Pathology of the female reproductive tract Flashcards
Vulva and vagina tissue type
Stratified squamous epithelium
Vagina change at puberty
Rise in oestrogen from ovary
- Matures squamous cells
Mature squamous cells secrete glycogen
- Glycogen is fermented by anaerobic bacteria–> lactobacilli
Lactobacilli- produce lactice acid
- pH <4.5
Ectocervix tissue type
Stratified squamous epithelium.
Endocervic structure
Simple columnar epithelium
- Secretes mucin
Blind ending channels/ clefts
- Increase surface area
- Radiate out of endocervical call into stroma.
Squamo-columnar junction
Junction between ectocervix (stratified squamous) to columnar endocervix.
Transformation zone
- Formation
- Structure
Distal end of the endocervix opens
- Trumpet shape
- Endocervical mucose becomes exposed to vaginal environment (acidic)
Forms metaplastic squamous change
Squamous metaplasia
Some of the endocervix becomes exposed to the acidic vaginal environment
- Reserve cells proliferate into squamous epithelium
Adaptation copes with acidic environment
Myometrium structure
Bundles of smooth muscle
Mixed with blood vessels and nerves
Endometrium proliferative phase
Occurs before ovulation
Composed of
- Tubular glands
- Specialised stroma
- Blood vessels.
Due to proliferative phase- glands undergo mitosis
Endometrium- Secretory phase
After ovulation
- Last 14 days
Tissue composed of
- Cork screw glands
- Specialised stroma
- Blood vessels.
Metaplasia
Adaptive cell change from one type of mature differentiated cell type to another differentiated cell type.
Benign neoplasm
- Behaviour
- Histogenesis
Neoplasm that is
- Localised, does not invade neighbouring tissue.
- Generally grow slowly
- Resembles parent tissue
Leiomyoma
Benign neoplasm of the myometrium (fibroid)
Localised, grows slowly
Resembles myometrium histologically
Consequences of benign neoplasm
Pressure on adjacent tissue
- Urinary frequency
- Constipation
Obstruction of hollow organ
- Urinary retention
- Endocervic block
Secretion of hormone
- Polycythemia
Transformation into malignancy
- Bleeding
- Pain
Malignant neoplasm
- Behaviour
- Histology
Invade into surrounding tissues
Spread
- Lymphatics, into lymph nodes
- By blood, into other organs/ tissues
Grow relatively quickly
Variable resemblance to parent tissue
4 main histological features of malignant neoplastic tissue
Loss of differentiation
Loss of cellular cohesion
Enlarged irregular dark nuclei
Increased number of mitosis- highly proliferative
Consequences of malignant neoplasms [7]
Destruction of adjacent tissue
Metastasis
Blood loss- when there is ulceration
Obstruction- hollow viscera
Secretion of hormones
Weight loss
Anxiety/ pain
Carcinoma
Malignant epithelial tumours
Dysplasia
Disordered differentiation and growth of cells.
Atypic cells
Highly proliferative
Loss of differentiation
Cervical intra-epithelial neoplasia (CIN)
Dysplasia of the cervix
Known as Squamous intra-epithelial lesion (SIL) in USA
Higher the grade, the most likely to progress into squamous cell carcinoma
Sites of metaplasia in the body
Regions where dysplasia is most likely to occur.
Cervical transformation zone
- Squamous metaplasia
Bronchial epithelium
- Squamous metaplasia
Distal oesophagus
- Glandular metaplasia
Normal constituents of a smear
Endocervical cells [columnar]
Squamous cells
Metaplastic cells
Normal cells will have small nucleus and larger cytoplasm.
HPV and cervical cancer
HPV infection causes CIN
CIN has high risk of developing into cervical cancer
HPV
- Description
- High and low risk.
Virus that infects the epithelium and keeps infection local to the site of contact.
High risk
- 16, 18–> Malignancy
Low risk
- 6, 11–> genital warts
