Pathology - Female Repro Flashcards
Koilocytic changes
HPV infection
Vulvar carcinoma forms by what 2 pathways?
HPV-related (HPV-16, -18) or Non-HPV related (long-standing Lichen Sclerosis)
40-50yo w/ Vulvar carcinoma what is the likely etiology?
HPV-related since it is seen years after peak sexual activity
60-70yo w/ Vulvar carcinoma what is the likely etiology?
Non-HPV related (long-standing Lichen Sclerosis causing chronic inflammation & irritation)
HPV infection risk factors
multiple partners & early age of intercourse
Extramammary Paget’s Disease must be distinguished from
Melanoma
Extramammary Paget’s Disease staining pattern
PAS+, keratin +, S100 - (malignant epithelial cells)
Melanoma staining pattern
PAS -, Keratin -, S100 + (malignant melanocytes)
Paget’s Disease of the Nipple we should assume
there is an underlying carcinoma
Lower 1/3 of the vagina is derived from
Urogenital sinus -> non-keratinized stratified squamous epithelium
Upper 2/3 of the vagina is derived from
Mullerian duct -> columnar epithelium
During development of the vagina, stratified squamous epithelium grows upward to replace the columnar epithelium, if this fails to occur —>
Vaginal adenosis
Vaginal adenosis risk factors
DES exposure in utero
Vaginal adenosis complication
Clear Cell Adenocarcinoma
Keratin + —–>
Epithelial Cell (Carcinoma)
S100 + ———–>
Melanocytes (Melanoma)
DES exposure increases the risk of _______ in the pregnant mothers
Breast cancer
DES was used for
Used for pregnant females w/ Hx of premature labor, miscarriage
Clear Cell Adenocarcinoma
proliferation of glands with clear cytoplasm
5yo female with “grape-like” protruding mass from vagina
Embryonal Rhabdomyosarcoma
Embryonal Rhabdomyosarcoma
mesenchymal malignancy of immature skeletal mm.
Rhabdomyoblast exhibits
cytoplasmic cross-striations & Desmin+ Myogenin+
Vaginal Carcinoma arises d/t
High-risk HPV (vaginal intraepithelial neoplasia)
Vaginal Carcinoma in the upper 2/3 may spread to what lymph nodes?
Iliac nodes
Vaginal Carcinoma in the lower 1/3 may spread to what lymph nodes?
Inguinal nodes
Transformation Zone
junction b/w the exocervix (non-keratinized stratified squamous) & the endocervix (single columnar layer)
High-risk HPV E6 proteins MOA
destruction of p53 (loss of tumor suppressor proteins)
High-risk HPV E7 proteins MOA
destruction of Rb (loss of tumor suppressor proteins)
p53 action
p53 stops progression into S phase by bringing in: BAX —-I BCL2 which causes -> cytochrome C release from now unstable mito membrane –> activates apoptosis
BCL2 action
stabilizes mitochondria membrane
Rb action
releases E2F after phosphorylation, E2F -> causes progression into S phase
Risk factors for Cervical Carcinoma
high-risk HPV, smoking, immunodeficiency
Smoking increases the risk of which cancers?
Oropharyngeal, esophageal, lung, kidney, urothelial, cervix, & pancreas
Why is Cervical Carcinoma and AIDS-defining illness?
Infection & CIN 1/2 is often resolved by the immune system, therefore cervical carcinoma is an indication of low immunity
CIN characteristics
koilocytic changes, nuclear atypia, high mitotic activity
CIN 1
<1/3 of epithelium thickness
CIN 2
<2/3 of epithelium thickness
CIN 3
< entire epithelium thickness
Carcinoma in situ
entire epithelium thickness
“Chocolate cyst” on ovary
endometriosis involving the ovary
“Gun-powder” nodules
endometriosis involving soft tissue
Adenomyosis
endometriosis w/in the myometrium
