Pathology Concepts - High Yield Flashcards
1
Q
Bartholin Cyst
A
unilateral, painful lesion near vaginal canal
2
Q
Condyloma
A
HPV 6 and 11 warty neoplasm, not risk for cancer histology - koilocytic change
3
Q
Lichen Sclerosis
A
Postmenopausal women Benign, slight increased risk for squamous cell carcinoma Leukoplakia on vulva Can be associated with autoimmune disorders painful intercourse
4
Q
Lichen Simplex Chronicus
A
Thick, leathery vulva hyperplasia of vulvar squamous epithelium benign
5
Q
Vulvar Carcinoma
A
HPV 16, 18, 31, 33 presents as leukoplakia rare VIN (vulvar intraepithelial neoplasia) cytokeratins - tumor markers can have keratin pearls on histo koilocytic change on histology
6
Q
Extramammary Paget Disease
A
indicates carcinoma in situ burning sensation malignant epithelial cells in epidermis erythamatous, pruritic, ulcerated vulvar skin PAS +, keratin -, S100-, CEA+
7
Q
Vaginal Adenosis
A
focal persistence of columnar epithelium in the upper vagina increased in females with DES exposure in utero
8
Q
Clear Cell Adenocarcinoma of the Vagina
A
complication of DES-associated vaginal adenosis
9
Q
Embryonal Rhabdomyosarcoma (Sarcoma Botryoides)
A
Bleeding Grape like mass protruding from vagina children
10
Q
HPV E6 protein
A
increased destruction of p53
11
Q
HPV E7 protein
A
increased destruction of Rb
12
Q
Cervical Intraepithelial Neoplasia (CIN)
A
Koilocytic change looks like a mosaic, inlaid woodwork carcinoma in situ is dysplasia involving the full thickness of the epithelium progression from CIN I to CIS is not inevitable
13
Q
Cervical Carcinoma
A
40-50 yrs post-coital bleeding high risk HPV infection cervical carcinoma is AIDS-defining most is squamous cell carcinoma, but both squamous cell and adenocarcinoma are associated with HPV hydronephrosis w/ postrenal failure is a common cause of mortality CIN to cancer 10-20 years
14
Q
Quadrivalent HPV vaccine
A
6, 11, 16, 18
15
Q
Proliferative phase
A
estrogen driven
16
Q
Secretory phase
A
progesterone driven
17
Q
Menstrual phase
A
loss of progesterone support
18
Q
Asherman Syndrome
A
Secondary amenorrhea due to loss of stratum basalis overaggressive D&C cause
19
Q
Acute Endometritis
A
usually due to retained products of conception, incompete abortion is nidus for inection bacterial infection –> fever, pelvic pain
20
Q
Chronic Endometritis
A
lymphocytes and plasma cells IUD, TB, chronic PID, retained products of conception abnormal bleeding, pain, infertility
21
Q
Endometrial Polyp
A
side effect of tamoxifen hyperplastic protrusion of endometrium (hypersensitive to estrogen stimulation) endometrial glands, fibrous endometrial stroma perimenopausal women
22
Q
Endometriosis
A
ovary most common site chocolate cysts gun-powder nodules increased risk of carcinoma at side of endometriosis (in ovary esp) adenomyosis when uterine myometrium is involved
23
Q
Endometrial Hyperplasia
A
glands >> stroma consequence of unopposed estrogen (ie PCOS, obesity) atypia is the key word for progression to cancer postmenopausal uterine bleeding
24
Q
Endometrial Carcinoma
A
most common invasive carcinoma of female genital tract postmenopausal bleeding endometrioid histology - hyperplasia pathway sporadic pathway - papillary serous adenocarcinoma - serous histology (surface epithelium) with psammoma bodies (laminated calcified concretions) p53 mutation common BRCA-1 mutation common
25
Leiomyoma
uterine fibroid whirled masses, come in sets usually without encapsulation benign can cause bleeding (--\> anemia)
26
Leiomyosarcoma
arises de novo unilateral, usually one mass, necrosis and hemorrhage postmenopausal women Actin+ 10+ mitosis per HPF or 5+ mitoses per 10 HPF Nuclear atypia, necrosis possible
27
FSH
granulosa cells convert androgen to estrogen
28
LH surge
caused by estradiol surge
29
Polycystic Ovarian Disease (PCOS, PCOD)
LH: FSH \> 2 unopposed acyclic estrogen secretion androgen converted to estrone in adipose tissue --\> increased risk for endometrial carcinoma T2DM common low FSH - cystic degeneration of follicles common (5% of repro age women) oligomenorrhea, hirsutism aka Stein-Leventhal Syndrome
30
Surface Epithelial Ovarian tumor
most common serous and mucinous BRCA1 mutations increase risk for serous carcinoma of ovary and fallopian tube malignant tumors - cystadenocarcinoma - complex cysts with thick, shaggy lining postmenopausal women poor prognosis (usually caught late) CA-125 serum marker Brenner tumor - benign - bladder-like epithelium
31
Cystic Teratoma
fetal tissue most common germ cell tumor\*\* often bilateral struma ovarii if composed of thyroid tissue
32
Dysgerminoma
tumor of large cells with clear cytoplasm and central nucleii malignant germ cell tumor LDH may be elevated female counterpart to testicular seminoma in males glycogen-filled cells with septa containing lymphocytes
33
Endometrial sinus tumor
malignant tumor that mimics the yolk sac most common germ cell tumor in children AFP elevated Schiller-Duval bodies (like glomeruli) histology
34
Choriocarcinoma
malignant tumor or cytotrophoblasts and syncytiotrophoblasts rapid breast enlargement/precocious puberty in younger patients mimics placental tissue, villi absent small and hemorhhagic tumor with early hematogenous spread b-HCG elevated\*\* due to syncytial cells poor response to chemo
35
Embryonal Carcinoma
malignant, large primitive cells aggressive with early metastases
36
Granulosa-Theca Cell Tumor
Sex-cord stromal tumor precocious puberty, but usually occurs in postmenopausal women malignant but not aggressive
37
Sertoli-Leydig cell tumor
hirsutism virilization sex-cord stromal tumors
38
Fibroma (of the ovary)
benign solid, firm, white tumor of fibroblasts pleural effusion, ascites (Meigs syndrome)
39
Krukenberg Tumor
metastatic mucinous tumor from GI cancer (gastric adenocarcinoma) involves both ovaries "signet ring" cell appearance pseudomyxoma peritonei - massive amounts of mucus in the peritoneum (from tumor of appendix)
40
Ectopic pregnancy
PID is risk for surgical emergency major bleed if bursts
41
Spontaneous abortion
most common is trisomy 16, hypercoagulable state, congenital infection, teratogen exposure usually in first 2 weeks gestation
42
Placenta Previa
implantation of placenta in lower uterus, blocks os 3rd trimester bleeding often requires C-section
43
Placental Abruption
separation of placenta from decidua prior to delivery of fetus reason for stillborn 3rd trimester bleeding, fetal insufficiency
44
Placenta Accreta
improper implantation of placenta into myometrium Difficult delivery of placenta, postpartum bleeding Often requires hysterectomy
45
Preeclampsia
HTN, proteinuria, edema usually arising in 3rd trimester DIC is a major complication - fibrin thrombi in liver, brain, kidneys HELLP (hemolysis, elevated liver enzymes, low platelets) abnormality of maternal-fetal vascular interface in placenta
46
Hyditaform Mole - Partial Mole
normal ovum, 2 sperm 69 chromosomes fetal tissue present snowstorm on ultrasound, fetal HR neg bHCG much higher than expected
47
Hytidaform Mole - Complete Mole
empty ovum, 2 sperm 46 chromosomes absent fetal tissue choriocarcinoma risk snowstorm on ultrasound, fetal HR neg bHCG much higher than expected
48
Acute mastitis
staph
49
Periductal mastitis
inflammation of subareolar ducts smokers subareolar mass with nipple retraction
50
Fat necrosis
trauma calcifications and giant cells
51
Fibrocystic change
usually benign, some changes associated with increased risk for invasive carcinoma cystic breasts blue dome gross appearance
52
Intraductal Papilloma
bloody nipple discharge in premenopausal woman \*subareolar (whereas Paget Disease is areola and nipple) must distinguish from papillary carcinoma fibrovascular projections lined by epithelium WITH myoepithelial cells (cancer has no myoepithelial cells)
53
Fibroadenoma
tumor of fibrous tissue and glands (epithelial and stromal elements) surgical removal is curative well-circumscribed, mobile, marble-like mass estrogen sensitive\*\*\* lifetime risk for cancer is doubled
54
Phyllodes Tumor
fibroadenoma-like tumor leaf-like projections on biopsy (benign growth of ductal structures) sharply circumscribed, glistening stroma has high mitotic activity postmenopausal women sometimes malignant (when they are, they are less sharply circumscribed and much more stromal components as compared with ductal components
55
DCIS
does not usually produce a mass calcification on mammography Paget Disease indicates underlying carcinoma
56
Invasive Ductal Carcinoma
most common invasive cancer of the breast irregular nests of cells and cords of epithelial cells can be tubular (well-differentiated tubules w/o myoepithelium), mucinous, medullary (large, high grade cells with lymphocytes, plasma cells) or inflammatory increased in BRCA1 carriers
57
Lobular Carcinoma In Situ (LCIS)
discohesive cells lacking E-cadherin no mass or calcifications treatment with tamoxifen \*\*LCIS, more than DCIS, serves as a marker for enhanced risk of subsequent invasive carcinoma in both breasts
58
Achondroplasia
dwarfism overexpression of FGF3 autosomal dominant failure of normal epiphyseal cartilage formation poor endochondral bone formation - long bones cant grow
59
Osteogenesis Imperfecta
blue sclera hearing loss congenital structurally weak bone mutations in the gene for type I collagen (COL1A1 and COL1A2)
60
Osteopetrosis
inherited defect of bone resorption abnormally thick, heavy bones marrow can be compromised, tx is bone marrow replacement aka Albers-Shonberg disease disorder of osteoCLASTS (failed resorption)
61
Osteomalacia
impaired mineralization of osteoid can be associated with autoimmune disorders (ie Chrons, celiac) pidgeon-breast deformity frontal bossing rachitic rosary low vitamin D in adults, Ca down, phosphate down, PTH up, alk phos up
62
Osteoporosis
reduction in trabecular bone mass DIP \> PIP involvement porous bone, fracture risk labs normal postmenopausal women --\> estrogen withdrawal --\> increased # of osteoclasts (type 1) OR, decreased osteoblast activity (type 2)
63
Paget Disease of Bone
\>60 years imbalance of osteoclast and osteoblast function mosaic pattern (puzzle pieces) of lamellar bone bone pain hearing loss lion-like facies elevated alk phos complication can include high output cardiac failure due to formation of AV shunts in bone increased risk of osteogenic sarcoma more common in people of English descent
64
Osteomyelitis
infection can be in children bacterial like staph lytic focus = sequestrum sclerosis around it = involucrum bone pain and fever etc.
65
Avascular Necrosis
DCS ischemic necrosis of bone, bone marrow can also be caused by trauma children and adolescents can be affected
66
Osteoma
Gardner syndrome benign tumor surface of facial bones
67
Osteoid Osteoma
small, painful lesion surrounded by reactive bone formation radiolucent core typically young people (5-25) aspirin resolves pain (osteoblastoma does NOT respond to aspirin) cortex of long bones (diaphysis) ie femur benign tumor of osteoblasts (produce osteoid)
68
Osteochondroma
overlying cartilage cap lateral projection of growth plate (metaphysis)
69
Osteosarcoma
highly malignant proliferation of osteoblasts mutations in Rb protein (some p53, but mostly Rb) teenagers, elderly lung mets Codman triangle ("sunburst appearance") arises in metaphysis of long bones or knee region pathologic fracture or bone pain
70
Giant Cell Tumor
young adults epiphysis of long bones soap-bubble appearance RANK ligand aggressive
71
Ewing Sarcoma
neuroectoderm derivation onion-skin appearance kids small, round blue cells on biopsy diaphysis of long bones t 11;22 translocation
72
Chondroma
intermedullary small bones of hands and feet
73
Chrondrosarcoma
intermedullary pelvis or central skeleton malignant
74
Chondroblastoma
chicken wire appearance adolescents primitive chondroblasts and cartilage matrix
75
Osteoarthritis
Progressive disease Herberden nodes - DIP - osteophyte formation Bouchard nodes - PIP - osteophyte formation morning stiffness, worsens during day
76
Rheumatoid Arthritis
HLA-DR4 pannus Baker cyst, vasculitis, pleural effusions morning stiffness that improves with movement synovitis progressive IgM autoantibody against Fc portion of IgG (rheumatoid factor)
77
Ankylosing Spondylitis
HLA-B27 axial skeleton involvement seronegative spondylarthropathy more common in young men uveitis
78
Reactive arthritis
HLA-B27 arthritis, urethritis, conjunctivitis Chlamydia or GI infection
79
Infectious Arthritis
DGI or staph warm joint, limited ROM, fever, ESR elevated usually knee
80
Gout
MSU crystals negative biferingence hyperuricemia podagra chronic gout --\> renal failure, tophi development
81
Dermatomyositis
heliotrope rash (upper eyelids) anti-Jo antibody, ANA+ inflammatory, involves skin and skeletal muscle
82
X-linked MD
dystrophin deletion replacement of skeletal muscle by adipose tissue
83
Liposarcoma
lipoblast is characteristic cell
84
Rhabdomyoma
tuberous sclerosis benign tumor of skeletal muscle
85
Rhabdomyosarcoma
most common malignant soft tissue tumor in children rhabdomyoblast desmin + head and neck common, vagina in young girls common
86
Caruncle
postmenopausal women near urethra ulcerated, bleeding
87
Lymphogranuloma venereum
Chlamydia serotype enlarged inguinal lymph nodes genital elephantiasis rectal strictures granulomatous inflammation \*with\* inclusion bodies\*\*
88
Chancroid
vesiculopapular lesion(s) purulence, bleeds, fever, malaise haemophilus ducreyi granulomatous inflammation, acute transmission (~5 days)
89
PTEN tumor suppressor gene
hormonally regulated in the normal endometrium biomarker for endometrial carcinogenesis
90
WT-1 tumor suppressor protein
loss of fx associated with Wilm's tumor
91
Endometrial stromal sarcoma
usually neoplastic cells surrounding a blood vessel rare
92
Adenomyosis
Presence of endometrial glands and stroma in the myometrium 1/5 of uteri have this characteristic can be associated with pelvic pain and bleeding, dyspareunia
93
Carcinosarcoma
aggressive mixed mesodermal tumor poor prognosis
94
Granulosa cell tumor
sex cord tumor prototypical functional neoplasm of the ovary associated with estrogen secretion usually postmenopausal women (in young girls, precocious puberty is an indicator) Exner bodies (look like flowers) on histology
95
Thecoma
postmenopausal women functional ovarian tumor estrogen production yellow on gross exam lipid-laden theca cells endometrial hyperplasia common, can progress to cancer
96
Papillomatosis
risk for developing cancer proliferative fibrocystic change ie increased cells lining the dilated terminal ducts (ductal epithelial hyperplasia)
97
Invasive Lobular Carcinoma
second most common form of invasive breast cancer can be a discrete firm mass or not single strands or lines of cells with stroma in between
98
Medullary carcinoma (of the breast)
nests of cells lymphocytes, dense lymphoid infiltrate fleshy, bulky tumors no calcifications better prognosis than infiltrating ductal or lobular carcinoma
99
Most common breast cancer in men:
Invasive ductal carcinoma (still very rare) BRCA2 plays a role
100
Mutations in the lysyl hydroxylase gene
Ehlers-Danlos Syndrome
101
Mutations in fibrillin gene
Marfan Syndrome
102
Androgenital syndrome
congenital 21-hydroxylase deficiency virilization in females a congenital adrenal hyperplasia high levels of androgens lead to premature closure of epiphyses
103
Pseudoarthrosis
joint like tissue formation at a site of fracture nonunion healing surgical removal to properly heal fracture
104
Legg-Calve-Perthes disease
avascular necrosis in the femoral head of children
105
Sequestrum
necrotic bone
106
Involucrum
periosteal new bone forms around the sequestrum
107
Osteitis Fibrosa Cystica
hyperparathyroidism complication
108
Pseudogout / Chondrocalcinosis
aspirate has rhomboid "coffin-like" crystals (CPPD) and neutrophils seen in the elderly gout-like symptoms + biferingence
109
8;14 translocation
Burkitt Lymphoma
110
Hand-Schuller-Christian disease
young children (2-5) proliferation of Langerhans cells radiolucent bony lesions lesion may produce exopthalmos infiltration of the hypothalamic stalk can lead to DI weepy skin lesions ie at hairline
111
Myositis ossificans
young people benign usually from blunt trauma occurs near a bone, often mistaken for a malignant bone thing
112
Synovial sarcoma
highly malignant soft tissue tumor spindle-shaped mesenchymal cells and cuboidal, epithelial-like cells keratin +
113
Papillary structures with psammoma bodies would characterize:
a cystadenocarcinoma
114
A choriocarcinoma with trophoblastic cells is usually gestational in origin and has a:
hemorrhagic appearance
115
α-Fetoprotein is a marker for:
some germ cell tumors that contain yolk sac elements
