Pathology Of Female Tract 3

Question 1

What percent of women with endometrial cancer present with post menopausal bleeding?

Answer 1

Over 80

Question 2

Subtypes of adenocarcinoma at one site by morphology?

Answer 2

Endometrioid
Serous
Clear cell
Carcinosarcomas 
Mixed 
Undifferentiated/ dedifferentiated

Question 3

Serous cancers resemble?

Answer 3

Fallopian tube epithelium

Question 4

Clear cell cancers?

Answer 4

Have clear cytoplasm

Question 5

Differences between endometrial adenocarcinoma types?

Answer 5

Type 1:
50-60s
Endometrioid
Good prognosis 
Spread through lymph nodes
Concurrent ovarian cancer is common 

Type 2:
60s-70s
Poor prognosis
Concurrent ovarian cancer is uncommon
Spreads through peritoneum
Serous mixed cancer

Question 6

Where is the genomic classification of endometrial cancers published?

Answer 6

The cancer genome atlas TCGA

Question 7

Precursor lesion to squamous cell carcinoma?

Answer 7

CIN cervical intra epithelial neoplasia, by a process of dysplasia

Question 8

How to detect a CIN?

Answer 8

Screening for HR HPV infection
Looking for abnormal cells
Examin by colposcopy
Treating by LLETZ

Question 9

What is the precursor lesion of endometrioid form of endometrial carcinoma?

Answer 9

Atypical hyperplasia

Question 10

Which is the most common female genital tract invasive cancer?

Answer 10

Endometrial adenocarcinoma

Question 11

What is the lifetime risk?

Answer 11

1 in 46

Question 12

Peak incidence of endometrial adenocarcinoma?

Answer 12

55-65 years

Question 13

Risk factors for endometrial cancer?

Answer 13

Endogenous hormones and respoductive factors
Excess body weight
DM and insulin
Exogenous hormones and modulators
Ethnicity 
Familial

Question 14

How does pregnancy and parity reduce risk of endometrial cancer?

Answer 14

Removal of abnormal cells at delivery

Break from unopposed oestrogen during pregnancy

Question 15

What increases risk of endometrial cancer?

Answer 15

Early menarche and late menopause

Reduced by 7% for each year fewer

Question 16

What percent of endometrial cancer are linked to excess body weight?

Answer 16

34%

Question 17

Risk of endometrial cancer in overweight people increased?

Answer 17

2-3 times

Question 18

Women with DM have endometrial cancer risk of?

Answer 18

2 fold

Question 19

Exogenous hormone and modulators?

Answer 19

Tamoxifen

HRT

Question 20

Ethnicity and endometrial cancer?

Answer 20

Greater in white then African American, but in these there is a higher mortality x 4

Question 21

Why is mortality higher in African American women?

Answer 21

Later diagnosis
Unfavourable tumour type
Sociodemographic factors and treatment
Comorbidities

Question 22

Grade 1?

Answer 22

Well differentiated

Question 23

How do you grade endometrial carcinoma?

Answer 23

Fraction of tumour forming glands is estimated than divided by 3

Question 24

Staging system?

Answer 24

T for tumour : local spread
N: lymph node deposits
M: metastatic deposits

But for gynae use FIGO

Question 25

FIGO staging?

Answer 25

Stage 1: Confined to corpus
Stage 2: Involving cervix
Stage 3: Serosa/Adnexa/Vagina/Lymph Nodes
Stage 4: Bladder, Bowel, Distant Metastasis

Question 26

Familial risk factors for endometrial carcinoma?

Answer 26

Cowdens syndrome HNPCC