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Oncology Flashcards

1
Q

pathology associated with ovarian cancer and endometriosis

A

Hobnail cells characterist clear cell ovarian cancer (adenocarcinoma associated with endometriosis)

Hobnail cell “bulbous nuclei that protrude far into the cystic lumen, beyond the apparent cytoplasmic limits of the cell”

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2
Q

pathology grandulosa cell tumors

A

Call-Exner bodies, rosette arragnement of cell around an eosinophilic fluid space.

low grade malg, typically demonstrate indolent growth, unilateral 90%, likely found stage 1

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3
Q

pathology papillary serous tumors

A

psammoma bodies, extracellular round laminar dark eosinophilic collections of calcium

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4
Q

Leydig call tumors

A

crystals found, as cytoplasmic inclusionss

post menopauseal women

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5
Q

Yolk sac tumors

A

10-20% of all malignant ovarian germ cell tumors
dealist form
Schiller duval bodies as pathonomoic

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6
Q

Risk of endometrial cancer at time of hysterectomy with diagnosis of EIN.

A
  • endometrial intraepithelial neoplasia
  • 40%
  • EIN is precursor into adenocarcinoma of the endometrium (increased estrogen)
  • ideally diagnose EIN with hysteroscopy.
  • HYST is diagnosis and treatment
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7
Q

EIN details

A

1) benign (benign endometrial hyperplasia),
2) **premalignant (endometrial intraepithelial neoplasia)
3) malignant (endometrial adenocarcinoma, endometrioid type, well differentiated)

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8
Q

EIN definition chart

A
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9
Q

pathology of choriocarcinoma

A
  • plexiform patterns composed of an admixture of syncytiotrophoblast and cytotrophobloasts
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10
Q

patholgoy of immature teratomas

A

immature neural tissue with rosettes and tubules

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11
Q

pathology dysgerminomas

A
  • germ cell tumor variant

- cytoplasmic glycogen demostrated wtih periodic acid-schiff stain is pathognomonic

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12
Q

complete molar pregnancy

A
  • bilateral ovarian cysts (thecal lutein cysts)
  • high bHGC
  • HTN, PreE, hyperemesis, post molar gestational trophoblastic neoplasia
  • p57 NEGATIVE (partial is positive)
  • villous edema
  • no fetal tissue
  • diploid paternal origin
  • uterus large for dates
  • snow storm/swiss cheese appearance, “diffuse hydropic villi”
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13
Q

risk breast cancer with atypical ductal hyperplasia

A

5%

  • pathologic finding of breast biopsies
  • means substantial increased risk for breast cancer both ipsi and contralateral
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14
Q

Risk ovarian cancer with BRCA 1/2

A

BRCA 1 - 40%

BRCA 2 - 15%

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15
Q

most likely malignant component that could be present in mature dermoid (teratoma) cyst

A
  • squamous cell carcinoma (skin)
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16
Q

partial molar pregnancy

A
  • fetal parts
  • focal cystic changes of the placenta
    ratio fo transverse to anteroposterior dimension of gestational sac >1.5 (larger)
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17
Q

prognostic factor of invasive vulvar cancer

A
  • lymph node mets
  • squamous cell carcinoma
  • vulvar lump on presentation and hx puritis
  • dx via biopsy of dermis and connective tissue so you can evaluate depth of invasion
  • spread via direct extension and hematogenous spread
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18
Q

vaginal cancer

  • upper 2/3 of vagina
  • lower 1/3
A
  • lymph node spread
    • upper 2/3 pelvic nodes
    • lower 1/3 deep inguinal nodes
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19
Q

inflammatory breast cancer

A
  • rare
  • rapid onset of sx
  • lymphatic involvement
  • HPI: breast pain or rapidly growing
  • erythema, edema, peau d’orange
  • duration no more than 6 months
  • occupies at least 1/3 of breast
  • biopsy for dx
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20
Q

ovarian cancer

A
  • transcoelomic spread
  • clockwise spread through perintoneal fluid
  • in addition to lympatic/hematogenous
  • 1.5% overall lifetime risk
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21
Q

heredity breast and ovarian cancer is also assoicated with

A
  • pancreatic, prostate, melaoma
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22
Q

lynch syndrome cancer types

A
  • ovarian, endo, colon (gastric ureteral, pancreatic, glioblastoma, renal pelvis)
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23
Q

Li-Fraumeni cancer associated

A
  • breast cancer
  • colon cancer
  • (other cancers: sarcomas, brain, adrenocortical
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24
Q

Cowden syndrome cancers associated

A
  • breast, endo, colon (benign mucocutanesous lesions, thyoids, gastrointestinal harmartomes)
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25
Q

Peutaz-Jeghers associated tumors

A
  • breast, ovarian, colon (cervical adenoma maligum, gastroinstentinal hamartomas, pancreatic, gastric, small bowel
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26
Q

Hereditary diffuse gastric cancer associated with

A
  • breast cancer, gastric, colorectal
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27
Q
  • Endometrial intraepithelial neoplasm risk cancer after hyst
  • EIN definition
A
  • 45%
  • benign endometrial hyperplasia (non-neoplastic changes due to longer estrogen exposure, anovulation etc).
  • EIN: endometrial precancer, epithelial crowding displaces stroma,
28
Q

clear cell carcinoma quick path

A

hobnail cells

29
Q

dysgerminoma quick path

A

sheets of lymphocytes/germ cells

30
Q

endodermal sinus tumor quick path

A

schiller-duval bodies

31
Q

grandulos cell tumor quick path

A

call-exner bodies

32
Q

serous tumor quick path

A

psammoma bodies

33
Q

brenner tumor quick path

A

wlthard nests, baldder epithelium

34
Q

immature teratoma quick path

A

immature neuroepithelium

35
Q

choriocarcinoma quick path

A

malignant cytotrophoblast/synchtiotrophoblast

36
Q

embryonal carcinoma quick path

A

malignant cytotrophblast/syncytiotrophoblast

37
Q

krukenberg tumor quick path

A

signet cells

38
Q

most prognostic for survival in vulvar cancer (specific)

A
  • inguinofemoral lymph node involvement
39
Q

paget disease breast HPI

A
  • red rash from nipple is the most common
40
Q

ovarian cancer associated with endometriosis

A
  • clear cell adenocarcinoma
  • cured by surgery along
  • 20% are advanced disease and platinum resistent
41
Q

HPV strains

A
  • 16: most commonly associated with cancer
  • 18: also associated with cancer
  • 6/11: genital warts
42
Q

CA-125 increased for

A
  • endometriosis, IBS, pancreatisis, pregnancy (inflammation)

- *not associated with cystitis

43
Q

lifetime risk of ovarian cancer

A

1 in 75

44
Q

MCC ovarian cancer

A

serous

45
Q

HPV gene associated for cancer issue

A

p53

46
Q

path findings for mature and immature teratomas

A
  • mature: many types of differentiated cells

- immature: neuroectoderm

47
Q

MCC endometrial cancer

A

adenocarcinoma

48
Q

Best next step once GTN has been diagnosed with plateaued BETAs

A
  • CXR next step

- no path sample because bleeds so much

49
Q

Granulosa cell tumor

  • path signs
  • makes what output
A
  • call exner bodies (rosette cells around eosinophilic fluid space most commonly associated with adult granulosa cell tumors
  • make estrogen
50
Q

sertoli leydig cell tumors path

A
  • frank virilization in 35% of patients (another 10-15% with mild symptoms)
  • cause menstrual disorders, virilization, non-specific symptoms resulting from an abdominal mass
  • 50% report abdominal pain or abdominal mass
51
Q

ovarian granulosa cell tumor path

A

sheets punctuated by small follicle like structures and coffee bean nuclei (call exner bodies)

52
Q

yolk sac endodermal sinus tumor path

A

invaginated papillary structures with a central vessel (schiller duval bodies)

53
Q

clear cell carcinoma path

A

hobnail cells

54
Q

dysgerminoma path

A

sheets of lymphocytes/germ cells

55
Q

brenner tumor path

A

walthard nests

56
Q

krukenberg path

A

signet cells

57
Q

immature teratoma path

A

immature neuroepthelium

58
Q

choriocarcinoma path

A

malignant cryotrophoblstats/cyncytiotrophooblast

59
Q

treatment stage 3 cervical cancer

A

cisplatin, radiation, brachytherapy

60
Q

What do these secrete

chorio:
dysgerminoma:
Embryonal:
endodermal sinus (yolk sac):
epithelial:
Granulosa:
Mucinous:

A

chorio: hCG
dygerminoma: LDH
Embryonal: hCG, AFP
endodermal sinus (yolk sac): AFP
epethelial: CA-125
Granulosa: inhibit
mucinoous: CEA

61
Q

treatment of placenta site trophoblastic tumor

A

actually hysterectomy (not chemo like chorio)

62
Q

vaginal cancer spread pattern

A

distal 1/3: superficial and deep inguinal nodes&raquo_space;femoral nodes

proximal 2/3: external, internal, and iliac notes

63
Q

vulvar cancer type 1 risk factors

A
  • cigarette smoking
  • HPV
  • younger age
  • hx sexually transmitted infection
  • Pre-existing vulvar intraepithelial neoplasia
64
Q

Reasons for MRI to breast cancer

A
  • history of cheat radiation therapy at age 24 for hodgkin lymphoma
  • BRCA
  • first degree relative of breast cancer genetic mutation carrier, but untested
  • 20% lifetime risk of breast cancer
  • radiation therapy to chest between ages 10-30 years
  • age 25-29 years and known BRCA pathogenic variant
65
Q

1A ovarian cancer popped in the abdomen

A

1C

66
Q

ovarian cancer diagnosis FIGO score

A

Stage 3C

67
Q

HPV independent vulvar cancer risk factors

A
  • Older
  • low association to HPV
  • vulvur atypia
  • keratinizing, squamous cell carcinoma
  • seldom HPV positive
  • vulvar inflammation, lichen sclerosus, squamous cell hyperplasia
  • rarely with condyloma
  • not associated with cigarette smoking

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