XIX - Female Genital System and the Breast

Question 1

Lesion of the female vulva characterized by thinning of the epidermis and disappearance of rete pegs, hydropic degeneration of basal cells, superficial hyperkeratosis, dermal fibrosis with scant perivascular, mononuclear inflammatory cell infiltrate. Occurs most commonly in postmenopausal women.

Answer 1

Lichen sclerosus(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 713

Question 2

This disorder of the vulva is marked by epithelial thickening, expansion of the stratum granulosum, significant surface hyperkeratosis and pronounced leukocytic infiltrate. Appears clinically as an area of leukoplakia.

Answer 2

Lichen simplex chronicus(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 713

Question 3

These are flat, moist, minimally elevated lesions that occur in secondary syphilis.

Answer 3

Condyloma lata(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 713

Question 4

Lesions of the anogenital area which may be papillary and distinctly elevated or may be somewhat flat and rugose. Characteristic cellular morphology is the presence of cytoplasmic vacuolization with nuclear angular polymorphism and koilocytosis. Hallmark of HPV infection.

Answer 4

Condyloma acuminata(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 713

Question 5

Red, scaly plaque, microscopically characterized by the spread of malignant cells within the epithelium, occasionally with invasion of underlying dermis. May have underlying carcinoma of a vulvar or perineal gland.

Answer 5

Paget disease of the Vulva(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 715

Question 6

A soft polypoid mass, which is a rare form of primary vaginal cancer. Usually encountered in infants and children less than 5 y/o.

Answer 6

Sarcoma botryoides (embryonal rhabdomyosarcoma)(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 716

Question 7

Most commonly develops in the transformation zone of the cervix. Produces a “barrel cervix” if the tumor encircles the cervix and invades the underlying stroma.

Answer 7

Invasive carcinoma of the cervix(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 719

Question 8

Protruding polypoid masses which are inflammatory in origin, soft, yields to palpation, and have a smooth, glistening surface with underlying cystically dilated spaces filled with mucinous secretion.

Answer 8

Endocervical polyp(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 721

Question 9

Refers to the growth of the basal layer of the endometrium down to the myometrium. Nests of endometrial stroma, glands or both are found in the myometrium, in between muscle bundles.

Answer 9

Adenomyosis(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 721

Question 10

Characterized by the presence of endometrial glands and stroma in a location outside the endomyometrium. Undergoes cyclic bleeding. Also called “chocolate cysts”.

Answer 10

Endometriosis(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 722

Question 11

These are sharply circumscribed, firm, gray-white masses of the uterus, with “whorled” cut surface.

Answer 11

Leiomyoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 721

Question 12

Solitary tumors of the uterus which arise de novo from the mesenchymal cells of the myometrium. Characterized byvtche presence of tumor necrosis, cytologic atypia and mitotic activity.

Answer 12

Leiomyosarcomas(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 725

Question 13

Type of endometrial carcinoma associated with estrogen excess and endometrial hyperplasia.

Answer 13

Endometroid carcinoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 727

Question 14

Type of endometrial carcinoma which occurs in older women and is usually associated with endometrial atrophy.

Answer 14

Serous carcinoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 727

Question 15

Small, fluid-filled cysts which originate from the unruptured graafian follicles or in follicles that have ruptured and immediately sealed.

Answer 15

Follicle and luteal cysts(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 728

Question 16

Triad of oligomenorrhea, infertility and obesity in young women secondary to excessive production of estrogens and androgens.

Answer 16

Polycystic ovaries(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 728

Question 17

Other name for polycystic ovary syndrome?

Answer 17

Stein-Leventhal syndrome(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 728

Question 18

Two most important risk factors for development of ovarian cancer.

Answer 18

Nulliparity and family history(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 729

Question 19

Mutation of this gene is associated in the development of both ovarian and breast cancers.

Answer 19

BRCA 1(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 729

Question 20

Mutation of this gene is associated with the development of breast cancer only,

Answer 20

BRCA 2(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 729

Question 21

Benign lesion of the ovary most commonly seen in women 30-40 years old. Most frequent of the ovarian tumors. Serosal covering is smooth and glistening. Characterized histologically by tall, columnar epithelium and the presence of Psammoma bodies.

Answer 21

Serous tumor of the ovary(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 730

Question 22

Large, multilocular tumors of the ovaries, without psammoma bodies. Composed of mucin-producing epithelial cells.

Answer 22

Mucinous Tumors (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 731

Question 23

Metastasis of mucinous tumor of the gastrointestinal tract to the ovaries is called?

Answer 23

Krukenberg tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 731

Question 24

A rare, solid, unilateral ovarian tumor consisting of an abundant stroma containing nests of transitional-like epithelium resembling that of the urinary tract.

Answer 24

Brenner Tumor (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

Question 25

Unilateral ovarian tumor composed of sheets or cords of large cleared cells separated by scant fibrous strands. Stroma may contain lymphocytes and occasional granuloma. Usually occur on the 2nd-3rd decade of life.

Answer 25

Dysgerminoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

Question 26

Unilateral ovarian tumor which occur during the 1st 3 decades of life. Characterized by small, hemorrhagic focus with syncitiothrophoblast and cytotrophoblast. Metastasize early.

Answer 26

Choriocarcinoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

Question 27

Sex cord tumor seen most commonly in postmenopausal women. Lesions may be tiny or large, gray to yellow (with cystic spaces). Produce large amounts of estrogen. (+) Call-Exner bodies

Answer 27

Granulosa-thecal cell tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

Question 28

Sex cord tumor characterized by solid gray fibrous cells to yellow (lipid-laden) plump thecal cells. Most hormonally inactive.

Answer 28

Thecoma-fibroma tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

Question 29

Sex cord tumor seen as small, gray to yellow-brown, and solid lesions. May resemble development of testis with tubules, or cords and plump pink Sertoli cells. May be masculinizing or defeminizing.

Answer 29

Sertoli-Leydig cell tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

Question 30

On transection, filled with sebaceous secretion and matted hair, bonw and cartilage, nests of bronchial or gastrointestinal epithelium, and other recognizable lines of development are also present.

Answer 30

Benign (Mature) Cystic Teratomas / Dermoid Cyst(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 733

Question 31

Microscopically, the distinguishing feature is a variety of immature or barely recognizable areas of differentiation toward cartilage, bone, muscle, nerve, and other structures. Found early in life.

Answer 31

Immature Malignant Teratomas (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 733

Question 32

Tumor of the ovary composed entirely of mature thyroid tissue. May hyperfunction and produce hyperthyroidism. Appear as small, solid, unilateral brown ovarian masses

Answer 32

Struma ovarii (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 733

Question 33

A voluminous mass of swollen, sometimes cystically dilated, chorionic villi, appearing grossly as grapelike structures.

Answer 33

Hydatidiform Mole (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 735

Question 34

This type of H. mole shows hydropic swelling of chorionic villi and virtual absence of vascularization of villi. No fetal parts seen.

Answer 34

Complete mole (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 736

Question 35

This type of H. mole shows villous edema that involves only some of the villi and the trophoblastic proliferation is focal and slight, with characteristic irregular scalloped margin. Fetal parts/embryo may be seen.

Answer 35

Partial mole(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 736

Question 36

These are complete moles that are more invasive locally but do not metastasize. Microscopically, the epithelium of the villi is marked by hyperplastic and atypical changes, with proliferation of both cuboidal and syncytial components.

Answer 36

Invasive Mole (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 736

Question 37

Appear as very hemorrhagic, necrotic masses within the uterus. The tumor is purely epithelial, composed of anaplastic cuboidal cytotrophoblast and syncytiotrophoblast, chorionic villi are not formed. High propensity for metastasis.

Answer 37

Choriocarcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 737

Question 38

A cystic dilation of an obstructed duct that arises during lactation.

Answer 38

Galactocele (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 739

Question 39

Multifocal, bilateral blue-brown cysts (“blue dome cysts”) of the breast, measuring 1-5 cm diameter, filled with serous turbid fluid. Occurs normally in the menstrual cycle.

Answer 39

Simple fibrocystic change of the breast(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 739

Question 40

Term used to describe hyperplasia that cytologically resemble lobular carcinoma in situ, but the cells do not fill or distend more than 50% of the acini within a lobule.

Answer 40

Atypical lobular hyperplasia (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 739

Question 41

The lumen of the ducts, ductules, or lobules of the breast is filled with a heterogeneous population of cells of different morphologies. Irregular slit-like fenestrations are prominent at the periphery.

Answer 41

Epithelial Hyperplasia (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 739

Question 42

These lesions are characterized by proliferation of lining epithelial cells and myoepithelial cells in small ducts and ductules, yielding masses of small gland patterns within a fibrous stroma. The acini are arranged in a swirling pattern, and the outer border is usually well circumscribed.

Answer 42

Sclerosing Adenosis (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 741

Question 43

A nonbacterial chronic inflammation of the breast associated with inspissation of breast secretions in the main excretory ducts.

Answer 43

Mammary duct ectasia (periductal or plasma cell mastitis) (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 742

Question 44

The lesion is small, often tender, rarely more than 2 cm in diameter, and sharply localized, with a central focus of necrotic fat cells surrounded by neutrophils and lipid-filled macrophages. Caused by some antecedent trauma to the breast.

Answer 44

Traumatic fat necrosis (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 742

Question 45

The most common benign neoplasm of the female breast.

Answer 45

Fibroadenoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 742

Question 46

A discrete, usually solitary, freely movable nodule, 1 to 10 cm in diameter, easily “shelled out” lesion of the breast. Histologically there is a loose fibroblastic stroma containing ductlike, spaces lined by a layer of epithelium that are regular and have a well-defined, intact basement membrane.

Answer 46

Fibroadenoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 742

Question 47

Small lobulated and cystic lesion of the breast that may grow rapidly. Exhibit “leaflike” clefts and slits on gross section.

Answer 47

Phyllodes Tumor (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 743

Question 48

A neoplastic papillary growth within a duct, usually solitary and less than 1 cm in diameter, consisting of delicate, branching growths within a dilated duct or cyst.

Answer 48

Intraductal Papilloma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 743

Question 49

A type of noninvasive carcinoma of the breast that tends to fill, distort, and unfold involved lobules and thus appears to involve ductlike spaces.

Answer 49

Ductal Carcinoma in Situ(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 745

Question 50

A type of noninvasive carcinoma of the breast expands but does not alter the underlying lobular architecture. cells are monomorphic with bland, round nuclei and occur in loosely cohesive clusters in ducts and lobules. Tend to be bilateral, and increases risk for development of breast CA.

Answer 50

Lobar Carcinoma in Situ(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 746

Question 51

Caused by the extension of DCIS up to the lactiferous ducts and into the contiguous skin of the nipple.

Answer 51

Paget disease of the nipple (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 746

Question 52

This type of cancer produces a desmoplastic response, replacing normal breast fat and forms a hard, palpable mass. Advanced cancers may cause dimpling of the skin, retraction of the nipple, or fixation to the chest wall.

Answer 52

Invasive ductal carcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747

Question 53

Breast cancer defined by the clinical presentation of an enlarged, swollen, erythematous breast, usually without a palpable mass. The blockage of numerous dermal lymphatic spaces by carcinoma results in the clinical appearance (e.g peau d’ orange)

Answer 53

Inflammatory carcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747

Question 54

Breast cancer which consists of cells morphologically identical to the cells of LCIS. Occasionally they surround cancerous or normal-appearing acini or ducts, creating a so-called “bull’s-eye pattern.”

Answer 54

Invasive lobular carcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747

Question 55

A rare subtype of carcinoma consisting of sheets of large anaplastic cells with pushing, well-circumscribed borders, with a pronounced lymphoplasmacytic infiltrate.

Answer 55

Medullary carcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747

Question 56

A rare subtype of carcinoma which appear grossly as a soft and gelatinous mass which abundant quantities of extracellular mucin that dissects into the surrounding stroma.

Answer 56

Colloid (mucinous) carcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747

Question 57

Usually present as irregular mammographic densities. Microscopically, the carcinomas consist of well-formed tubules with low-grade nuclei. Lymph node metastases are rare, and prognosis is excellent.

Answer 57

Tubular carcinomas (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747

Question 58

Grossly, appears as a button-like, subareolar swelling. in bilateral breasts of males.

Answer 58

Gynecomastia (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 750

Question 59

Large, multilocular tumors of the ovaries, without psammoma bodies. Composed of mucin-producing epithelial cells.

Answer 59

Mucinous Tumors (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 731

Question 60

Metastasis of mucinous tumor of the gastrointestinal tract to the ovaries is called?

Answer 60

Krukenberg tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 731

Question 61

A rare, solid, unilateral ovarian tumor consisting of an abundant stroma containing nests of transitional-like epithelium resembling that of the urinary tract.

Answer 61

Brenner Tumor (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

Question 62

Unilateral ovarian tumor composed of sheets or cords of large cleared cells separated by scant fibrous strands. Stroma may contain lymphocytes and occasional granuloma. Usually occur on the 2nd-3rd decade of life.

Answer 62

Dysgerminoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

Question 63

Unilateral ovarian tumor which occur during the 1st 3 decades of life. Characterized by small, hemorrhagic focus with syncitiothrophoblast and cytotrophoblast. Metastasize early.

Answer 63

Choriocarcinoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

Question 64

Sex cord tumor seen most commonly in postmenopausal women. Lesions may be tiny or large, gray to yellow (with cystic spaces). Produce large amounts of estrogen. (+) Call-Exner bodies

Answer 64

Granulosa-thecal cell tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

Question 65

Sex cord tumor characterized by solid gray fibrous cells to yellow (lipid-laden) plump thecal cells. Most hormonally inactive.

Answer 65

Thecoma-fibroma tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

Question 66

Sex cord tumor seen as small, gray to yellow-brown, and solid lesions. May resemble development of testis with tubules, or cords and plump pink Sertoli cells. May be masculinizing or defeminizing.

Answer 66

Sertoli-Leydig cell tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

Question 67

On transection, filled with sebaceous secretion and matted hair, bonw and cartilage, nests of bronchial or gastrointestinal epithelium, and other recognizable lines of development are also present.

Answer 67

Benign (Mature) Cystic Teratomas / Dermoid Cyst(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 733

Question 68

Microscopically, the distinguishing feature is a variety of immature or barely recognizable areas of differentiation toward cartilage, bone, muscle, nerve, and other structures. Found early in life.

Answer 68

Immature Malignant Teratomas (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 733

Question 69

Tumor of the ovary composed entirely of mature thyroid tissue. May hyperfunction and produce hyperthyroidism. Appear as small, solid, unilateral brown ovarian masses

Answer 69

Struma ovarii (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 733

Question 70

A voluminous mass of swollen, sometimes cystically dilated, chorionic villi, appearing grossly as grapelike structures.

Answer 70

Hydatidiform Mole (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 735

Question 71

This type of H. mole shows hydropic swelling of chorionic villi and virtual absence of vascularization of villi. No fetal parts seen.

Answer 71

Complete mole (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 736

Question 72

This type of H. mole shows villous edema that involves only some of the villi and the trophoblastic proliferation is focal and slight, with characteristic irregular scalloped margin. Fetal parts/embryo may be seen.

Answer 72

Partial mole(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 736

Question 73

These are complete moles that are more invasive locally but do not metastasize. Microscopically, the epithelium of the villi is marked by hyperplastic and atypical changes, with proliferation of both cuboidal and syncytial components.

Answer 73

Invasive Mole (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 736

Question 74

Appear as very hemorrhagic, necrotic masses within the uterus. The tumor is purely epithelial, composed of anaplastic cuboidal cytotrophoblast and syncytiotrophoblast, chorionic villi are not formed. High propensity for metastasis.

Answer 74

Choriocarcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 737

Question 75

A cystic dilation of an obstructed duct that arises during lactation.

Answer 75

Galactocele (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 739

Question 76

Multifocal, bilateral blue-brown cysts (“blue dome cysts”) of the breast, measuring 1-5 cm diameter, filled with serous turbid fluid. Occurs normally in the menstrual cycle.

Answer 76

Simple fibrocystic change of the breast(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 739

Question 77

Term used to describe hyperplasia that cytologically resemble lobular carcinoma in situ, but the cells do not fill or distend more than 50% of the acini within a lobule.

Answer 77

Atypical lobular hyperplasia (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 739

Question 78

The lumen of the ducts, ductules, or lobules of the breast is filled with a heterogeneous population of cells of different morphologies. Irregular slit-like fenestrations are prominent at the periphery.

Answer 78

Epithelial Hyperplasia (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 739

Question 79

These lesions are characterized by proliferation of lining epithelial cells and myoepithelial cells in small ducts and ductules, yielding masses of small gland patterns within a fibrous stroma. The acini are arranged in a swirling pattern, and the outer border is usually well circumscribed.

Answer 79

Sclerosing Adenosis (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 741

Question 80

A nonbacterial chronic inflammation of the breast associated with inspissation of breast secretions in the main excretory ducts.

Answer 80

Mammary duct ectasia (periductal or plasma cell mastitis) (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 742

Question 81

The lesion is small, often tender, rarely more than 2 cm in diameter, and sharply localized, with a central focus of necrotic fat cells surrounded by neutrophils and lipid-filled macrophages. Caused by some antecedent trauma to the breast.

Answer 81

Traumatic fat necrosis (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 742

Question 82

The most common benign neoplasm of the female breast.

Answer 82

Fibroadenoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 742

Question 83

A discrete, usually solitary, freely movable nodule, 1 to 10 cm in diameter, easily “shelled out” lesion of the breast. Histologically there is a loose fibroblastic stroma containing ductlike, spaces lined by a layer of epithelium that are regular and have a well-defined, intact basement membrane.

Answer 83

Fibroadenoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 742

Question 84

Small lobulated and cystic lesion of the breast that may grow rapidly. Exhibit “leaflike” clefts and slits on gross section.

Answer 84

Phyllodes Tumor (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 743

Question 85

A neoplastic papillary growth within a duct, usually solitary and less than 1 cm in diameter, consisting of delicate, branching growths within a dilated duct or cyst.

Answer 85

Intraductal Papilloma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 743

Question 86

A type of noninvasive carcinoma of the breast that tends to fill, distort, and unfold involved lobules and thus appears to involve ductlike spaces.

Answer 86

Ductal Carcinoma in Situ(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 745

Question 87

A type of noninvasive carcinoma of the breast expands but does not alter the underlying lobular architecture. cells are monomorphic with bland, round nuclei and occur in loosely cohesive clusters in ducts and lobules. Tend to be bilateral, and increases risk for development of breast CA.

Answer 87

Lobar Carcinoma in Situ(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 746

Question 88

Caused by the extension of DCIS up to the lactiferous ducts and into the contiguous skin of the nipple.

Answer 88

Paget disease of the nipple (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 746

Question 89

This type of cancer produces a desmoplastic response, replacing normal breast fat and forms a hard, palpable mass. Advanced cancers may cause dimpling of the skin, retraction of the nipple, or fixation to the chest wall.

Answer 89

Invasive ductal carcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747

Question 90

Breast cancer defined by the clinical presentation of an enlarged, swollen, erythematous breast, usually without a palpable mass. The blockage of numerous dermal lymphatic spaces by carcinoma results in the clinical appearance (e.g peau d’ orange)

Answer 90

Inflammatory carcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747

Question 91

Breast cancer which consists of cells morphologically identical to the cells of LCIS. Occasionally they surround cancerous or normal-appearing acini or ducts, creating a so-called “bull’s-eye pattern.”

Answer 91

Invasive lobular carcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747

Question 92

A rare subtype of carcinoma consisting of sheets of large anaplastic cells with pushing, well-circumscribed borders, with a pronounced lymphoplasmacytic infiltrate.

Answer 92

Medullary carcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747

Question 93

A rare subtype of carcinoma which appear grossly as a soft and gelatinous mass which abundant quantities of extracellular mucin that dissects into the surrounding stroma.

Answer 93

Colloid (mucinous) carcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747

Question 94

Usually present as irregular mammographic densities. Microscopically, the carcinomas consist of well-formed tubules with low-grade nuclei. Lymph node metastases are rare, and prognosis is excellent.

Answer 94

Tubular carcinomas (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747

Question 95

Grossly, appears as a button-like, subareolar swelling. in bilateral breasts of males.

Answer 95

Gynecomastia (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 750

Question 96

Morphology: large macrophages with granular PAS positive cytoplasm and several dense, round Michaelis Gutmann bodies.

Answer 96

Malacoplakia (TOPNOTCH)

Question 97

In gonococcal infection of the female reproductive system, inflammatory changes will appear about how many days after the inoculation of the organism?

Answer 97

2-7 days (TOPNOTCH)

Question 98

These cells are distinguised by a clear separation “halo” from the surrounding epithelial cells and a finely granular cytoplasm containing mucopolysaccharide that stains with PAS, Alcian Blue, and Mucicarmine

Answer 98

Paget cells (TOPNOTCH)

Question 99

What is the probable precursor of vaginal adenocarcinoma?

Answer 99

Vaginal adenosis (TOPNOTCH)

Question 100

What do you call the glandlike structures filled with an acidophilic material similar to immature follicles that are seen in Granulosa Theca Cell tumors?

Answer 100

Call Exner bodies (TOPNOTCH)

Question 101

Presence of these structures characterize serous tumors of the ovaries

Answer 101

Psammoma bodies (TOPNOTCH)

Question 102

These tumors are distinguished from serous and mucinous tumors of the ovaries by the presence of tubular glands that resemble the endometrium

Answer 102

Endometriod tumor (TOPNOTCH)

Question 103

Morphology: whorled pattern of smooth muscle bundles and well differentiated spindle shaped smooth muscle cells

Answer 103

Leiomyoma (TOPNOTCH)

Question 104

A key factor in the development of endometrial hyperplasia and related cancers is the inactivation of what tumor suppressor gene?

Answer 104

PTEN (TOPNOTCH)

Question 105

What is the most common location of vaginal adenocarcinoma?

Answer 105

Anterior wall of the upper third of Vagina (TOPNOTCH)

Question 106

This is a condition in which glandular columnar epithelium of mullerian type either appears beneath the squamous epithelium or replaces it

Answer 106

Vaginal Adenosis (TOPNOTCH)

Question 107

What are the 4 cardinal histologic features of Lichen Sclerosus of the Vulva or Chronic atrophic vulvitis?

Answer 107

Atrophy of the epidermis with disappearance, of the rete pegs, hydrophic degeneration of the basal cells, replacement of the underlying dermis by dense collagenous fibrous tissue, and monoclonal band like lymphocytic infiltrate (TOPNOTCH)

Question 108

Morphology: acanthosis of the vulvar squamous epithelium frequently with hyperkeratosis

Answer 108

Lichen SImplex Chronicles (TOPNOTCH)

Question 109

Morphology: presence of large tumor cells lying singly or in small lusters within the epidermis and its appendages

Answer 109

Extra mammary Paget Disease (TOPNOTCH)

Question 110

Morphology: tumor cells resemble tennis racket with small protrusions of cytoplasms from one end

Answer 110

Embryonal Rhabdomyosarcoma (TOPNOTCH)

Question 111

Clustering of tumor cells in a so called “Cambium Layer” is seen in what type of rhabdomyosarcoma?

Answer 111

Embryonal Rhabdomyosarcoma (TOPNOTCH)

Question 112

On histological examination of the cervix, epithelial spongiosis is associated with what type of infection?

Answer 112

T. vaginal infection (TOPNOTCH)

Question 113

On histological examination of the cervix, epithelial ulcers with intranuclear inclusions within the epithelial cells and lymphocytic infiltration is associated with what type of infection?

Answer 113

HSV (TOPNOTCH)

Question 114

Morphology: these are composed of dense fibrous stroma covered with endocervical columnar epithelium

Answer 114

Endocervical polyp (TOPNOTCH)

Question 115

What is considered the most important agent in cervical oncogenesis?

Answer 115

HPV (TOPNOTCH)

Question 116

Koilocytic atypia is considered what type of CIN lesion?

Answer 116

CIN I (TOPNOTCH)

Question 117

What is the most common pattern seen in invasive cervical carcinoma?

Answer 117

Fungating (TOPNOTCH)

Question 118

On histological examination of the endometrium, what is the earliest morphological evidence of ovulation?

Answer 118

Basal vacuolation (TOPNOTCH)

Question 119

Morphology: ectopic endometrial glands and stroma with numerous macrophages containing hemosiderin

Answer 119

Endometriosis (TOPNOTCH)

Question 120

Morphology: hydrophic swelling of most chorionic villi and virtual absence or inadequate development of vascularization of villi

Answer 120

Complete mole (TOPNOTCH)

Question 121

The combination of ovarian tumor, hydrothorax, and ascites is designated as

Answer 121

Meigs Syndrome (TOPNOTCH)

Question 122

What type of ovarian cancer is best considered as the counterpart of the seminoma of the testes?

Answer 122

Dysgerminoma (TOPNOTCH)

Question 123

About 1% of the dermoids undergo malignant transformation of any one of the component elements present, but most commonly, they differentiate into what type of carcinoma?

Answer 123

Squamous Cell Carcinoma (TOPNOTCH)

Question 124

Morphology: epithelial component consists of nests of transitional cells resembling the lining of the urinary bladder

Answer 124

Brenner Tumor (TOPNOTCH)

Question 125

Morphology: characterized by a lining of tall columnar epithelial cells with apical mucin and the absence of cilia, resembling cervical or intestinal epithelium

Answer 125

Mucinous tumors (TOPNOTCH)

Question 126

Morphology: lined by a rim of bright yellow luteal tissue containing luteinized granulosa cells

Answer 126

Luteal cyst (TOPNOTCH)

Question 127

Morphology: characterized chiefly by dilations of ducts, inspissation of breast secretions, and marked periductal and interstitial chronic granulomatous reaction

Answer 127

Mammary Duct Ectasia (TOPNOTCH)

Question 128

What are the 3 principal patterns of morphologic changes seen in Fibrocystic Changes of the breast?

Answer 128

1. Cyst formation with apocrine metaplasia2. Fibrosis3. Adenosis (TOPNOTCH)

Question 129

Morphology: “leaflike” architecture

Answer 129

Phyllodes Tumor (TOPNOTCH)

Question 130

Morphology: proliferation of intralobular stroma surrounding and often pushing and distorting the associated epithelium. The border is sharply delimited from the surrounding tissue

Answer 130

Fibroadenoma (TOPNOTCH)

Question 131

What is the most important prognostic factor useful as a predictive factor for the response of therapy in patients with breast cancer?

Answer 131

Presence of estrogen and progesterone receptors (TOPNOTCH)

Question 132

In breast cancer, what is the most important prognostic factor for invasive carcinoma in the absence of distant metastases?

Answer 132

Lymph node metastases (TOPNOTCH)

Question 133

Morphology: tumor cells are prsent as small clusters within large pools of mucin

Answer 133

Mucinous colloid carcinoma (TOPNOTCH)

Question 134

Morphology: characterized by solid syncytium like sheets occupying 75% of the tumor , prominent lymphoplasmacytic infiltrate and a non inflitrative border

Answer 134

Medullary carcinoma of the breast (TOPNOTCH)

Question 135

The histologic hallmark of this tumor is the pattern of single infiltrating tumor cells, often only one cell in width, or in loose clusters or sheets

Answer 135

Invasive lobular carcinoma (TOPNOTCH)

Question 136

This is a rare manifestation of breast cancer and presents as a unilateral erythematous eruption with a scale crust

Answer 136

Paget disease (TOPNOTCH)

Question 137

These are stellate lesions characterized by a central nidus of entrapped glands in a hyalinized stroma

Answer 137

Complex Sclerosing Lesion or Radial Scar (TOPNOTCH)

Question 138

Morphology: composed of multiple branching fibrovascular cores, each having a connective tissue axis lined by luminal and myoepithelial cells

Answer 138

Papillomas (TOPNOTCH)

Question 139

What is the most common clinical presentation of breast disease

Answer 139

Pain (TOPNOTCH)

Question 140

The principal mammographic signs of breast carcinoma

Answer 140

densities and calfications (TOPNOTCH)

Question 141

Morphology: the main histologic feature is keratinizing squamous epithelium extending to an abnormal depth into the orifices of the nipple ducts

Answer 141

Periductal mastitis (TOPNOTCH)

Question 142

Mammographic appearance: Large lobulated “popcorn” calcifications

Answer 142

Fibroadenoma (TOPNOTCH)

Question 143

Morphology: characterized by solid sheets of pleomorphic cells with high-grade nuclei and central necrosis detected mamographically as clusters or linear and branching microcalcifications

Answer 143

Comedocarcinoma (TOPNOTCH)

Question 144

Morphology: Terminal ducts (without lobule formation) are lined by a multilayered epithelium with small papillary tufts and surrounding periductal hyalinization and fibrosis.

Answer 144

Gynecomastia (TOPNOTCH)

Question 145

Morphology: terminal duct lobular unit is enlarged, and the acini are compressed and distorted within the lumens. Calcifications are often present within the lumens.

Answer 145

Sclerosing adenosis(TOPNOTCH)

Question 146

Morphology: central fibrovascular core extends from the wall of a duct. The papillae arborize within the lumen and are lined by myoepithelial and luminal cells

Answer 146

Intraductal papilloma(TOPNOTCH)

Question 147

Cellular proliferation resembling ductal carcinoma in situ or lobular carcinoma in situ but lacking sufficient qualitative or quantitative features for a diagnosis of carcinoma in situ

Answer 147

Atypical hyperplasia(TOPNOTCH)

Question 148

Refers to a proliferation of cells identical to those of LCIS but the cells do not fill or distend more than 50% of the acini within a lobule.

Answer 148

Atypical Lobular hyperplasia(TOPNOTCH)

Question 149

Recognized by its histologic resemblance to ductal carcinoma in situ, including a monomorphic cell population, regular cell placement, and round lumina. However, the lesions are characteristically limited in extend, and the cells are not completely monomorphic in type or they fail to completely fill ductal spaces

Answer 149

Atypical hyperplasia(TOPNOTCH)

Question 150

What are the two major risk factors for breast carcinoma?

Answer 150

Hormonal and Genetics/family history(TOPNOTCH)

Question 151

This is a subtype of DCIS which is recognized by bulbous protrusions without a fibrovascular core, often forming complex intraductal patents.

Answer 151

Micropapillary DCIS(TOPNOTCH)