Pathology Flashcards
What types of epithelium are normally found in the cervix?
ectocervix = stratified squamous epithelium (non-keratinised)
endocervix - simple columnar epithelium
What is the transformation zone of the cervix?
where the columnar epithelium transitions to stratified squamous epithelium
What is cervical erosion?
Physiological squamous metaplasia to protect against trauma, resulting in immature squamous epithelium (benign)
What name is given to the benign mucous-filled cysts found on the surface of the cervix, and what commonly causes them?
Nabothian follicles/cysts - commonly caused by cervical erosion
What is condyloma acuminatum and what condition is it associated with?
thickened papillomatous squamous epithelium with cytoplasmic vacuolation (koilocytosis) - associated with Genital warts (HPV 6 and 11)
What does koilocytosis indicate?
HPV infection
Name 3 physiological processes that alter the position of the transition zone.
Menarche
Pregnancy
Menopause
What is a complication of cervicitis?
Infertility due to simultaneous silent fallopian tube damage
What benign cervical condition can cause IMB and PMB?
cervical polyp
What are the risk factors for cervical cancer?
Persistence of high risk HPV infection - many sexual partners - long term use of OCP - non-use of barrier contraception Smoking Immunosuppression
Where does CIN occur?
Transformation zone
What are the stages of CIN and where do they occur?
CIN 1: lower (basal) third of epithelium
CIN 2: lower and middle third of epithelium
CIN 3: all thirds (full thickness) of epithelium
Why is CIN pre-malignant, and not malignant?
There is no breach of the basement membrane
What is stage 4 invasive cervical carcinoma?
Distant metastasis or involvement of bladder or rectum
What is stage 2 invasive cervical carcinoma?
spread to adjacent organs - vagina, uterus
What is stage 3 invasive cervical carcinoma?
Involvement of pelvic wall
Where does CGIN originate from?
endocervical epithelium
What is CGIN?
cervical glandular intraepithelial neiplasia - pre-invasive phase of endocervical adenocarcinoma
What is vulvar Paget’s disease?
crusting rash
tumour cells in the epidermis, contain mucin
tumour arises from sweat glands in the skin, usually no underlying cancer
What is Meigs syndrome?
Triad of ascites, plural effusion (classically right sided), and benign ovarian tumour (e.g. fibroma, Brenner tumour, granulosa cell tumour)
What is the best management for moderate dyskariosis on a smear?
suggestive of CIN II - refer to colposcopy
What is the best management of severe dyskariosis on a smear?
suggestive of CIN III - refer to colposcopy
When is urgent referral to colposcopy indicated?
suspected invasive cancer
emergency referral is 2 weeks
What is the histological definition of a teratoma?
Made from all three germ cell layers - mesoderm (e.g. muscle, connective tissue), endoderm (epithelium e.g. organ epithelium, sebaceous glands), ectoderm (skin and it’s appendages)
