Uterus (incl cervix) Flashcards
benign mimics of malignancy - endometrium
menstrual endometrium
papillary syncytial metaplasia
arias stella
benign mimics of malignancy - myometrium
coagulative necrosis in leiomyoma
benign metastasizing leiomyoma
intravascular leiomyomatosis
polyps
endometrial polyp
submucosal leiomyoma
adenomyoma
atypical polypoid adenomyoma
adenofibroma
adenosarcoma
atypical polypoid adenomyoma (features)
APA: lower uterine segment, focal, atypical endometrial hyperplasia, squamous morules
adenosarcoma vs adenofibroma
adenosarc: raised mitoses, stromal cellularity, stromal overgrowth, HG atypia
spindle cell neoplasms
leiomyoma
endometrial stromal nodule
PEComa
undifferentiated uterine sarcoma
carcinosarcoma
epithelioid neoplasms
carcinoma
adenomatoid tumour
epithelioid leiomyoma/sarcoma
endometrial stromal nodule/sarcoma
uterine neoplasm with sex cord-like elements (no stromal component, inhibin+)
PEComa
placental site
biphasic lesions
endometrial polyp
adenofibroma/sarcoma
carcinosarcoma
adenomyoma/APA
tumour cell necrosis vs hyaline necrosis
TCN: abrupt transition, ghosted tumour cells with atypical nuclei, karyorrhectic debris
LG endometrial stromal sarcoma vs intravascular leiomyomatosis
LG ESS: diffuse CD10+, desmin+/-, keratin-
leiomyomatosis: always desmin+, CD10+/-, keratin+/-
NB: if ambiguous, call LG ESS
endometrial stromal nodule vs stromal sarcoma
nodule: non-infiltrative, no intravascular component
carcinosarcoma vs endometrial ca with spindle cell elements
endometrial ca: low grade, no marked spindle cell atypia
adenoid cystic carcinoma
tubular, cribriform or solid
hyaline material with pallisaded epithelial cells
PNI and locally aggressive (as in salivary gland)
benign mimics of malignancy - cervix (8)
T-CRAMMED
mesonephric remnants (bland, no desmoplasia)
microglandular hyperplasia (bland, no desmoplasia)
tuboendometrioid metaplasia
endometriosis
decidual change
Arias-Stella (nucleoli but no mitoses)
CMV/HSV
radiation
tuboendometrioid metaplasia vs AIS
AIS: stratification, hyperchromasia, nuclear enlargement, mitoses
malignant mimics of benign - cervix
minimal deviation adenoca (infiltrative, focal atypia)
early adenosarcoma (polypoid)
clear cell adenocarcinoma DDX
microglandular hyperplasia
mesonephric remnants
Arias-Stella
metastatic RCC
superficially invasive cervical SCC - criteria (4)
>=3mm depth
<=7mm width
not grossly visible
completely excised
(low potential for mets/recurrence if excision complete and no LVI)
endometrial ca vs endocervical ca
endometrial: vimentin, ER+
endocervical: CEA, p16+

Villoglandular adenocarcinoma (interlacing glands, cellular fibrous stroma)

Adenoid basal carcinoma (peripheral palisading, central squamous differentiation)

Uterine neoplasm with sex cord like elements

Glassy cell carcinoma (subtype of adenosquamous ca): ground glass cytoplasm, inflammation (eosinophils and plasma cells)
serous vs endometrioid vs clear cell ca
serous: p53 diffuse, wt+/-, er+/-, ki67 high
endometrioid: p53 patchy, wt1-, er+, ki67 low
clear cell: p53+/-, wt1-, er+/-, ki67 intermediate; HNF1-beta +
leiomyoma vs leiomyosarcoma
tabulated criteria based on:
cell type (spindled, myxoid, epithelioid)
atypia (severity and distribution)
necrosis
mitotic rate