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[PATHO] REVISION 2 Flashcards

1
Q

purulent inflammation 2ry to introduction of bacteria from uterine cavity to tubal lumen

A

acute salpingitis

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2
Q

MC causative agent of acute salpingitis

A

Neisseria gonorrhea

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3
Q

acute salpingitis gross picture

A

tube is swollen congested
lumen filled w/ pus

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4
Q

acute salpingitis microscopic picture

A

acute inflammatory process
polymorphs & pus cells

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5
Q

chronic non specific salpingitis gross picture (4)

A

1-tube is irregular, distended
2-fibrous adhesion over serosal surface
3-permanent bridging b/w plicae
4-wall infiltrated by lymphocytes + plasma cells

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6
Q

salpingitis complications (5)

A

1-extension–> pelvic peritonitis
2-extension–>tubo-ovarian abscess
3-chronicity—> hydrosalpinx/ pyosalpinx
4-if bilateral–>sterility
5-ectopic pregnancy

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7
Q

if chronicity of salpingitis is mild this leads to

A

hydrosalpinx

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8
Q

if chronicity of salpingitis is severe this leads to

A

pyosalpinx

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9
Q

TB salpingitis gross picture (3)

A

1-serosal tubercles
2-tube is elongated, nodular, irregularly distended
3-adhesions to nearby organs

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10
Q

TB salpingitis microscopic picture

A

caseating granuloma

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11
Q

tubal pregnancy gross picture

A

tube distended by hemorrhagic clot enmeshing chorionic villi

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12
Q

tubal pregnancy fate

A

1-abortion
2-rupture & intraperitoneal bleeding

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13
Q

tubal pregnancy pathogenesis

A

1-factors ↑ tubal receptibility (endometriosis)
2-factors blocking zygote passage to uterine cavity (chronic salpingitis/ congenital tubal diverticulae)

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14
Q

purulent inflammatory process following introduction of neisseria gonorrhea from uterine cavity to tubal lumen

A

acute salpingitis

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15
Q

obliteration of fimbriated end w/ dilatation of tube
wall is whitish, thin, translucent
tube contains clear serous fluid

A

hydrosalpinx

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16
Q

uterus is enlarged
mass of grapelike structures of translucent white cysts
no fetal parts
weighs > 200g
hydropic swelling of chorionic villi
chorionic villi filled w/ avascular loose myxoid stroma
hyperplastic sheets of cytotrophoblasts & syncytiotrophoblasts
cytologic atypia is present

A

complete hydatidiform mole

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17
Q

obliteration of fimbriated end w/ dilatation of tube
wall is thick & opaque
lumen distended w/ pus

A

pyosalpinx

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18
Q

tubes are swollen & congested
lumen is filled w/ pus
tubes show polymorphs & pus cells

A

acute salpingitis

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19
Q

tube is distended, irregular
fibrous adhesions on serosal surface
healing & organization
permanent bridging b/w plicae
lymphocytes & plasma cells

A

chronic salpingitis

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20
Q

blood borne organism lodged in tubes
tube is elongated, nodular, irregularly distended
adhesions to nearby organs
serosal tubercles
caseating granuloma

A

TB salpingitis

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21
Q

MC routes of lymphatic spread in TB salpingitis

A

intestinal
bladder

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22
Q

tube is distended w/ hemorrhagic clot enmeshing chorionic villi

A

tubal pregnancy

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23
Q

uterus may be enlarged
few vesicles
few fetal parts seen
villous edema of some villi
trophoblastic proliferation is focal & slight

A

partial hydatidiform mole

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24
Q

gross picture of complete hydatidiform mole (4)

A

1-usually uterus is enlarged
2-grape-like structures of thin translucent cysts
3-NO fetal parts
4-weighs> 200g

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25
Q

complete hydatifirom mole microscopic picture (4)

A

1-hydropic swellings of chorionic villi
2-chorionic villi filled w/ avascular loose myxoid stroma
3-hyperplastic sheets of cyto & syncytiotrophoblasts
4-cytologic atypia

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26
Q

complete hydatiform complications

A

choriocarcinoma
invasive mole

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27
Q

invasive mole micro picture

A

chorionic villi show active proliferation of both cyto & syncytiotrophoblasts

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28
Q

grape like clusters in uterine cavity

A

complete hydatidiform mole

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29
Q

hyperplastic sheets of cyto & synctiotrophoblasts

A

complete hydatidform mole

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30
Q

uterine bleeding
possible rupture of uterus
abortion
↑ hCG
complete mole
penetrates myometrium & can perforate uterine wall
villi show active proliferation to cyto & syncytiotrophoblasts

A

invasive mole

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31
Q

large hemorrhagic necrotic mass destroying uterine wall
invades uterine wall, BV, lymphatics
no stroma
no BV
no chorionic villi formed
extravasated blood & necrosis
contains cytotrophoblasts & synyctial cells
invades

A

choriocarcinoma

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32
Q

choriocarcinoma spread

A

lungs
liver
vulva
vagina

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33
Q

polymorphs & pus cells seen in

A

acute salpingitis

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34
Q

lymphocytes & plasma cells seen in

A

chronic salpingitis

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35
Q

cytotrophoblasts & syncytiotrophoblasts seen in

A

1-complete mole
2-partial mole
3-invasive mole

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36
Q

cytotrophoblasts & syncytial cells seen in

A

choriocarcinoma

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37
Q

cannon ball appearance seen in

A

choriocarcinoma spread to lungs

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38
Q

coffee bean nucleus seen in

A

cuboidal cells of granulosa cell tumor

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39
Q

tuboovarian abscess gross picture (2)

A

fibrotic wall
cavity containing purulent material

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40
Q

wall of ovary is fibrotic
cavity filled w/ purulent material
necrosis
granulation tissue
inflammatory cell infiltration
fallopian tube bound to ovary in distorted mass

A

tubo-ovarian abscess

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41
Q

tubo-ovarian abscess micro picture (3)

A

necrosis
granulation tissue
inflam cell infiltration

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42
Q

chronic granulomatous oophritis caused by

A

TB
Bilharziasis

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43
Q

MC cause of enlarged ovaries

A

cysts

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44
Q

palpable ovarian mass
pelvic pain
menstrual abnormalities
↑estrogen
unilocular cyst 1-5cm
outer surface is smooth
thin wall
cyst contains clear serous fluid
cyst lined by granulosa cells surrounded by theca internal cells

A

follicular cysts

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45
Q

follicular cyst gross picture (7)

A

1-unilocular
2-1-5 cm
3-unilateral/ bilateral
4-single/multiple
5-smooth outer surface
6-thin wall
7-filled w/ clear serous fluid

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46
Q

follicular cyst micro picture

A

lined by granulosa cells surrounded by theca interna cells

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47
Q

follicular cysts originate from

A

unruptured graafian follicle
or
follicle which had ruptured & immediately sealed

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48
Q

corupus luteum cyst orignates from

A

delayed resolution of corpus luteum

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49
Q

corpus luteum gross picture (2)

A

1-unilocular 3-6 cm
2-yellow festooned lining

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50
Q

corpus luteum cyst micro picture

A

lined by luteinizing granulosa cells
that may be hemorrhagic

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51
Q

estrogen secreting cyst

A

follicular cyst

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52
Q

progesterone secreting cyst

A

corpus luteum

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53
Q

menstrual irregularities
↑ progesterone
cyst diameter: 3-6cm
cyst lined w/ luteinizing granulosa cells
unilocular cysts w/ yellow festooned lining

A

corpus luteum cyst

54
Q

patient taking gonadotropin therapy for infertility/pregnant/ pt w/ choriocarcinoma/ pt w/ hydatidiform mole
hyperplastic luteinized theca interna cells
Hg & rupture
may require surgical intervention

A

theca lutein cyst

55
Q

theca lutein cyst forms due to

A

↑ gonadotropins

56
Q

PCOS gross picture (3)

A

1-both ovaries enlarged 2-5x their original size
2-capsule is thickened
3-capsule is studded w/ multiple small cysts

57
Q

PCOS micro picture(4)

A

1-thickened T.albuginea
2-cysts lined w/ granulosa cells & hyperplastic luteinizing theca interna cells
3- no corpora luteum
4-no T. albicantia

58
Q

Cl/P of PCOS

A

1-hyperoestronism
2-Stein-leventhal $
3-virilism

59
Q

hyperoestronisim

A

↑estrogen + irregular bleeding

60
Q

stein leventhal $

A

2ry amenorrhea
sterility
PCOS

61
Q

virilism

A

progressive hirustism
voice changes
breast atrophy

62
Q

ovarian endometriosis gross picture (4)

A

1-punctate red-brown spots or patches w/ dense fibrous adhesions
2-thick fibrotic cyst wall
3-shaggy/smooth red-brown inner lining
4-cyst filled w/ red-brown chocolate material

63
Q

ovarian neoplasm can be lethal dt

A

late symptoms & detection

64
Q

ovarian neoplasms RF

A

nulliparity
family history
genetic mutation in BRACA 1&2

65
Q

genetic mutation possibly leading to ovarian neoplasms

A

BRACA 1&2 mutation
(suppressor genes)

66
Q

punctate red brown spots
patches w/ dense fibrous adhesions
thick fibrotic cyst wall
smooth/ shaggy red-brown inner lining
cyst contains red brown chocolate material

A

ovarian endometriosis

67
Q

type I ovarian tumors progression

A

benign neoplasms–>borderline tumors–>low grade carcinoma

68
Q

Type II ovarian tumors progression

A

inclusion cysts from ovary/fallopian tube via STIC –>high grade serous tumors

69
Q

STIC

A

serosal tubal intraepithelial carcinoma

70
Q

surface epithelial tumors derived from

A

coelomic mesothelium

71
Q

surface epithelial tumors form dt

A

repeated ovulation–>surface scarring–>mesothelium pulled into ovarian cortex–>epithelial cysts—>metaplasia & neoplastic transformation—> surface epi tumors

72
Q

serous tumors types

A

benign
borderline
malignant

73
Q

benign serous cystadenoma gross picture (5)

A

1-thin walled distended unilocular cysts
2-clear straw colored fluid
3-unilateral
4-smooth outer+inner surfaces
5-may be: serous cystadenofibroma/ papillary serous cystadenoma

74
Q

benign serous cystadenoma w/ stromal fibrous component=

A

serous cystadenofibroma

75
Q

benign serous cystadenoma w/ exophytic/ endophytic papillae

A

papillary serous cystadenoma

76
Q

benign serous cystadenoma micro picture

A

cyst lined w/ cuboidal epi/columnar partially ciliated epithelium resembling fallopian tubes

77
Q

borderline serous cystadenoma micro picture

A

cytological atypia
NO stromal invasion

78
Q

malignant serous cystadenoma micro picture

A

cytologic atypia + stromal invasion
PSAMMOMA BODIES

79
Q

mucinous tumors gross picture (7)

A

1-ovoid/lobulated
2-outer surface is smooth
3-thick fibrotic wall
4-unilateral
5-multilocular
6-variable sized locules separated by fibrous tissue septa
7-filled w/ mucinous fluid

80
Q

mucinous tumor types

A

benign
borderline
malignant

81
Q

benign mucinous tumor micro picture

A

1-lined by tall columnar cells
2-basal nuclei
3-basophilic mucin containing cytoplasm
resembling endocervical mucosa

82
Q

tumor lined by cells resembling endocervical mucosal cells

A

benign mucinous tumor

83
Q

tumor lined by cells resembling fallopian tubes cells

A

benign serous cystadenoma

84
Q

tumor lined by cuboidal cells/columnar partially ciliated cells

A

benign serous cystadenoma

85
Q

tumor lined by tall columnar cells w/ basal nuclei + basophilic mucin containing cytoplasm

A

benign mucinous tumor

86
Q

borderline mucinous tumor micro pic

A

cytologic atypia
NO stromal invasion

87
Q

malignant mucinous tumor micro pic

A

cytologic atypia + stromal invasion

88
Q

endometrioid tumors of ovary are usually

89
Q

brenner’s tumor gross picture (4)

A

1-unilateral
2-up to 20 cm in diameter
3-solid, circumscribed, firm-rubbery
4- may have cystic component (not common)

90
Q

brenner’s tumor micro picture

A

transitional epithelium nests in fibrous stroma

91
Q

thin walled unilocular cysts
dilated w/ clear straw-colored fluid
unilateral
lined by cells resembling fallopian tube cells
may have stromal fibrous components or show papillae on external/internal cyst surface
lined by cuboidal epithelium/ columnar partially ciliated epithelium

A

benign serous cystadenoma

92
Q

ovoid lobulated tumor
outer surface is smooth
thick fibrotic wall
unilateral
multilocular
variably sized lobules supported by fibrous tissue septa
filled w/ mucinous fluid

A

mucinous tumors

93
Q

rare unilateral tumor 20 cm
arising from surface epithelium
solid circumscribed
firm-rubbery
may have cystic component (not common)
surface epithelium underwent metaplasia–>transitional urothelium

A

brenner’s tumor

94
Q

malignant surface epi tumors gross picture (4)

A

1-cystic, solid or partly cystic/partly solid
2-endophytic/exophytic papillary growths
3-areas of necrosis + Hg
4-cystic spaces content: serous/mucoid and/or hemorrhagic

95
Q

malignant surface epi tumors micro pic

A

adenocarcinoma w/ different differentiation grades :serous
mucinous
endometrioid
clear cell

96
Q

postmenopausal women
abnormal bleeding
possibility of endometrial hyperplasia/carcinoma
unilateral tumor
unilocular/mutlilocular
solid/ partly cystic
can grow to fill pelvis
cuboidal cells w/ longitudinal nuclear groove

A

granulosa cell tumors

97
Q

granulosa cell tumor gross picture (4)

A

1-unilateral
2-unilocular/multilocular
3-can grow to fill pelvis
4-solid/partly cystic /totally cystic

98
Q

granulosa cell tumor micro picture

A

cuboidal cells w/ coffee bean nucleus arranged in following patterns:
-trabecular
-insular
-microfollicular
- diffuse sarcomatoid

99
Q

Cl/P granulosa cell tumor in pre-menarchal age

A

precocious puberty

100
Q

Cl/P granulosa cell tumor in reproductive age (5)

A

1-abnormal bleeding
2-leiomyomas
3-endometrial hyperplasia
4-fibrocystic disease
5-carcinoma of breast

101
Q

Cl/P granulosa cell tumor in postmenopausal age (3)

A

1-abnormal bleeding
2-endometrial hyperplasia
3-carcinoma

102
Q

biological behavior of granulosa cell tumor

A

unpredictable
sometimes behaves benign & sometimes malignant

103
Q

thecoma gross picture (3)

A

1-unilateral
2-solid firm rubbery
3-grey-ish white w/ yellow tinge

104
Q

thecoma microscopic picture (2)

A

1-spindle shaped theca cells arranged in fibroma-like pattern
2-foci of luteinization

105
Q

sertoli cell tumor gross picture (3)

A

1-lobulated
2-solid firm
3-yellow-orange

106
Q

sertoli cell micro picture

A

tubules lined by cells w/ clear cytoplasm & basal nuclei

107
Q

estrogen producing tumor
solid firm rubbery
grey-ish white w/ yellow tinge
cells are spindle-shaped arranged in a fibroma like pattern
foci of luteinization is seen

A

thecoma cell tumor

108
Q

testosterone-producing tumor
lobulated
solid firm
yellow-orange colored
tubules lined w/ cells w/ clear cytoplasm & basal nuclei

A

sertoli cell tumors

109
Q

leydig cell tumor gross picutre

A

small solid w/ yellow tinge

110
Q

Leydig cell tumor micro picture

A

sheets of Leydig cells w/ eosinophilic vacuolated cytoplasm

111
Q

secrete testosterone
rarely malignant
defeminizing
amenorrhea
breast atrophy
hirustism
clitoris enlaregement
male voice

A

sertoli & Leydig cell tumors

112
Q

large tumor
pink-grey color
immature cells
central nuclei
prominent nucleoli that’s arranged in cords/groups
supported by fibrous stroma
infiltrated by lymphocytes

A

dysgerminoma

113
Q

malignant cell tumor w/ extra-embryonic differentiation

A

yolk sac tumor (endodermal sinus tumor)

114
Q

tumor infiltrated by lymphocytes

A

dysgerminoma

115
Q

large tumor
10-20 yo
extra-embryonic differentiation
nodular cut surface
firm rubbery
grey-white
microcystic pattern of flat/cuboidal cells
Schiller-Duvan bodies
↑AFP

A

yolk sac tumor

116
Q

yolk sac tumor microscopic picture

A

1-microcystic pattern of flat/cuboidal cells
2-Schiller-Duval body
3-↑AFP

117
Q

pathognomic sign of yolk sac tumors

A

schilelr-duval body

118
Q

AFP is increased in

A

yolk sac tumors

119
Q

central BV enveloped by germ cells resembling glomerulus

A

Schiller-Duval body

120
Q

solid grey white tumor
necrosis & Hg in large tumors
solid aggregates of epithelial cells
nucleus: hyperchromatic/vesicular
prominent nucleoli
contain choriocarcinoma/ yolk sac tumor elements

A

embryonal carcinoma

121
Q

Meig’s $

A

1-fibroma
2-ascites
3-hydrothorax

122
Q

metastatic tumors of ovary
originating from GIT/breasts
bilateral
enlarged ovary
multinodular surface
signet ring cell appearance in hypercellular stroma

A

Krukenberg tumor

123
Q

Krukenberg tumor stains pink by

A

Mucin stain

124
Q

Krukenberg tumor mico picture

A

signet ring cells in hypercellular stroma

125
Q

implantation of mucinous tumor cells from borderline/malignant mucinous tumors in peritoneum w/ ↑mucin production

A

pseudomyxoma peritonii

126
Q

pseudomyxoma peritonii MC caused by

A

metastasis from appendix

127
Q

CA-125 elevated in

A

epithelial ovarian cancer

128
Q

CEA elevated in

A

mucinous ovarian cancer

129
Q

inhibin elevated in

A

granulosa cell tumor

130
Q

AFP elevated in

A

yolk sac tumor
embryonal carcinoma

131
Q

HCG elevated in

A

choriocarcinoma
embryonal carcinoma

132
Q

psammoma bodies seen in

A

malignant serous cystadenoma

UROGENITAL (22 decks)

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