Repro PATH lab

Question 1

Histo of seminomas

Answer 1

sheets of uniform polygonal cells with clear cytoplasm, round nuclei, and prominent nucleoli.

Question 2

What group of lymph nodes (location) is typically the first involved by metastatic penile squamous cell carcinoma?

Answer 2

The inguinal lymph nodes.

Question 3

Which sexually transmitted disease is associated with the development of penile squamous cell carcinoma?

Answer 3

Human papilloma virus infection.

Question 4

How do malignant prostatic glands differ from benign prostatic glands in histologic appearance?

Answer 4

Malignant prostatic glands tend to be small, back-to-back, and infiltrating; they have a single cell layer and prominent nucleoli. Benign prostatic glands tend to be larger, have a lobular configuration, and are lined by two cell layers.

Question 5

What are some common metastatic sites for prostatic adenocarcinoma?

Answer 5

Pelvic lymph nodes, bone, lungs.

Question 6

What are the risk factors for the development of cervical dysplasia?

Answer 6

Multiple lifetime sexual partners (five or more), high-risk sex partners (those with: condyloma, penile carcinoma, multiple sexual partners, partners who have condyloma, dysplasia, or cervical carcinoma), early coitarche.

Question 7

Why can we consider squamous cell carcinoma (SCCA) of the cervix a sexually transmitted disease?

Answer 7

Squamous carcinoma of the cervix is the end point of a progression of lesions that begins with infection by human papilloma virus (HPV), probably in tandem with environmental cofactors. Women who are sexually active can become infected; women who are not sexually active generally don’t get SCCA of the cervix. The risk factors that predispose sexually active women to develop SCCA are: young age at first sexual intercourse, especially before age 16 (the hormonal interactions on the changing cervix of menarche render it susceptible to infection); multiple lifetime sexual partners (the more partners, the higher the probability of infection); male sexual partners who are high risk themselves (they have had condyloma or penile cancer, other partners with cervical cancer or dysplasia, or multiple sexual partners); and cigarette smoking.

Question 8

Is endometriod carcinoma malignant or benign?

Answer 8

Malignant

Question 9

How doesthe histologic appearance of endometriod adenocarcinoma differ from adenomyosis?

Answer 9

Adenomyosis has both benign endometrial glands and stroma in the myometrium, while in endometrial adenocarcinoma, only malignant glands involve the myometrium.

Question 10

What are other common locations for endometriosis?

Answer 10

Uterine ligaments, rectovaginal septum, and pelvic peritoneum.

Question 11

What are the potential origins of the development of endometriosis?

Answer 11

Regurgitation through the fallopian tubes; metaplasia of the peritoneum; vascular or lymphatic invasion.

Question 12

What is a possible complication of endometriosis of the intestines?

Answer 12

Obstruction.

Question 13

Dyspareunia

Answer 13

pain when sexual intercourse or other sexual activity that involves penetration is attempted or pain during these activities.

Question 14

What symptoms may be associated with adenomyosis?

Answer 14

Menorrhagia, dysmenorrhea, and dyspareunia.

Question 15

Histo of cystadenocarcinoma

Answer 15

complex papillary structures with occasional psammoma bodies.

Question 16

What histologic characteristic distinguishes serous tumors of low malignant potential from serous cystadenomas?

Answer 16

Serous tumors of low malignant potential are lined by complex papillary structures covered by epithelium with nuclear atypia and mitotic activity, while serous cystadenomas are lined by a flat, bland epithelium.

Question 17

What is the prognosis for a completely excised ovarian serous tumor of low malignant potential that is confined to the ovary?

Answer 17

Excellent; 100% cured.

Question 18

Where else in the body do teratomas arise?

Answer 18

They occur in testis and, rarely, in the mediastinum, pineal gland, and sacrococcygeal region.

Question 19

Fibrothecomas are discovered in which age group of patients most commonly?

Answer 19

Middle-aged to elderly women.

Question 20

What other tumors commonly metastasize to the ovaries?

Answer 20

Endometrial carcinoma, breast carcinoma, and other gastrointestinal carcinomas.

Question 21

What histologic features distinguish proliferative from nonproliferative fibrocystic change?

Answer 21

Nonproliferative changes include stromal fibrosis and cyst formation; proliferative changes include the nonproliferative changes plus epithelial hyperplasia and sclerosing adenosis.

Question 22

How are apocrine metaplasia cells different morphologically from normal ductal cells?

Answer 22

Apocrine metaplasia cells have abundant eosinophilic cytoplasm and large round nuclei with nucleoli.

Question 23

Is the presence of ductal hyperplasia without atypia a risk factor for the subsequent development of breast carcinoma?

Answer 23

Yes, but only a slightly increased risk (1.5 - 2X). Atypical ductal hyperplasia has a 4-5X increased risk.

Question 24

Besides the axillary lymph nodes, what other organs are commonly involved by metastatic breast carcinoma?

Answer 24

Lungs, liver, bone.

Question 25

What factors influence the prognosis of breast cancer?

Answer 25

Size of tumor, number of lymph node metastases, histologic type and grade of tumor, presence or absence of estrogen receptors, proliferative rate and DNA ploidy, and overexpression of HER2.

Question 26

What are the typical symptoms of an intraductal papilloma?

Answer 26

Serous or bloody nipple discharge, occasionally with an underlying palpable nodule.

Question 27

How does lobular carcinoma in situ differ from ductal carcinomas in situ with regard to the subsequent risk for invasive breast carcinoma?

Answer 27

With long-term follow-up (~ 24 years), 30% of patients with LCIS develop invasive carcinoma; however, the tumor may be ductal or lobular, in the same or opposite breast. Thus, lobular carcinoma in situ is considered a marker of increased risk for invasive breast carcinoma, while intraductal carcinomas are considered precursors to invasive breast carcinoma.

Question 28

In comparison, what is the typical gross appearance of a partial molar pregnancy?

Answer 28

A partial molar pregnancy is composed of bloody, friable tissue indistinguishable from spontaneous abortion tissue.

Question 29

What is a common complication of metastatic choriocarcinoma?

Answer 29

Hemorrhage.