XIX - Female Genital System and the Breast Flashcards
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. SEE SLIDE 19.1
Lichen sclerosus(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 713
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. SEE SLIDE 19.2
Lichen simplex chronicus(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 713
These are flat, moist, minimally elevated lesions that occur in secondary syphilis.
Condyloma lata(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 713
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. SEE SLIDE 19.3. Hallmark of HPV infection.
Condyloma acuminata(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 713
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.
Paget disease of the Vulva(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 715
A soft polypoid mass, which is a rare form of primary vaginal cancer. SEE SLIDE 19.4. Usually encountered in infants and children less than 5 y/o.
Sarcoma botryoides (embryonal rhabdomyosarcoma)(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 716
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.
Invasive carcinoma of the cervix(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 719
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.
Endocervical polyp(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 721
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. SEE SLIDE 19.5.
Adenomyosis(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 721
Characterized by the presence of endometrial glands and stroma in a location outside the endomyometrium. Undergoes cyclic bleeding. Also called “chocolate cysts”. SEE SLIDE 19.6.
Endometriosis(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 722
These are sharply circumscribed, firm, gray-white masses of the uterus, with “whorled” cut surface. Histologically, it shows bundles of smooth muscle cells mimicking the appearance of normal myometrium.
Leiomyoma. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p 693
Solitary tumors of the uterus which arise de novo from the mesenchymal cells of the myometrium. Characterized by the presence of tumor necrosis, cytologic atypia and mitotic activity.
Leiomyosarcomas. (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 725
Type of endometrial carcinoma associated with estrogen excess and endometrial hyperplasia.
Endometroid carcinoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 727
Type of endometrial carcinoma which occurs in older women and is usually associated with endometrial atrophy.
Serous carcinoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 727
Small, fluid-filled cysts which originate from the unruptured graafian follicles or in follicles that have ruptured and immediately sealed.
Follicle and luteal cysts(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 728
Triad of oligomenorrhea, infertility and obesity in young women secondary to excessive production of estrogens and androgens.
Polycystic ovaries(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 728
Other name for polycystic ovary syndrome?
Stein-Leventhal syndrome(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 728
Two most important risk factors for development of ovarian cancer.
Nulliparity and family history(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 729
Mutation of this gene is associated in the development of both ovarian and breast cancers.
BRCA 1(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 729
Mutation of this gene is associated with the development of breast cancer only
BRCA 2(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 729
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. SEE SLIDE 19.7
Serous tumor of the ovary(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 730
Large, multilocular tumors of the ovaries, without psammoma bodies. Composed of mucin-producing epithelial cells.
Mucinous Tumors (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 731
Metastasis of mucinous tumor of the gastrointestinal tract to the ovaries is called?
Krukenberg tumor. SEE SLIDE 19.24. Usually bilateral, as opposed to mucinous tumors of primarily ovarian origin. (TOPNOTCH) Robbins Basic Pathology, 9th ed., p 698
A rare, solid, unilateral ovarian tumor consisting of an abundant stroma containing nests of transitional-like epithelium resembling that of the urinary tract. SEE SLIDE 19.8
Brenner Tumor (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732
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. SEE SLIDE 19.9
Dysgerminoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732
Unilateral ovarian tumor which occur during the 1st 3 decades of life. Characterized by small, hemorrhagic focus with syncitiothrophoblast and cytotrophoblast. Metastasize early. SEE SLIDE 19.10
Choriocarcinoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732
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.
Sertoli-Leydig cell tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732
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.
Immature Malignant Teratomas (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 733
Tumor of the ovary composed entirely of mature thyroid tissue. May hyperfunction and produce hyperthyroidism. Appear as small, solid, unilateral brown ovarian masses. SEE SLIDE 19.11
Struma ovarii (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 733
A voluminous mass of swollen, sometimes cystically dilated, chorionic villi, appearing grossly as grapelike structures. SEE SLIDE 19.12
Hydatidiform Mole (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 735
This type of H. mole shows hydropic swelling of chorionic villi and virtual absence of vascularization of villi. No fetal parts seen.
Complete mole (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 736
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.
Partial mole(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 736
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.
Invasive Mole (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 736
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. SEE SLIDE 19.10
Choriocarcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 737
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.
Atypical lobular hyperplasia (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 739
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.
Epithelial Hyperplasia (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 739
Histology shows proliferation of luminal spaces (adenosis) lined by epithelial and myoepithelial cells, tielding masses of small glands within FIBROUS STROMA. Acini are arranged in a swirling pattern, and the outer border is well circumscribed.
Sclerosing Adenosis (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 741
A nonbacterial chronic inflammation of the breast associated with inspissation of breast secretions in the main excretory ducts.
Mammary duct ectasia (periductal or plasma cell mastitis) (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 742
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.
Traumatic fat necrosis (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 742
Small lobulated and cystic lesion of the breast that may grow rapidly. Exhibit “leaflike” clefts and slits on gross section. SEE SLIDE 19.13
Phyllodes Tumor (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 743
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.
Intraductal Papilloma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 743
A type of noninvasive carcinoma of the breast that tends to fill, distort, and unfold involved lobules and thus appears to involve ductlike spaces.
Ductal Carcinoma in Situ. SEE SLIDE 19.14 (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 745
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.
Lobar Carcinoma in Situ(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 746
Caused by the extension of DCIS up to the lactiferous ducts and into the contiguous skin of the nipple.
Paget disease of the nipple. SEE SLIDE 19.14 (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 746
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. SEE SLIDE 19.15
Invasive ductal carcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747
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)
Inflammatory carcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747
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.”
Invasive lobular carcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747
A rare subtype of carcinoma consisting of sheets of large anaplastic cells with pushing, well-circumscribed borders, with a pronounced lymphoplasmacytic infiltrate. SEE SLIDE 19.16
Medullary carcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747
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.
Colloid (mucinous) carcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747
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. SEE SLIDE 19.17
Tubular carcinomas (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747
Grossly, appears as a button-like, subareolar swelling. in bilateral breasts of males.
Gynecomastia (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 750
Large, multilocular tumors of the ovaries, without psammoma bodies. Composed of mucin-producing epithelial cells.
Mucinous Tumors (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 731
Metastasis of mucinous tumor of the gastrointestinal tract to the ovaries is called?
Krukenberg tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 731
Sex cord tumor characterized by solid gray fibrous cells to yellow (lipid-laden) plump thecal cells. Most hormonally inactive.
Thecoma-fibroma tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732
A cystic dilation of an obstructed duct that arises during lactation.
Galactocele (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 739
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.
Simple fibrocystic change of the breast(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 739
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.
Atypical lobular hyperplasia (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 739
The most common benign neoplasm of the female breast.
Fibroadenoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 742
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. SEE SLIDE 19.18
Fibroadenoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 742
Morphology: Large macrophages with granular PAS positive cytoplasm and several dense, round Michaelis Gutmann bodies. SEE SLIDE 19.19
Malacoplakia (TOPNOTCH)
In gonococcal infection of the female reproductive system, inflammatory changes will appear about how many days after the inoculation of the organism?
2-7 days (TOPNOTCH)
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
Paget cells. SEE SLIDE 19.14 (TOPNOTCH)
What is the probable precursor of vaginal adenocarcinoma?
Vaginal adenosis (TOPNOTCH)
What do you call the glandlike structures filled with an acidophilic material similar to immature follicles that are seen in Granulosa Theca Cell tumors?
Call Exner bodies. SEE SLIDE 19.20 (TOPNOTCH)
Presence of these structures characterize serous tumors of the ovaries
Psammoma bodies (TOPNOTCH)
These tumors are distinguished from serous and mucinous tumors of the ovaries by the presence of tubular glands that resemble the endometrium
Endometriod tumor (TOPNOTCH)
A key factor in the development of endometrial hyperplasia and related cancers is the inactivation of what tumor suppressor gene?
PTEN (TOPNOTCH)
What is the most common location of vaginal adenocarcinoma?
Anterior wall of the upper third of Vagina (TOPNOTCH)
This is a condition in which glandular columnar epithelium of mullerian type either appears beneath the squamous epithelium or replaces it
Vaginal Adenosis (TOPNOTCH)