Tumors of Uterus and Cervix

Question 1

PTEN tumor suppressor gene is associated with what uterine pathology

Answer 1

endometrial hyperplasia

Question 2

what is the difference between simple and complex hyperplasia in endometrial hyperplasia?

Answer 2

• simple: gland to stroma ratio is even (area taken up by glands vs storm is the same)
• complex: ↑ gland to stroma ratio

Question 3

the precursor histological appearance to type I endometrial carcinoma is _______

Answer 3

complex endometrial hyperplasia with atypia; endometrioid epithelium

Question 4

what is the precursor to type II endometrial carcinoma

Answer 4

endometrial intraepithelial carcinoma

Question 5

what mutation is associated with the endometrial carcinoma type with endometrioid epithelium

Answer 5

PTEM, KRAS, and MSI; (type 1 which is the most common and relatively indolent)

Question 6

what mutation is associated with type II endometrial carcinoma

Answer 6

p53; serous, clear cell epithelium

Question 7

grading is only required for type ___ endometrial carcinoma

Answer 7

type 1; type 2 is already considered to be high grade

Question 8

what are the two components in a mixed mullein tumor?

Answer 8

epithelial and stromal elements

Question 9

metastasis and behavior is defined by the _____ component in a malignant mixed mullein tumor

Answer 9

epithelial

Question 10

are leiomyomas estrogen sensitive?

Answer 10

yes; these typically regress with menopause

NO malignant potential

Question 11

when looking at smooth muscle tumors of the uterus what are 3 features you look for to differentiate between leiomyoma and leiomyosarcoma?

Answer 11

• nuclear atypia
• Mitotic índex (MI > 10 = NOT leiomyoma)
• necrosis (coagulative tumor necrosis)

Question 12

how often does leiomyoma progress to leiomyosarcoma

Answer 12

NEVER

Question 13

what is the metaplasia seen in the transformation zone in the cervix?

Answer 13

squamous metaplasia (columnar → squamous)

Question 14

what changes being about the formation of the transformation zone in the cervix?

Answer 14

after puberty, that area gets exposed to vaginal acidity leading to the production of more squamous eptfhielum

Question 15

transition zone cells are susceptible to infection by _____

Answer 15

HIGH risk HPV

Question 16

is there malignant potential associated with endocervical polyps?

Answer 16

NO

Question 17

condyloma ______ is associated with low risk HPV

Answer 17

accuminatum (HPV 6,11)

Question 18

______ is a differentiating factor between leiomyoma and leiomyosarcoma

Answer 18

MI > 10 for leiomyosarcoma while MI < 10 for leiomyoma

both can have nuclear atypia and necrosis

Question 19

presence of a _______ is indicative of a cel infected by HPV

Answer 19

koilocyte: enlarged hyperchromatic, irregular nuclei with a perinuclear halo

Question 20

CIN (cervical intraepithelial neoplasia) is divided into LSIL (low grade squamous intraepithelial lesion) and HSIL (high grade squamous intraepitheiial lesion).
what is the point of this classicfication and which CIN’s are in each category

Answer 20

LSIL and HSIL are what determine what course of treatment (NOT CIN I, II, or III)

LSIL: CIN I
HSIL: CIN II, III

Question 21

in a Pap smear, what area of the cervix are you trying to sample?

Answer 21

transformation zone

Question 22

what are three major common causes of death in patients with carcinoma of the cervix?

Answer 22

• pyelonephritis
• uremia
• ureteral obstruction