XIX - Female Genital System and the Breast

Question 2

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 2

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

Question 3

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 3

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

Question 4

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

Answer 4

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

Question 5

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 5

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

Question 6

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 6

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

Question 7

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 7

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

Question 8

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 8

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

Question 9

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 9

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

Question 10

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 10

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

Question 11

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

Answer 11

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

Question 12

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

Answer 12

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

Question 13

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 13

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

Question 14

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

Answer 14

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

Question 15

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

Answer 15

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

Question 16

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

Answer 16

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

Question 17

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

Answer 17

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

Question 18

Other name for polycystic ovary syndrome?

Answer 18

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

Question 19

Two most important risk factors for development of ovarian cancer.

Answer 19

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

Question 20

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

Answer 20

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

Question 21

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

Answer 21

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

Question 22

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 22

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

Question 23

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

Answer 23

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

Question 24

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

Answer 24

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

Question 25

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

Answer 25

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

Question 26

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 26

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

Question 27

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

Answer 27

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

Question 28

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 28

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

Question 29

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

Answer 29

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

Question 30

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 30

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

Question 31

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 31

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

Question 32

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 32

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

Question 33

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

Answer 33

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

Question 34

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

Answer 34

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

Question 35

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

Answer 35

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

Question 36

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 36

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

Question 37

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 37

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

Question 38

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 38

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

Question 39

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

Answer 39

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

Question 40

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 40

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

Question 41

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 41

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

Question 42

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 42

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

Question 43

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 43

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

Question 44

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

Answer 44

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

Question 45

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 45

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

Question 46

The most common benign neoplasm of the female breast.

Answer 46

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

Question 47

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 47

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

Question 48

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

Answer 48

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

Question 49

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 49

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

Question 50

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 50

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

Question 51

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 51

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

Question 52

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

Answer 52

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

Question 53

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 53

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

Question 54

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 54

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

Question 55

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 55

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

Question 56

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

Answer 56

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

Question 57

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 57

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

Question 58

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 58

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

Question 59

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

Answer 59

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

Question 60

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

Answer 60

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

Question 61

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

Answer 61

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

Question 62

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

Answer 62

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

Question 63

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 63

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

Question 64

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

Answer 64

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

Question 65

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 65

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

Question 66

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

Answer 66

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

Question 67

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 67

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

Question 68

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 68

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

Question 69

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 69

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

Question 70

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

Answer 70

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

Question 71

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

Answer 71

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

Question 72

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

Answer 72

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

Question 73

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 73

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

Question 74

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 74

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

Question 75

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 75

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

Question 76

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

Answer 76

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

Question 77

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 77

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

Question 78

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 78

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

Question 79

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 79

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

Question 80

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 80

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

Question 81

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

Answer 81

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

Question 82

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 82

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

Question 83

The most common benign neoplasm of the female breast.

Answer 83

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

Question 84

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 84

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

Question 85

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

Answer 85

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

Question 86

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 86

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

Question 87

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 87

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

Question 88

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 88

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

Question 89

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

Answer 89

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

Question 90

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 90

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

Question 91

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 91

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

Question 92

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 92

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

Question 93

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

Answer 93

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

Question 94

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 94

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

Question 95

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 95

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

Question 96

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

Answer 96

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

Question 97

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

Answer 97

Malacoplakia (TOPNOTCH)

Question 98

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

Answer 98

2-7 days (TOPNOTCH)

Question 99

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 99

Paget cells (TOPNOTCH)

Question 100

What is the probable precursor of vaginal adenocarcinoma?

Answer 100

Vaginal adenosis (TOPNOTCH)

Question 101

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 101

Call Exner bodies (TOPNOTCH)

Question 102

Presence of these structures characterize serous tumors of the ovaries

Answer 102

Psammoma bodies (TOPNOTCH)

Question 103

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

Answer 103

Endometriod tumor (TOPNOTCH)

Question 104

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

Answer 104

Leiomyoma (TOPNOTCH)

Question 105

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

Answer 105

PTEN (TOPNOTCH)

Question 106

What is the most common location of vaginal adenocarcinoma?

Answer 106

Anterior wall of the upper third of Vagina (TOPNOTCH)

Question 107

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

Answer 107

Vaginal Adenosis (TOPNOTCH)

Question 108

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

Answer 108

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 109

Morphology: acanthosis of the vulvar squamous epithelium frequently with hyperkeratosis

Answer 109

Lichen SImplex Chronicles (TOPNOTCH)

Question 110

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

Answer 110

Extra mammary Paget Disease (TOPNOTCH)

Question 111

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

Answer 111

Embryonal Rhabdomyosarcoma (TOPNOTCH)

Question 112

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

Answer 112

Embryonal Rhabdomyosarcoma (TOPNOTCH)

Question 113

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

Answer 113

T. vaginal infection (TOPNOTCH)

Question 114

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 114

HSV (TOPNOTCH)

Question 115

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

Answer 115

Endocervical polyp (TOPNOTCH)

Question 116

What is considered the most important agent in cervical oncogenesis?

Answer 116

HPV (TOPNOTCH)

Question 117

Koilocytic atypia is considered what type of CIN lesion?

Answer 117

CIN I (TOPNOTCH)

Question 118

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

Answer 118

Fungating (TOPNOTCH)

Question 119

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

Answer 119

Basal vacuolation (TOPNOTCH)

Question 120

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

Answer 120

Endometriosis (TOPNOTCH)

Question 121

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

Answer 121

Complete mole (TOPNOTCH)

Question 122

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

Answer 122

Meigs Syndrome (TOPNOTCH)

Question 123

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

Answer 123

Dysgerminoma (TOPNOTCH)

Question 124

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 124

Squamous Cell Carcinoma (TOPNOTCH)

Question 125

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

Answer 125

Brenner Tumor (TOPNOTCH)

Question 126

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

Answer 126

Mucinous tumors (TOPNOTCH)

Question 127

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

Answer 127

Luteal cyst (TOPNOTCH)

Question 128

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

Answer 128

Mammary Duct Ectasia (TOPNOTCH)

Question 129

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

Answer 129

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

Question 130

Morphology: “leaflike” architecture

Answer 130

Phyllodes Tumor (TOPNOTCH)

Question 131

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

Answer 131

Fibroadenoma (TOPNOTCH)

Question 132

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

Answer 132

Presence of estrogen and progesterone receptors (TOPNOTCH)

Question 133

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

Answer 133

Lymph node metastases (TOPNOTCH)

Question 134

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

Answer 134

Mucinous colloid carcinoma (TOPNOTCH)

Question 135

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

Answer 135

Medullary carcinoma of the breast (TOPNOTCH)

Question 136

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 136

Invasive lobular carcinoma (TOPNOTCH)

Question 137

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

Answer 137

Paget disease (TOPNOTCH)

Question 138

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

Answer 138

Complex Sclerosing Lesion or Radial Scar (TOPNOTCH)

Question 139

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

Answer 139

Papillomas (TOPNOTCH)

Question 140

What is the most common clinical presentation of breast disease

Answer 140

Pain (TOPNOTCH)

Question 141

The principal mammographic signs of breast carcinoma

Answer 141

densities and calfications (TOPNOTCH)

Question 142

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

Answer 142

Periductal mastitis (TOPNOTCH)

Question 143

Mammographic appearance: Large lobulated “popcorn” calcifications

Answer 143

Fibroadenoma (TOPNOTCH)

Question 144

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 144

Comedocarcinoma (TOPNOTCH)

Question 145

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

Answer 145

Gynecomastia (TOPNOTCH)

Question 146

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 146

Sclerosing adenosis(TOPNOTCH)

Question 147

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 147

Intraductal papilloma(TOPNOTCH)

Question 148

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 148

Atypical hyperplasia(TOPNOTCH)

Question 149

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 149

Atypical Lobular hyperplasia(TOPNOTCH)

Question 150

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 150

Atypical hyperplasia(TOPNOTCH)

Question 151

What are the two major risk factors for breast carcinoma?

Answer 151

Hormonal and Genetics/family history(TOPNOTCH)

Question 152

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

Answer 152

Micropapillary DCIS(TOPNOTCH)