Pathology of Uterus and Ovaries

Question 1

what is the most common symptom of uterine cancer?

Answer 1

abnormal bleeding (DUB or post menopausal)

Question 2

what are the different types of uterine cancer?

Answer 2

endometroid

serous

Question 3

when is the peak incidence of endometrial cnacer?

Answer 3

50-60yr

v uncommon under 40yrs

Question 4

what is classically seen in the DNA of endometroid carcinomas?

Answer 4

microsatellite instability

Question 5

what is microsatellite instability?

Answer 5

predisposition to genetic mutation due to impaired DNA mismatch repair

Question 6

what are microsatellites?

Answer 6

repeated sequences of DNA

Question 7

microsatellite instability is evidence that what process isn’t working properly?

Answer 7

MMR- DNA mismatch repair

(this is what usually fixes errors that occur in DNA replication)

Question 8

microsatellite instability is a good marker for which condition?

Answer 8

Lynch Syndrome

Question 9

serous carcinoma commonly affect which age group?

Answer 9

elderly post-meno pausal women

Question 10

which gene is typiclly mutated in serous carcinoma?

Answer 10

TP53

Question 11

why is obesity thought to increase risk of cancer?

Answer 11

adipocytes express aromatase which converts androgens into oestrogens stimulating endometrial proliferation

Question 12

what is Lynch Syndrome?

Answer 12

cancer predispostion syndrome with high risk of colorectal, endometrial and ovarian cancer.

Question 13

Lynch syndrome follows which mode of inheritance?

Answer 13

autosomal dominant

Question 14

what are the Grades of Endometrial Cacncer

Answer 14

Grade 1: 5% or less solid growth

Grade 2: 6-50% solid growth

Grade3: >50% solid growth

Question 15

how many stages of endometrial cancer are there?

Answer 15

Stage IA/B

Stage II

Stage IIIA/B/C

Stage IV

Question 16

what is a malignant tumour of the smooth muscle?

Answer 16

leiomyosarcoma

Question 17

what is commonly seen in morphology of leiomyosarcoma?

Answer 17

spindle cells

Question 18

58yr old women presenting w abnormal vaginal bleeding, palpable pelvic mass and pelvic pain is likely to be?

Answer 18

leiomyosarcoma

Question 19

what is the prognosis like for leiomyosarcoma?

Answer 19

poor prognosis

Question 20

are most uterine cancers detected early or late?

Answer 20

early as usually present w abnomral bleeding

Question 21

which is more aggressive, endometroid ro serous carcinoma of the uterus?

Answer 21

serous

more aggressive and spreads along fallopian tube mucoase and peritoneal surfaces - may present as extrauterine disease

Question 22

which type of uterine cancer is assoc w unopposed oestrogen?

Answer 22

endometroid

(seerous is not asoc w unopposed oestrogen)

Question 23

atypical hyperplasia is the precursor of which type of uterine cancer?

Answer 23

endometroid

Question 24

what is the mainstay treaetment for uterine cancer?

Answer 24

surgery- hysterectomy/ablation

can also treat w chemo/radiotherapy

Question 25

which type of endometrual cancer arises from endometrial stroma?

Answer 25

endometrial stromal sarcoma

Question 26

which type of endometrial cancer arises from mixed malignant epithelial and stromal elements?

Answer 26

carcinosarcoma

Question 27

follicular cysts are common in which condition?

Answer 27

PCOS

Question 28

how would you describe follicular ovarian cysts?

Answer 28

thin walled lined by granulosa cells

Question 29

what is endometriosis?

Answer 29

endometrial glands and stroma outside the uterine body

Question 30

what can be seen macroscopically in ovarian endometriosis?

Answer 30

peritoneal spots/nodules fibrous adhesions choclate cysts

Question 31

what are the complications of ovarian endometriosis?

Answer 31

pain cyst formation adhesions infertility ectopic pregnancy malignancy

Question 32

ovarian endometriosis can predispose to which malignancy?

Answer 32

endometroid carcinoma

Question 33

what is the most common type of ovarian tumour?

Answer 33

epithelial

Question 34

what are the 4 types of epithelial ovaran cancer?

Answer 34

serous endometroid clear cell mucinous

Question 35

what are the three classifications of mucinous tumour?

Answer 35

benign borderline malignant

Question 36

what is a benign ovarian tumour of transitional type epithelium?

Answer 36

brenner tumour | (malignant variant is rare)

Question 37

what is the most common germ cell tumour?

Answer 37

Mature teratoma

Question 38

a mature teratoma is also often called what?

Answer 38

dermoid cyst | (contains sebum and hair)

Question 39

are mature teratomas benign or malignant?

Answer 39

can be both

Question 40

what are the malignant types of germ cell tumour?

Answer 40

immature teratoma dysgerminoma yolk sac tumour chroiocarcinoma mixed germ cell

Question 41

what are the different types of sex cord/stromal tumours?

Answer 41

fibroma/thecoma granulosa sertoli-leydig

Question 42

fibroma are typically benign or malignant?

Answer 42

benign may produce oestrogen causing uterine bleeding

Question 43

granulosa cell tumours are benign/malignant?

Answer 43

potentially malignant may be assoc w oestrogenic manifestations

Question 44

what is brachytherapy?

Answer 44

intrauterine tube used to deliver radiotherapy