Pathology Flashcards
What is the normal thickness of the endometrium in postmenopausal women on TVUS and what is the threshold for further testing?
Should be 1mm thick
Once >4mm should do biopsy
(>16mm in premenopausal)
How is endometritis diagnosed histologically?
Abnormal pattern of inflammatory cells in in the endometrium
What protections does the uterus have in place to prevent endometritis?
Cervical mucous plug protects from any ascending infection
Cyclical shedding of the endometrium
What is a molar pregnancy?
An abnormal form of pregnancy in which a non-viable fertilised egg implants in the uterus.
What is adenomyosis?
Endometrial glands and stroma within the myometrium of the uterus.
Often causes menorrhagia/dysmenorrhoea
What is a leiomyoma?
Benign tumour of the smooth muscle (can be found outside the uterus). Growth is oestrogen dependent. Can progress to leiomyosarcoma.
What are nabothian follicles?
Mucus filled cysts found on the surface of the cervix that are often the result of squamous metaplasia in the endocervix.
What would be seen histologically on in follicular cervicitis?
Reactive lymphoid follicles present in the cervix
What is Cervical Intraepithelial Neoplasia (CIN)?
Abnormal proliferation within the epithelium of the cervix - has not reached the basement membrane yet. No malignant but can progress to it.
Which cancers can be found in the cervix?
Adenocarcinoma
Squamous carcinoma
Which forms of HPV have a high risk of developing cervical neoplasm?
Types 16 and 18
How long does it take for high grade CIN to turn into invasive cancer?
Between 5 - 20 years
How long does it take for HPV infection to turn into high grade CIN?
Between 6 months and 3 years
What is dyskarosis?
Abnormal cytologic changes of squamous epithelial cells characterized by hyperchromatic nuclei
Where does CIN develop?
In the transformation zone
How is CIN graded?
CIN 1: Abnormality in lower third of epithelium, cells dividing and proliferating above the base
CIN 2: Abnormality extends into the middle third of the basement membrane
CIN 3: Abnormality extends into the upper third of the epithelium, may even see mitotic figures on surface
What histological changes occur in the cells in CIN?
Delay in maturation/differentiation
Nuclear abnormalities: hyperchromasia, increased nucleocytoplasmic ratio
Excess mitotic activity
What are the stages of Invasive Squamous Carcinoma?
Stage 1: confined to the cervix
Stage 2: Spread to adjacent organs - vagina, uterus
Stage 3: involvement of the pelvic wall
Stage 4: distant metastases/involvement of rectum or bladder
What are the symptoms of invasive carcinoma?
Usually none at early stages Abnormal bleeding Pelvic pain Haematuria/UTI Ureteric obstruction/renal failure
What are the 3 modes of spread in squamous carcinoma?
Local
Lymphatic
Blood
Where does cervical glandular intraepithelial neoplasia (CGIN) originate from and what can it develop into?
Endocervical epithelium and is a preinvasive phase of endocervical adenocarcinoma. Affects the glandular tissue
Which has a worse prognosis - endocervical adenocarcinoma or invasive squamous carcinoma?
Endocervical adenocarcinoma
Apart from cervix pathology what other disease can HPV cause?
Vulvar Intraepithelial Neoplasia (VIN)
Vaginal Intraepithelial Neoplasia (VaIN)
Anal Intraepithelial Neoplasia (AIN)
What is the name given to breast development in the male?
Gynaecomastia
What is a harmatoma?
Benign circumscribed lesion made up of cells normal to breast tissue but in abnormal proportion/distribution
What is normally seen in fibrocystic breast change?
Usually multiple cysts present in the breast tissue, can interfere with menstrual cycle. Exclude malignancy, reassure, excise of necessary
Which benign breast condition is “breast mouse” seen in?
Fibroadenoma
What would a histological sample from the breast showing radiating fibrosis containing distorted ductules be an indication of?
A radial scar
How does sclerosing adenosis present?
Pain , tenderness or lumpiness/thickening
May be asymptomatic
What are the causes of fat necrosis in the breast?
Local trauma
Warfarin therapy
-> damage and destruction of adipocytes, infiltration by acute inflammatory cells leading to fibrosis and scarring
How is fat necrosis managed?
Exclude malignancy
Don’t excise - only going to make fibrosis and scarring worse
Which inflammatory benign breast lesion is associated with smoking?
Duct ectasia
