vulval and cervical pathology Flashcards
normal or abnormal smear
normal
what is this
normal endocervix
normal or abnormal smear
normal
inflammatory conditions of the cervix
-cervicitis
-cervical polyp
causes of cervicitis
-follicular cervicitis
-chlamydia
-herpes simplex
neoplastic conditions of the cervix
-cervical intraepithelial neoplasia
-cervical cancer
risk factors for cervical cancer
-presence of high risk HPV (16 and 18)
-many sexual partners
-early age of first intercourse
-long term use of oral contraceptives
-non-use of barrier contraception
-smoking
-immunosuppression
what is this
cervical intraepithelial neoplasia: high risk HPV
infected epithelium shows kilocytes
what is this
cervical cancer
-squamous cell carcinoma
how long can it take for HPV infection to become a high grade CIN
6 months - 3 years
how long does it take for high grade CIN to become invasive cancer
5-20 years
what is CIN
what are you looking for on histology of CIN
-delay in maturation/differentiation
-nuclear abnormalities
-excess mitotic activity
-often kilocytosis
what is CIN I
basal 1/3 of epithelium occupied by abnormal cells
what is CIN II
abnormal cells extend to the middle 1/3
what is CIN III
abnormal cells occupy full thickness of epithelium
what is this
CIN I
what is this
CIN 2
what is this
CIN 3
most common type of cervical cancer
squamous carcinoma
-develops from pre-existing CIN, therefore most cases should be preventable by screening
symptoms of invasive carcinoma
where can squamous carcinoma spread
-uterine body
-vagina
-bladder
-ureters
-rectum
-lymphatics (pelvic, para-aortic)
-haematogenous (liver, lungs, bone)
grading of squamous cell carcinoma
what is cervical glandular intraepithelial neoplasia (CGIN)
-origin from endocervical epithelium
-the preinvasive phase of endocervical adenocarcinoma
is CGIN more or less difficult to diagnose on smears than sqaumous
more difficult
what is this
high grade CGIN
who usually gets endocervical adenocarcinoma
young women
name some other HPV-driven diseases
what is VIN (vulval intraepithelial neoplasia) a precursor of
hpv driven SCC
what is differentiated VIN a precursor of
hpv independent vulval scc
-higher risk of invasive malignancy than hpv driven
who gets VIN
-young women
-older women
(bimodal)
what does vulvar invasive squamous carcinoma present as
in elderly women, ulcer or exophytic mass
where does vulvar invasive squamous carcinoma spread to
inguinal lymph nodes
surgical treatment for vulvar invasive squamous carcinoma
-radical vulvectomy
-inguinal lymphadenectomy
what is vulvar paget’s disease
where can vulvar paget’s disease spread from
-colorectal
-urothelial
what is VaIN
vaginal intraepithelial neoplasia
-may also have cervical and vulval lesions
