Pathology Flashcards
What non-gynaecological cancer is COCP protective against?
Colorectal cancer
What is the type of cells line the labia majora?
Keratinized stratified squamous
Cancer seen with presence of endometrioma
Clear cell carcinoma
Endometrioma = endometriosis on the ovary
Clear cell is a type of epithelial ovarian Ca
Silicone breast implants became deformed and rigid. What cells are involved in this process?
Giant cells
HRT reduces the risk of which cancer?
Colorectal cancer
Radiation does not effect which type of cell?
Cortical cells of the neuron
the 2 oncogenes HPV 16 and HPV 18 are responsible for this percentage of cervical cancer:
70%
This granulated white blood cell has phagocytic action but constitutes only 2-3% of total WBC count:
Eosinophils
Spread of choriocarcinoma is
Haematogenous
a patient who is BRCA 1 positive has the following risk for breast and ovarian cancer:
Lifetime Breast Cancer Risk 70%
Lifetime Ovarian Cancer Risk 40%
(pass medicine)
75/50 (booklet)
Soft tumour. Histology: interstitial haemorrhage and Call–Exner bodies. Dx?
Granulosa cell tumour
Inflammation releases all of the following except which:
von willebrand
nitric oxide
prostacyclin
bradykinin
plasminogen activator
plasminogen activator
Which of the ovarian cysts is most prone to torsion?
Dermoid cyst
most common type of degeneration in fibroid of non pregnant woman?
Hyaline degeneration
A pregnant woman presents with abdominal pain. What type of fibroid degeneration is common in pregnant women?
Red degeneration
Best word to describe endometrial mitotic division
proliferative
Post menopausal women with vulval itching and thin discharge. Histopathology shows keratin pearl
??vaginal squamous cell carcinoma
30 yrs, cyst multi-loculated no solid mass, the CA125 is 100, RMI index is 300. Diagnosis (general)
Ovarian cancer
RMI >200 high risk for ovarian malignancy
The stroma and endometrial glands protrude into the myometrium and there is symmetrical uterine enlargement. What is the most likely cause?
Adenomyosis
= endometrium within myometrium
65-year-old nullip with vaginal spotting. A hysterectomy is performed, and pathologic examination reveals heterologous components of a malignant tumor of the endometrial glands and metaplastic cartilage. Dx?
Endometrial carcinosarcoma
(A mixture of carcinoma (i.e. epithelial) and sarcoma; rare)
What is the calculation for RMI?
e.g. premenopausal, Ca125 250, ovarian mass with solid areas and ascites
RMI = ultrasound score x menopausal score x CA-125
3 x 1 x 250 = 750
3 for 2+ USS abnormalities
(mets, ascites, loculated cyst, solid areas)
1 for 1 USS abnormality
3 for postmenopausal
1 for premenopausal
(this is ‘RMI 1’ scoring = 3 rather than 4
What is the type of necrosis in acute tubular necrosis of Kidney?
Coagulative necrosis (infarct)
For most stuff
Liquefactive - brain
Gangrenous - limb
Fat - pancreas
Caseous - TB
Ultrasound picture of the ovary shows cystic lesion measuring 3.3x 2.5 cm with echogenic septea. What is the most likely finding?
R pelvic pain, 5cm well defined cystic lesion with mixed echoes
Benign teratoma
Which is common malignant tumour in newborn?
Sacrococcygeal teratoma
A 55 year old presents to clinic due to vulval itch and discolouration. examination reveals pale white discoloured areas to the vulva. A biopsy shows epidermal atrophy with subepidermal hyalinization and deeper inflammatory infiltrate. What is this characteristic of?
Lichen sclerosus
Which pattern of endometrium do simple endometrial hyperplasia most likely resemble?
Proliferative endometrium
Emergency hysterectomy at CS. The placenta has not invaded the myometrium. Diagnosis?
Placenta accreta
Accreta - invades endometrium
Increta - invades myometrium
Percreta - invades serosa
The probability of sarcomatous change occurring in fibroid is
0.1%
Which tumours demonstrate Schiller Duval bodies?
Endodermal sinus tumour (EST)
aka
Yolk sac tumour
Classically a testicular tumour in children under 3 years old
Transformation Zone is from X to Y cell type
Columnar to Squamous metaplasia
Patient post abortion presents with difficulty breathing and haemoptysis, fluffy circular pacifications on CXR - which tumour marker may be elevated?
HCG
RIF pain, USS showing fluid collection, LMP 1/52 ago
Endometrioma
Epithelial lining of cervix exterior to transformation zone is what tissue type?
Stratified squamous non-keratinised
71 y/o with unilocular cyst measuring 30 mm and a Ca 125 of 25 iu/ml. What is her RMI?
zero
USS
0 = No abnormality
1 = 1 abnormality
3 = 2 or more
USS features
multilocular cyst
Solid areas
Ascites
Intra-abdominal mets
1 = Premenopausal
3 = Postmenopausal
Ca125 value
What cell type lines the cervix?
Columnar epithelium
aka glandular epithelium
LDH elevates in which type of ovarian ca ?
Dysgerminoma
Infection with which one of the following less common human papillomaviruses (HPVs) is associated with an increased risk of cervical cancer?
33
Postmenopausal patient with PVB, endometrium 1.2mm on USS. What is the management?
Ask to return if bleeding recurs
<4mm and no RF discharge
>4mm endometrial sampling +/- hysteroscopy
From which organ / system does the Krukenberg tumor of the ovaries originate?
GI tract
Most common cancer type in fallopian tube?
Serous (an epithelial carcinoma)
STIC - serous tubal intraepithelial carcinoma
Which cancer most commonly diagnosed in pregnancy and postpartum?
Breast cancer
What is the most common cause of postmenopausal bleeding?
Atrophic vaginitis and endometritis
Which Ovarian Ca is associated with mutation of mismatch repair genes?
Endometroid Cancer
What type of necrosis is seen in the heart after an acute myocardial infarction?
Coagulative necrosis
Increase in cell size is called?
Hypertrophy
Patient with ovarian mass plus pleural effusion histopath revealed white, firm, spindle shape cells. Diagnosis?
Fibroma
A 27-year-old woman after normal vaginal birth develops shortness of birth and seizures. Despite resuscitation she died. At autopsy squamous cells and fetal hair are found in lungs. What is the most likely cause of death?
Amniotic fluid embolus
Psammoma bodies are a histologic feature of ovarian papillary serous cystadenoma. ‘
Psammoma bodies’ are composed of ?
Calcium
woman with complete hydatidiform mole has bilateral multiple tiny ovarian cysts, an enlarged uterus at 12/40. β-hCG is 300,000 mIU/mL. What is the most likely type of these ovarian cysts?
Theca lutein cyst
Caused by overstimulation and high HCG
Placenta had invaded through the full thickness of the myometrium. Diagnosis?
Placenta increta
In which subsites does vulval cancer most commonly arise?
Labia majora
Which neoplasm is characteristically associated with paraneoplastic syndrome of inappropriate antidiuretic hormone (SIADH)?
SC lung ca
Thrombosis in protein C deficiency is due to
Factor V and VIIIa
Trophoblast cells that invade the lumen of spiral arteries are called
Endovascular trophoblast
Where can Arias Stella be found?
Endometrium - associated with presence of chorionic tissue
Type of necrosis found in the brain
colliquative necrosis
What kind of epithelium covers the ovary?
cuboidal
Patient with haematuria, biopsy shows a papillary structure, which type of cancer is this?
Transitional cell carcinoma
What is the most common type of vulval cancer?
Squamous carcinoma
What causes meig’s syndrome?
Fibroma - a benign ovarian tumour
Meig’s is a triad: ascites, pleural effusion, fibroma
A 60-year-old with erythematous erosive lichen planus on the vulva. What type of cancer is linked to lichen planus
Squamous cell carcinoma
Remember usually it is lichen sclerosus that causes vulval plaques
HPV +ive, cytology normal
Re-screen in 12 months
HPV +ive, cytology abnormal (i.e. borderline or worse)
Colposcopy
What gene mutation is found in high grade serous adenocarcinoma?
P53
Commonest uterine sarcoma
Leiomyosarcoma
Same tissue origin as leiomyoma (fibroids)
Doesn’t generally evolve from one to the other.
What % of hyperplasia without atypia progress to malignancy? (+bonus how is it managed?)
<5%
6 monthly surveillance
What % of atypical hyperplasia progress to malignancy? (+bonus how is it managed?)
25-30%
Hysterectomy
Ovarian mismatch repair genes are seen in
Clear cell carcinoma vs endometroid?
Which element rises in ovarian clear cell carcinoma
Calcium
Where is factor 8 produced
The liver
Which cells in the corpus luteum become vascularised and bleed causing a haemorrhage luteal cyst?
Granulosa cells
What platelet level triggers transfusion in PPH
<75
Ovarian cyst is 4cm - management?
<50mm - reassure no follow up
50-70mm - ultrasound yearly
>70mm - MRI/surgery
Which vulval disease is associated with autoimmune disease
Lichen sclerosus
Why does red degeneration of fibroids occur in pregnancy?
Fibroid enlarges, outgrowing blood supply and becomes ischaemic
What percentage of Brenner tumours are malignant?
<5%
Types of subdural fibroid definition
type 0
type 1
type 2
type 0 - pedunculated
type 1 - <50% intramural extension
type 2 - >50% intramural extension
A neoplasm of the female genital tract occurring in an 18-year-old girl whose mother was treated with diethylstilbestrol during the pregnancy is likely to be a:
Clear cell carcinoma of vagina
