Pathology o the cervix

Question 1

Cells in Endocervix

Answer 1

•Columnar epithelium

Question 2

–Ectocervix

Answer 2

•Squamous epithelium

Question 3

Transformation zone

Answer 3

• Area where the squamous epithelium abuts the columnar epithelium
• Susceptible to human papillomavirus infection (HPV)
• Cervical dysplasia and carcinoma develops in this area

•

Question 4

Area of cervix susceptible to human papillomavirus infection (HPV)

Answer 4

Transformation zone

•

Question 5

area of Cervical dysplasia and carcinoma develops in this area

Answer 5

Transformaiton Zone

Question 6

The squamocolumnar junction is situated at the ___ cervical os

Answer 6

external

Question 7

What encourages squamous metaplastic change

Answer 7

Acidic environment of the adolescent environment

Question 8

When does inversion vs eversion occur in the cervix

Question 9

What type of change do you see?

Answer 9

Metaplasia

Question 10

Is the change seen here reversible?

How can you tell?

Answer 10

Reversible.

This is metaplasia. You can see that mature cells have replaced typical mature cells.

Question 11

Atypia and hyperchromasia limited to the lower third of the epithelium

Answer 11

CIN1 aka LSIL (lower 1/3)

2/3 resolve on own

Question 12

Are the cells here mature or immature?

Answer 12

CIN2 with atypia and hyperchromasia limited to the lower two-thirds of the epithelium

1/3rd will resolve on own

Note: HSIL=CIN2 and 3

SIL=squamous intrapeithelial lesion

Question 13

What are the chances this will resolve on its own?

Answer 13

Slim: CIN 3 rarely resolves.

Question 14

Can this be reversed?

Answer 14

NO!!! This is normal!!!

Question 15

What types of cells are found in each zone?

Question 16

High Risk Types of HPV in woman

Answer 16

E6

E7

Question 17

Mechanism of mutation for HPV protein E6

Answer 17

E6–> binds p53 activating E6AP–> p53 degradation

Question 18

E7 path of mutation

Answer 18

E7 downregulates p27, p53 and binds Rb

phosphorylates Rb+E2F–> transcription

Question 19

Low risk HPV

Found on ___

Answer 19

6,11

6 and 11 you probably won’t go to heaven!

Found on Codylomas (warts)

Question 20

PAP smears:

When to start

When is it inadequate?

What is a better test?

Answer 20

21. Stop at 65 (this is variable)

HPV testing is more accurate

Question 21

Describe the cells you see

Answer 21

Superficial cell is pink with smallest nuclei

Interediate cell large nuclei and lots of cytoplasm

intermediate cell has large nuclei but less cytoplasm

Question 22

What organism is causing this?

Answer 22

Candida

Question 23

What organism is causing this?

Answer 23

Trichamonas

Question 24

What organism?

What are the 3 M’s and where are you seeing this in this specimen?

What type of Virus is this?

Answer 24

Herpes

1. Multinucleated
2. Molding of their neighbor
3. Marginated Chromosome

See notes to desbribe each

Enveloped Double stranded linear

Robe

Question 25

Organism?

Answer 25

Garderella Vaginsois

Question 26

Organism

Answer 26

HPV ## Footnote Well defined clear area around nucleus Rim of thickened cytoplasm Irregular nuclear membranes Nuclear enlargement Hyperchromasia