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Year2 Repro exam I > Uterus path II > Flashcards

Uterus path II Flashcards

1
Q

What are the cancers that arise in the epithelium of the endometrium

A

hyperplasia/EIN

adenocarcinoma

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2
Q

what are the types of adenocarcinomas of endometrium

A

type I- glandular

non endometroid which is type II- surface

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3
Q

types of type II-surface endometrial adenocarcinomas

A

papillary serous carcinoma

MMMT carcinosarcoma

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4
Q

majority of endometrial CA are what type

A

endometroid adenocarcinoma- type I

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5
Q

endometroid adenocarcinomas present when

A

45-55 y.o

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6
Q

endometroid adenocarcinoma is assoc with what

A 
exogenous E
endogenous E
E from peripheral conversion of androgen
infertility
DM and HTN
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7
Q

what mutations can occur with endometroid adenocarcinom

A

PTEN mutations

microsatellite instability in KRAS gene assoc with HNPC lynch syndrome

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8
Q

presentation of endometroid adenocarcinoma

A

abrnomal bleeding, spotting or staining

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9
Q

how does endometroid adenocarcinoma spread

A

direct extension, late spread to nodes and distance mets

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10
Q

risk factors for endometrial cancer

A 
increasing age
E therapy
tamoxifen therapy
early menarch
late menopause >55
obestiy
DM
lynch syndrome
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11
Q

what do the grades of endometroid adenocarcinoma relate to

A

percent that is solid

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12
Q

with a Bx of the endometrium is suspect adenocarcinoma what should you stain for

A

PTEN

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13
Q

if adenocarcinoma in endometrium has p53 mutation what is it

A

serious carcinoma, non-endometroid (type II)

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14
Q

how should you follow a non-endometroid adenocarcinoma (type II)

A

high grade, 2/3 with aggressive course
early spread in lymph and into fallopian tubes to peritoneal cavity
follow closely!!
has papillary architecture

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15
Q

What are MMMT tumors

A

malignant mixed mullerian tumors, carcinosarcomas
bulky polypoid mass
epithelial and mesenchymal components

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16
Q

when does non endometroid adenocarcin type II usually arise

A

65-75 y.o

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17
Q

clinical setting of those affected with non endometroid adenocarcinoma

A

atrophy, thin physique

common in african americans

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18
Q

morpholocy of the non endometroid adenocarcinoma

A

serous, clear cell with mixed mullerian features

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19
Q

non endometroid adenocarcinoma is a precursor ro what

A

endoetiral intraepithelial carcinoma

20
Q

which lynch syndrome genotype is most closely relate dot endometrial cancer

A

MLH1

21
Q

What is grade 3 adenocarcinoma

A

poorly differentiated >50% solid growth

22
Q

what is stage 1 adenocarcinoma

A

carcinoma confined to corpus uteri itself

23
Q

what is stage 3 adenocarcinoma

A

outside uterus but not outside true pelvis

24
Q

what is satge 4 adenocarcinom

A

outside true pelvis, may involve mucosa of bladder or rectum

25
Q

stage 2 adenocarcinoma

A

involves corpus and cervix

26
Q

what is stage IIIC endometrial cancer

A

spread to lymph nodes in pelvis or around aorta

27
Q

if endometrial cancer has spread to lymph nodes what is 5 yr survival

A

60%

28
Q

what is 5 yr survival of type II endometrial adenocarcinoma

A

20%

29
Q

how does type I adenocarcinom of endometrium present

A

post menopausal bleeding, Bx and curettage

30
Q

Tx enometrial adenocarcinoma

A

surgery
chemo and radiation if stage III or IV
biologics in trials

31
Q

When do you use hormone therapy instead of surgery for uterine carcinoma

A

grade 1 endometroid adenocarcinoma AND fertility preservation
or Grade 1 endometroid adenocarcinoma AND poor surgical candidate

32
Q

What are the stromal neoplasms of the uterus

A

benign stromal nodule
endometrial stroma sarcoma
adenosarcoma

33
Q

what are the neoplasms of the uterus myometrium

A

leiomyoma

leimyosarcoma

34
Q

how do adenosarcomas of the endometrium present

A

large sessile polyps that may protrude through cervical os

histo show malignant stroma with benign glands

35
Q

what is an endometrial stromal nodule

A

benign mass without clinical importance

need to differentiate from sarcoma

36
Q

what is an endometrial stromal sarcoma

A

spindle cell sarcoma, no glands

predilection for lymphatic invasion

37
Q

how do you confrim endometrial stromal sarcoma

A

IPX stain for CD10

38
Q

what is prognosis of endometrial stomal sarcoma

A

5 yr survival 50%

39
Q

what is a leiomyoma

A

benign smooth muscle neoplasm “fibrinoid”

40
Q

What is mutaiton in leiomyomas and leiomyosarcomas

A

MED12 gene

41
Q

what are Sx of leiomyomas

A 
(depends on location)
bleeding- submucosal
pain- infarction/large mass
urinary frequency- pressure on bladder
infertility
miscarriage in 2nd trimester!
42
Q

what is a leiomyosarcoma

A

malignant smooth muscle neoplasm

can invade uterine wall or polypoid mass in lumen

43
Q

how do we Dx a leiomyosarcoma

A

high mitotic rate >10HPF, cytologc atypia and tumoral necrosis

44
Q

peak incidence of leiomyosarcoma

A

40-60 yrs

45
Q

where do leiomyosarcomas mets to

A

blood vessel invasion

Year2 Repro exam I (19 decks)

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