Path 2

Question 1

autoimmune ECM1, HLARQ7-9; superficial hyperkeratosis, no rete ridges, hydropic basal cells; fusion of labias, clit, introitus scar. sl inc risk of vulvar SCC

Answer 1

lichen sclerosus

Question 2

emotional/itch -> leathery thickened skin, sq cell hyperplasia w/ no atypia

Answer 2

lichen simplex chronicus

Question 3

MRSA, E coli, peptostrep + bacteroides cause this

Answer 3

vulvar abscess

Question 4

bartholin cyst/abscess caused by?

Answer 4

gonorrhea, E coli + bacteroides

Question 5

Papillary hidadrenoma

Answer 5

from HPV; red nodule in inter/labia w/ double layered epith: top = columnar glandular epith pos for CK7, bottom = flat myoepith cells pos for actin

Question 6

eczema-like scaly sl raised red edges in vulvar area, from apocrine glands -> mucus-producing neoplastic cells

Answer 6

vulvar extramammary Paget

Question 7

vulvar or vag (ant distal third) melanoma mets by?

Answer 7

can mets via hematogenous

Question 8

know 3 types of vulvar SCC

Answer 8

basaloid, warty; keratinizing

Question 9

ovarian stromal hyperplasia vs ovarian hyperthecosis

Answer 9

prolif stromal cells w/ scant cyto w/o luteinization vs prolif stromal cells w/ abundant cyto w/ luteinization. both produce excess androgen

Question 10

GCT: dysgerminoma vs yolk sac tumor vs chorioca

Answer 10

isochrom12p, KIT; lg undifferentiated germ cells w/ glycogen rich cyto & thin fibrous septa vs primitive epith cells w/ glycogen rich cyto; schiller-duval bodies vs cytiotropho -> mononucleated, clear cyto; syncytiotropho -> hyperechromatic nucli, baso cyto

Question 11

which GCT has high LDH & BHCG w/ fried egg appearance?

Answer 11

dysgerminoma & seminoma

Question 12

sertoli vs leydig vs granulosa tumors

Answer 12

male sex stromal tumors: hormonally silent or estrogen, no atypia, fibrous stroma vs Reinke rhomboid inclusions, testosterone or estrogen, yellow/tan, lots eos cyto vs Call/Exner bodies, coffee bean sign, lightly eos cyto, juvenile & adult type

Question 13

HPV 16/18, verrucous papules w/ hyperkeratosis, koilo, acanthosis, melanin pig

Answer 13

bowenoid papulosis

Question 14

4 forms of HGPIN. This is a precursor to? What else is over-expressed in PAC?

Answer 14

Tuft, micropapillary, cribriform, flat. PAC. AMACR mito and peroxisome enzyme

Question 15

Primary intraepothelial & secondary epidermoidtropic; eczema, mucin secreting; pos for PAS, alcian blue, mucicarmine

Answer 15

Vulvar extra mammary Paget

Question 16

Pelvic vs extra pelvic endometriosis. Immuno chem for endometriosis

Answer 16

Superficial peritoneal: serosa, blue/black powder lesion; ovarian endometrioma: chocolate cyst; deep infiltrating: rectal, sigmoid vs upper abd or diaphragm -> hemoptysis, hematochezia, hematuria. CK 7/18, E/P (colon ca is CK20 pos)

Question 17

Type I vs II endometrial carcinoma

Answer 17

Estrogen sensitive. PTEN, MMR, MSH1/2/6, ARID1A, POLE vs not estrogen sensitive; grade 3 endometrial ca, clear cell ca, serous ca, carinosarcoma; all ER/PR neg. PPP2R1A