Trophoblst and Cervical Cancer Flashcards
What is a Hydatid?
A cyst containing watery fluid
What is a Mole?
Mole: An abnormal mass of tissue in the uterus
What is a Hydatidiform mole?
Devt Abnormality of the placenta resulting from faulty fertilization
4-5 month gestation w/ discordance bet uterine size and dates, vaginal bleeding, expulsion of vesicles
What is a Complete vs Partial mole?
Comp: 1) empty egg + 1 sperm (duplicate later)
2) Empty Egg + 2 sperm
46XX/XY
Partial: 1 egg + 2 sperm
69 XXX/XXY/XYY
What happens in A Complete Mole?
No embryo develops
Uterus distended by large, bizarre gelatinous mass
Serum hCG VERY high
Chorionic Villi are edematous w/ var degree of trophoblastic prolif
“SNOWSTORM” on US
What is seen in the Chorionic Villi in Complete mole?
Gross: Grape-like villi
Micro: Large Avascular Villi with areas of Trophoblastic proliferation
What is seen in a partial Mole?
Some, not all villi edematous
Fetus or fetal parts present
hCG not as markedly elevated as in complete mole
slight hyperplasia of Trophoblast
What is an invasive mole?
Complete mole with penetration of villi and trophoblast into myometrium => serosal surface
Uterine Rupture
Vascular inv may => emboli of villi to lung
hCG elevated after evac of uterine cavity
Waht are the traits of ChorioCA?
Uncommon highly malignant neoplasm of trophoblastic cells derived from normal gestation, spon abortion, ectopic preggo, comp mole (50%)
VERY Sensitive to CHEMO!
Fleshy, hemorrhagic tumor consisting of cytotrophoblast and syncitio, NO VILLI
What is A placental Site Tumor?
Low hCG levels
50% follow normal pregnancy
10% will mets
What is the TRANSFORMATION zone of the Cervix?
Transition from columnar epi to squamous epi results from squamous METAPLASIA
Affected by hormones, pH, flora, trauma
CIN and CA originate from TZ
What are the risk factors for Cervical CA?
high risk oncogenic HPV 16 + 18
infection of columnar or sqamous epi transitional zone
Early age at sexual debut
Multiple sex partners
Genital infections, HIV, Cig Smoking, immune compromise
What viral proteins interfere with p53, p21 and Rb?
E6 inhibits p53
E7 inhibits p53 + p21 + Rb
What are the morphologic features of Cervical intraepithelial Neoplasia?
Nuclear Atypia Alterned nuclear-cytoplasmic ratio Loss of basal polarity Pleomorphism Increased mitotic figures lack of diff and maturation
What is seen on In situ hybridization test for HPV DNA.
Dark granular staining notably in koilocytes(HPV infected cells)
