Pathology - Female Flashcards
most common cause of primary amenorrhea
Turner’s Syndrome (XO)
Second most common cause of primary amenorrhea
Mullerian Agenesis (a/w ectopic kidneys)
Involuntary spasm of the muscles of the pelvic floor –> pain
Vaginismus
Cells infected w/ HPV
Koilocytes
Cx a/w mothers who took DES (diethylstilbestrol) during pregnancy to prevent miscarriage
Clear Cell Adenoma
Cervical motion tenderness
Chandeleir sign (PID)
PID w/ right upper quadrant tenderness from bacterial transmigration to liver capsule
Fitz-Hugh-Curtis syndrome
Presence of entometrial tissue outside of the uterus; transvaginal sonogram can detect endometriotic cysts
Ovaries > pouch of Douglass
endometriosis
Endometrial glands & stroma within the myometrium of the uterus
Adenomyositis
Proliferation of endometrial glands & stroma in galnd> stroma due to unopposed estrogen on endometrial tissue
endometrial hyperplasia (simple vs. complex and Atypia vs no atypia
2 kinds of endometrial cancera
Endometrioid (from endometrial hyperplasia, due to unopposed estrogen)
Papillary serous & clear cell - poorly differentiated cancers that do not arise from endometrial hyperplasia (more aggressive tumors)
Major reason for post-menopausal bleeding
endometrial cancer
Arise from mesenchymal cells of the myometrium (NOT pre-existing leiomyomas) - pleomorphic spindle cells w/ mitosis
leiomyosarcoma
result of the fertilization of an empty ovum by 2 sperm or by haploid sperm, divides nuclear material and forms diploid chromosomes
Increased maternal age is a risk factor
46,XX or 46XY
first trimester bleeding, symptoms of preeclampsia
excessive elevation of HCG > Hyperthyroidism
greater risk of malignancy
Completeley paternal in origin
15-20% chance of malignancy
complete mole
Benign tumor of the chorionic villus resulting from abnormal fertilization of an ovum, characterized by proliferation of trophoblastic cells
Hydatiform mole
Results from fertilization of a normal ovum by 2 sperm, triploid chromosomes (69,XXY,XXX, XYY) - both maternal and paternal in origin, some identifiable fetal parts present
more rare, elevations in HCG
Rarely malignant
incomplete mole
Most common cause of bloody nipple discharge in patient <50 y/o
double layered epitheliual cells overlying myoepithelial layer within lactiferous duct or sinus
Intraductal papilloma
Most common fibrocystic change, increase in fibrous stroma a/w dilation of ducts, formation of cysts w/o hyperplasia; can calcify & appear radiodense
non-proliferative, cysts and fibrosis
most common benign tumor of breast in women <25 y/o; caused by increase in estrogen; firm, solitary, discrete movable mass
Fibroadenoma
Arises from intralobular stroma (rarely from pre-existing fibroadenoma) - can grow to a massive size; leaf-like clefts; no ductal invasion, no bleeding
15% are malignant, <15% metastasize
phyllodes
Usually arises from the major ducts, non-palpable, commonly w/ microcalcifications, 1/3 will eventually invade, lumpectomy
Ductal carcinoma in situ (DCIS)
Involves terminal lobular unit; non-palapable; signet rings are common; usually estrogen & progesterone +, 1/3 cases invade, 50-75% increase risk of cx in oppo breast
Lobular Carcinoma in situ (LCIS)
Invasive Ductal Carcinoma: young, better prognosis, a/w BRAC1; sheet-like growth w/ no alveolar ducts or alveolar pattern
lack estrogen/ progesterone receptors
medullary
Invastive ductal tubules
well-formed tubules
young, better prognosis
estrogen/ progesterone +
Tubular
Ductal Carcinoma
surrounded by mucin, estrogen/ progesterone present
elderly, better prognosis
Mucinous
Ductal Carcinoma
Papillary architecture w/ fibroblastic cores; estrogen-progesterone receptor present
elderly better prognosis
Papillary
Invasion to dermal lymphatics and dimpling of the skin
young, poor prognosis
Inflammatory
often bilateral breast cancer; invades individually into the stroma, alligned in chains; more likely to metasize to cerebrospinal fluid; usually express hormone receptors
lobular breast cancer
Caused by DCIS extension into the lactiferous ducts and the skin of the nipple; unilateral crusting exudate over the nipple and areolar skin - abundant cytoplasm
Paget Disease of Nipple
thinning of epidermis; post-menopausal women - white plaques
Lichen sclerosus
epithelial thickening, hyperkaratosis
lichen simplex chronicus
3 theories of endometriosis
1 - regurgiation
2- metaplasia of coelimic epitherlium
3-lymphatic/ vascular dissemination
Growth of basal layer of endometrium down into the myometrium causes hypertrophy of the myometrium; enlarged globular uterus (does not have cyclical bleeding)
adenomyosis
2 kinds of endometrial cx
1- PTEN, resembles hyperplasia
2-Serous - endometrial atrophy in older post-menopausal women (TP53)
1- endometrioid
2-serous
Monitors response to therapy; epithelial ovarian cx
CA-125
Benign cystic teratoma aka
dermatoid cyst
Most common disorder of fallopian tubes in PID
salpingitis
Most ovarian tumors are formed from ovarian epithelium
Coelemic epithelium
serous tumors (most common)
Mucinous is less likely bilateral
GI primary adenocarcinoma to the ovary, produces copious amt of mucin = pseudomyxoma peritonel
Krukenberg tumor
Ovarian tumor w/ abundant stroma
Brenner tumor
HELLP Syndrome
Hemolysis, elevated liver enzymes, low plateletes
in breast - cystic dilation of obstructed duct
galactocele
variant of DCIS, high grade nuclei w/ central necrosis
comedo
BRCA1 vs. BRCA2
which one more often ER+?
BRAC2
BRCA1 - also ovarian maligancy
Embyronic rhabdomyosarcoma in vagina of young girls
sarcoma botyoides
Derived from embryonic wolfian duct, rests in anterolateral vaginal wall
Gartner duct cysts
fluid filled cysts (incidental finding) near the fimbriated end of the fallopian tube
Parovarian cyst
takes on arrangement of granulosa cells, similar to a follicle surrounding an egg
Call Exner bodies
common histological finding in serous ovarian carcinomas
psammamoma body
Thecoma-fibroma tumor, triad of ovarian fibroma, ascites, hydrothorax
Meig’s syndrome
Attachment of placenta directly to the myometrium; the decidual layer is defective; predisposed by CSD, endometrial inflammation
Can cause massive hemorrhage after delivery
Placenta accreta
Attachment of the placenta to the lower uterine segment
Placenta previa
Fluid-filled cyst in fibrocystic breast disease
Blue dome cyst
