REPRODUCTIVE NEOPLASMS Flashcards
ovarian tumour producing aromatase
granulosa cell tumour
if affectes younger - can cause precocious puberty
post menopausal women
sex cord stromal tumour
produce oestrogen / progesterone
FSH stimulates granulosa cell to convert theca cell androgens to oestrogens
increased inhibin –> inhibits FSH
markers: inhibin, AMH
oestrogen secreting
s/s:
breast tenderness, menstural irregularities
abn endometrial bleeding
ovarian fibroma
pleural effusion
ascites
meigs syndrome
(ovarian fibroma)
benign sex cord stroma tumour
name (4) ovarian germ cell tumours
mature and immature teratomas
dysgerminoma
yolk sac tumors
nongestational choriocarcinomas
large adnexal mass
weight loss
oligomenorrhea
tachycardia
hyperreflexia
struma ovarii
(type of mature teratoma)
hyperthyroidism clincal features
produce thyroxine
germ cell tumour
ovarian mass
hirsutism, virilization
cytoplasmic inclusions
** sertoli-leydig cell tumour**
(testosterone producing)
elevated testosterone levels
Reinke crystals in leydig cells
germ cell tumour
leydig cells are homologous with what cell in females
theca interna
cover granulosa cell layer of follicle
produce testosterone
express
elevated CA-125 seen in ovarian cancers derived from
epithelium
i.e. serous cystadenocarcinoma
aggressive
often bilateral
raised CA-125
papillary structures, stromal cores
lined by atypical epithelial cells
hypochromatic (dark blue) stain
small cytoplasms
inclusions - psammoma bodies
Serous cystadenocarcinoma
epithelial ovarian cancer (CA-125)
psamomma bodies
HCG, AFP normal
what is an increased risk factor for epithelial ovarian carcinoma
endometriosis
roles of oestrogen and progesterone in endometrium
oestrogen -> growth of endometrium
progesterone -> preparation for implantantion
progesterone loss -> shedding
growth - proliferative
preparation - secretory
loss of basalis causes
stem cells of endometrium
Asherman syndrome
unable to regenerate endometrium
overaggressive curettage and dilation, scarring
causes secondary amennorrhoea
most common time for anovulatory cycle
menache (first period)
menopause
lack progesterone secretory phase
endometrium eventually breaks down
uterine bleeding
what cells are normally found in endometrium
lymphocytes
plasma cells are neccessary on histology for Dx of chronic endometritis
what drug can cause endometrial polyps
tamoxifen
pro-oestrogenic effects on endometrium
anti-oestrogenic effects on breas
abnormal uterine bleeding
what cancer is at an increased risk with endometriosis
carcinoma at site of endometriosis, especially ovary
fever
abnormal uterine bleeding
pelvic pain
retained products conception
acute endometritis
acute infection
abnormal uterine bleeding
pain
infertility
plasma cells & lymphocytes
retainde products conception. PID / IUD / TB
chronic endometritis
chronic inflammation
plasma cells dx on histology
most important predictor of progression to carcinoma
cellular atypia
simple vs complex
presence/absence cellular atypia
simple hyperplasia with atypia - typically progress to cancer
complex hyperplasia without atypia - rarely does
endometrial glands > stroma
endometrial hyperplasia
stimulated by unopposed oestrogen
postmenopausal women
postmenopasual lack progesterone phase
oese pts - androgen to oestrogen - stimulate endometrium bleeding
location of bartholin cyst
either side of vaginal canal (enterance)
drains via ducts into lower vestible
produce mucous like fluid
reproductive age
unilateral painful cystic lesions
cyst from remants of mesonephric (wollfian) duct
anterolateral vaginal wall
gartner cyst
cyst from remants of female embryonic duct
vaginal wall
Mullerian cyst
gland either side of urethra
homologous to male prostate
skene glands
persistance of columnar epithelium in upper vaginal canal
adenosis
exposure to DES - diethylsetilbestrol in uterus
can lead to clear cell adenocarcinoma
mesenchymal proliferation of immature skeletal muscle
**embryonal rhabdomyosarcoma
sarcoma botryoides
bleeding
grape like mass
protrude vagina/penis
child <5yo
desmin +, myogen +
cytoplasmic cross striations
what neoplasm shows cytoplasmic cross striations
embryonal rhabdomyosarcoma
bleeding, grape like mass
desmin, myogenin +
what is the characteristic cell in rhabdomyosarcoma
rhabdomyoblast
what are desmin and mygenin
desmin: intermiediate filament in muscle cells
mygenin: nuclear transcription factor in immature skeletal muscle
positive immunohistochemical staining for these in rhabdomyosarcoma
vaginal carcinoma usually related to
high risk HPV 16, 18, 31, 33
precurosr lesion vaginal intraepitheial neoplasia (VAIN)
the precurosr lesion vaginal intraepitheial neoplasia (VAIN) can progress to
vaginal carcinoma
vaginal cancer from upper 2/3 will spread to
iliac lymph nodes
mullerian duct
vaginal cancer from lower 1/3 will spread to
inguinal lymph nodes
urogenital sinus
male adenocarcinoma from prostate metastastis can be treated with -? to help prevent spread
**17-a-hydroxylase **enzyme inhibitor
(limits extratesticular androgen production)
i.e. abiraterone
androgens produced adrenals, testes, tumour cells
other 17α-hydroxylase inhibitors - spironolactone, ketaconazole
germline mutations in ____ gene increases risk for breast and ovarian cancer due to inability to repair ____
BRCA1
double strand DNA breaks
susceptable to platinum compounds i.e. carboplatin - forms DNA crosslinks
what type of carcinoma is Pagets of the breast
intraepithelial adenocarcinoma
what is a cause of angiosarcoma
radiation
vinyl chloride
arsenic
pre-menopausal
bloody nipple discharge
no mass
no skin changes
no systemic symptoms
intrductal papilloma
benign
Papillary fronds lined by epithelial and myoepithelial cells
Central fibrovascular cores
