Vaginal Pathology & Cervical Cancer Flashcards
Describe the transition zone in the cervix in terms of the type of epithelium
Ectocervix: squamous
Endocervix: columnar
How is the transition zone in the cervix formed?
Acidic environment of vagina causes squamous metaplasia of the endocervical epithelium
What is a Nabothian cyst?
Distended endocervical gland
What causes cervicitis?
Chlamydia (40%)
Herpes simplex virus
IU devices
Allergic reactions
Cervicitis is often asymptomatic. True/False?
True
Where do cervical polyps typically grow?
Surface of cervical canal
Inner lining of uterus
What are the 2 main groups of neoplasia that affect the cervix?
Cervical intraepithelial neoplasia Cervical cancer (adenocarcinoma, squamous carcinoma)
Which strains of HPV are associated with cervical cancer?
16 and 18
Smoking increases the risk of cervical cancer by 3x. True/False?
True
How long does it take HPV infection to cause high grade cervical intraepithelial neoplasia?
6 months - 3 years
How long does it take HPV infection to cause invasive cervical cancer?
5-20 years
Cervical intraepithelial neoplasia is the pre-invasive stage of cervical cancer. True/False?
True
Where does cervical intraepithelial neoplasia occur?
Transition zone of cervix
Cervical intraepithelial neoplasia is usually asymptomatic. True/False?
True
Important to screen before becomes invasive
What 3 histological factors are assessed when determining the grade of CIN?
Delay in differentiation
Nuclear abnormalities
Excess mitotic activity
Describe CIN grade I
Basal 1/3 of epithelium occupied
Raised mitotic figures
Surface cells mature
Nuclei slightly abnormal
Describe CIN grade II
Extension to middle 1/3 of epithelium
Abnormal mitotic figures
Describe CIN grade III
Occupy full thickness of epithelium
Abnormal mitotic figures
Invasive cervical cancer always develops from pre-existing CIN. True/False?
True
Describe stage 1 invasive squamous carcinoma of cervix
1A1: depth 3mm, width 7mm
1A2: depth 5mm, width 7mm
1B: confined to cervix
Describe stage 2 invasive squamous carcinoma of cervix
Spread to adjacent organs (uterus, vagina)
Describe stage 3 invasive squamous carcinoma of cervix
Involvement of pelvic wall
Describe stage 4 invasive squamous carcinoma of cervix
Distant metastases or involvement of rectum/bladder
Describe the clinical features of invasive cervical cancer
Abnormal bleeding Brown/bloody vaginal discharge Contact bleeding Pelvic pain Haematuria Infections
Which cervical epithelium does adenocarcinoma derive from - ecto or endo -cervix?
Endocervical (glandular) epithelium
Adenocarcinoma of cervix is easier to diagnose than squamous carcinoma of cervix. True/False?
False
Often harder to diagnose as endocervix is more difficult to reach
Which carries the worse prognosis - adenocarcinoma or squamous carcinoma of cervix?
Adenocarcinoma
Which HPV is particularly associated with adenocarcinoma of cervix - 16 or 18?
18
Although both are associated
