Week 9: Cervix Pathology

Question 1

What are common cervical symptoms?

Answer 1

• Vaginal discharge or dryness
• AUB
• Urinary Symptoms
• Pelvic Pain
• Sexual Dysfunction

Question 2

ID

Answer 2

normal cervix

Question 3

ID

Answer 3

Normal Cytology stain

basophilic cells - mature/intermediate squamous cells
eosinophilic cells - superficial squamous cells

Question 4

ID

Answer 4

Low-Grade Squamous Intraepithelial Lesion (LSIL)

Question 5

What are the features of Koilocytic Atypia

Answer 5

• Perinuclear Halo - HPV proteins break down the perinuclear keratin (orange arrow)
• Enlarged, Irregular, Hyperchromatic Nuclei - may be multinucleated or incompletely split (rasinoid/dumb-bell nucleus) (cyan arrow)
• Increased N/C ratio - more nucleus and less cytoplasm (yellow arrow)

Question 6

ID

Answer 6

Low-Grade Squamous Intraepithelial Lesion (LSIL)

HPV infection: Perinuclear Halo (orange arrow), multinucleated with increased N/C ratio and fine chromatin (yellow arrow), and rasinoid/dumb-bell nucleus (cyan arrow)

Question 7

ID

Answer 7

Normal cervix

Colposcopy

Question 8

ID

Answer 8

Low-Grade Squamous Intraepithelial Lesion (LSIL)

Colposcopy

Question 9

ID structure #1

Answer 9

Mature Squamous Cells

Ectocervix

Question 10

ID structure #2

Answer 10

Immature Squamous Cells

Susceptible to HPV

Question 11

ID structure #3

Answer 11

Squamocolumnar Junction (SCJ)

Question 12

ID structure #4

Answer 12

Columnar Glandular Cells

Endocervix

Question 13

ID

Answer 13

Low-grade Squamous Intraepithelial Lesion (LSIL)

HPV infection: koilocytic changes

Question 14

ID

Answer 14

normal stratified squamous epithelium

Question 15

ID

Answer 15

Low-grade Squamous Intraepithelial Lesion (LSIL)

Question 16

ID

Answer 16

High-grade Squamous Intraepithelial Lesion (HSIL)

CIN-2 and CIN-3

Question 17

What HPV strains lead to dysplasia?

Answer 17

HPV 16 and 18

Question 18

What HPV strains do not lead to dysplasia, but lead to genital warts?

Answer 18

HPV 6 and 11

Question 19

What does the HPV E6 protein do?

Answer 19

• Activates Telomerase Transcriptase (TERT) promotor
• Inhibits p53

Question 20

What does the HPV E7 protein do?

Answer 20

• Inhibits p21
• Inhibits RB

you have to be 21 to drink “root” beer (RB) and your blood alcohol content (BAC) can’t be >.079

Question 21

ID

Answer 21

High-grade Squamous Intraepithelial Lesion (HSIL)

CIN 3

Question 22

ID

Answer 22

Adenocarcinoma in Situ

invasion has gone beyond the basement membrane

Question 23

ID

Answer 23

Squamous Cell Carcinoma

Keratin pearl lower half of the image

Question 24

ID

Answer 24

Endocervical Adenocarcinoma

Question 25

ID

Answer 25

Adenocarcinoma

Question 26

ID

Answer 26

Squamous Cell Carcinoma

Question 27

ID

Answer 27

Endocervical Polyp

Question 28

ID

Answer 28

Endocervical Polyp ## Footnote Endocervical Polyps are located on the Ectocervix, but if you look at the tissue it is the tissue type of the Endocervix, hence the name.

Question 29

ID

Answer 29

Candida albicans infection/candidiasis vaginalis

Question 30

ID

Answer 30

Candida albicans infection/candidiasis vaginalis ## Footnote Gram stain

Question 31

ID

Answer 31

Candida albicans infection/candidiasis vaginalis ## Footnote Potassium Hydroxide (KOH) Mount - dissolves cement substances that holds keratinized cells together making yeast easily visible

Question 32

ID

Answer 32

Trichomonas vaginalis infection ## Footnote Strawberry cervix and yellow frothy discharge

Question 33

ID

Answer 33

Trichomonas vaginalis infection ## Footnote Flagellated ovoid protozoan

Question 34

ID

Answer 34

*Gardnerella Vaginalis* infection ## Footnote causes Bacterial Vaginosis (BV) with a green-gray and "fishy" scent

Question 35

ID

Answer 35

*Gardnerella vaginalis* infection ## Footnote Gram-positive coccobacillus with a clue cell - squamous cell covered in bacteria (yellow ellipse)