells with high nuclear:cytoplasmic)
What conditions is illustrated here?
Meig syndrome
(Ovarian fibroma [surface-derived] + pleural effusion + ascities)
A postmenopausal woman has an abnormal pap smear. Her gynecologist takes a cervical biopsy, and the pathologist stains the sample with Ki 67. The results shown below indicate:
She has dysplasia
(If Ki 67 + = cells are dividing; if Ki 67 - = cells are resting, so the atypia would be due to mucosal atrophy)
The most common tumor of the female genital tract histologically looks like:
Cigar-shaped nuclei
(Common appearance of smooth muscle neoplasms like leiomyoma)
Your patient mentions that she has terrible pain when she uses the restroom during her cycle. After several tests, you refer her to surgery, expecting they will find:
Endometriosis in the pouch of Douglas
Dx?
CIN I
(Notice bigger nuclei than normal but still low nuclear:cytoplasmic)
Dx of this cervical biopsy?
Invasive squamous cell carcinoma
(Nests of squamous cells + keratin invading stroma)
Dx of this ovarian biopsy? Sx?
Struma ovarii
Hyperthyroidism sx
(Notice the thyroid tissue to the left, adipose tissue in center, GI tissue to the right = struma ovarii)
