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Neoplastic Path of F Repro Tract Flashcards

1
Q

What are the low risk types of HPV? How is their DNA characterized?

A

6, 11 (episomal viral DNA)

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2
Q

What are the high risk types of HPV? How is their DNA characterized?

A

16, 18, 31, 33, 35, etc. (genomically integrated viral DNA, expression of viral oncogens)

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3
Q

What genes are important in development of high grade dysplasia and invasive cancer?

A

E6 and E7

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4
Q

What type of HPV has E6/E7?

A

16, 18

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5
Q

gene product binds to and causes degeneration of the p53

A

E6

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6
Q

gene product binds to and inactivates Rb protein

A

E7

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7
Q

How do E6 + E7 affect epithelial cells?

A

increase life span

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8
Q

found in 70% of invasive cervical cancers

A

HPV 16, 18

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9
Q

Allows up-regulation of Cyclin E and p16INK4 (prolif promoters)

A

E7 (occurs via binding to + inactivating Rb)

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10
Q

How is original squamous epithelium of cervix characterized (grossly)?

A

smooth, shiny and featureless

squamo-columnar junction separates the squamous epithelium from the villous endocervix

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11
Q

Application of ___ to cervix will identify CIN/SIL.

A

acetic acid

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12
Q

How is Invasive Squamous Cell Carcinoma

of cervix characterized (grossly)?

A

nodular, with bizarre vessels and areas of hemorrhage

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13
Q

How is CIN1characterized?

A

Flat Condyloma with Mild Atypia/dysplasia

basal layer slightly thickened

prominent koilocytes

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14
Q

How is CIN2 characterized?

A

moderate dysplasia

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15
Q

How is CIN3 characterized?

A

severe dysplasia&raquo_space; carcinoma in situ

involves entire thickness of epithelium

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16
Q

What are the Features of Koilocytotic Changes in cervical epithelium?

A 
Cytomegaly
Nucleomegaly
Perinuclear halo
Irreg nuclear mem
Stippled (coarse) chromatin
Increased mitotic activity
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17
Q

Where do viral particles reside within cervical epithelium?

A

intermediate layer

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18
Q

Features of Intraepithelial Dysplasia/ CIN/SIL?

A
  1. Maturation arrest (decreased or missing superficial epithelial cells)
  2. Blurred or missing distinction of basal cell layer
  3. Loss of cellular orientation, polarity
  4. Increased nuclear/cytoplasmic ratio
  5. Hyperchromatic epithelium
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19
Q

This stain can be very helpful to differentiate between atypia associated with postmenopausal mucosal atrophy and true dysplasia:

A

Ki 67 immunostain

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20
Q

Histology of invasive squamous cell carcinoma demonstrates:

A

irregular tumor islands of sq cells
variable amount of keratinization
spindled cell stroma w/ inflmm cells

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21
Q

Survival of Cervical Invasive Squamous Cancer depends on:

A

clinical stage

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22
Q 
Stages Cervical Squamous Cell Carcinoma:
I involves...
II involves...
III involves...
IV involves...
A 
I = cervix
II = upper vagina
III = lower vagina, pelvic wall
IV = bladder, rectum, beyond
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23
Q

CIN Risk Factors:

A
  1. Early age at 1st intercourse
  2. Multiple sexual partners
  3. male partner with multiple previous sexual partners
  4. High parity, family hx, other viruses
  5. Immune status
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24
Q

precursor of cervical cancer

A

CIN

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25
Screening System for cervical cancer involves:
Exfoliative cytology of cervix | Bethesda nomenclature
26
Cervical cancer vaccine uses ____ to increase immunity.
Virus-like particles
27
Survival of Endometrial Cancer is related to:
Stage/Grade age progesterone R activity depth of endometrial invasion
28
What factors correlate with a better prognosis in Endometrial Cancer?
High levels of estrogen and progesterone R in tumor low levels of proliferative activity
29
Benign Tumors of the Uterine Corpus
leiomyoma (smooth muscle) | endometrial stromal nodule
30
Malignant Tumors of the Uterine Corpus
adenocarcinoma of endometrium (endometrioid, serous papillary) mixed mullerian tumors leiomyosarcoma endometrial stromal sarcoma
31
most common tumor of the female genital tract
Leiomyoma
32
Epidemiology of leiomyoma?
>30
33
Histopath of leiomyoma?
markedly elongated smooth muscle cells eosinophilic cytoplasm elongated, cigar-shaped nuclei mitotic figures absent or sparse
34
Abnormal Uterine Bleeding can be caused by:
hormonal abnormality or can be intrinsic to the uterus
35
Abnormal Uterine Bleeding can lead to:
severe anemia
36
cause of ab uterine bleeding in baby girls?
Maternal estrogen
37
cause of ab uterine bleeding in kids?
trauma or tumors
38
cause of ab uterine bleeding in adolescents?
Hypothalamic immaturity inadequate luteal function psychological + nutritional problems
39
Adenomyosis is:
presence of benign endometrial glands and stroma within the myometrium
40
Endometriosis is:
presence of benign endometrial glands and stroma outside the uterus
41
Adenomyosis, histo?
glands are proliferative, but can show secretory changes leading to repeated bleeding and cystic changes
42
Causes of endometriosis?
retrograde menstrual implantation, vascular dissemination and metaplasia
43
Endometriosis can cause:
1. infertility 2. fibrous adhesions or strictures impairing fallopian tube function 3. chocolate cysts” containing old altered blood, on the ovary
44
Why is ovarian cancer usually spread at time of dx?
Early detection is difficult
45
Classification of ovarian tissue is by:
tissue of origin
46
account for over 90% of ovarian neoplasms
Epithelial tumors
46
account for over 90% of ovarian neoplasms
Epithelial tumors
47
Large simple cyst, thin wall and serous fluid content
Benign Serous Cystadenoma
47
Large simple cyst, thin wall and serous fluid content
Benign Serous Cystadenoma
48
Histo of Serous Carcinoma of Ovary
Invasive cell nests forming papillary fronds; Psammoma bodies
49
types of Surface Epithelial Stromal Tumors
Serous Mucinous Endometrioid Transitional cell
50
Granulosa cell tumor, gross pathology
tumor is mustard-yellow with areas of necrosis
51
most common ovarian cancers in kids
Germ cell tumors
52
tumor of germ cell origin that differentiates toward somatic structures
teratoma
53
highly malignant tumor of women under the age of 30 that histologically resembles the mesenchyme of the primitive yolk sac
yolk sac tumor (yeah, sorry)
54
Mature cystic teratoma, gross pathology
The cystic mass has sebaceous content, hair
55
Mature Cystic Teratoma, Microscopy
Keratin, skin, skin appendages and subcutaneous fat tissue
56
Mature Cystic Teratoma, Microscopy
Keratin, skin, skin appendages and subcutaneous fat tissue
57
Germ cell tumors tend to be malignant in:
children
58
types of germ cell tumors
``` Mature cystic teratoma Immature teratoma Dysgerminoma Endodermal sinus tumor (yolk sac tumor) Mixed germ cell tumor ```
59
Granulosa Cell Tumor: Microscopic Pathology
Coffee-bean shaped nuclei, nuclear grooves, | Call-Exner bodies (circular arrangement around sparsely cellular space recapitulating ovarian follicle)
60
When do most granulosa cell tumors occur?
after menopause
61
What do granulosa cell tumors secrete?
inhibin (+ associated w/ estrogen secretion)
62
types of sex cord-stromal tumors
Granulosa cell Tumors of thecoma-fibroma group Sertoli cell Sex cord
63
Histology of benign serous cystadenoma
epithelium is cuboidal-low columnar, ciliated, single-celled layer
63
Serous papillary cystadenocarcinoma, gross pathology
Tan-yellow-white with papillary projections and solid areas.
63
Histo of Serous Carcinoma of Ovary
Invasive cell nests forming papillary fronds; Psammoma bodies
63
types of Surface Epithelial Stromal Tumors
Serous Mucinous Endometrioid Transitional cell
63
Granulosa cell tumor, gross pathology
tumor is mustard-yellow with areas of necrosis
63
most common ovarian cancers in kids
Germ cell tumors
63
tumor of germ cell origin that differentiates toward somatic structures
teratoma
63
highly malignant tumor of women under the age of 30 that histologically resembles the mesenchyme of the primitive yolk sac
yolk sac tumor (yeah, sorry)
63
Mature cystic teratoma, gross pathology
The cystic mass has sebaceous content, hair

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