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Pathology 2017 > The Female Genital Tract > Flashcards

The Female Genital Tract Flashcards

1
Q

Cystic dilation of the Bartholin gland due to duct obstruction; may be infected and may lead to abscess formation; occurrence in women >40 years old requires biopsy to rule out carcinoma.

A

Bartholin cyst

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2
Q

Lesion characterized by thinning of the epidermis, basal cell degeneration, hyperkeratosis, sclerotic changes of superficial dermis, dermal lymphocytic infiltrate; not premalignant, but symptomatic form has increased risk of vulvar cancer.

A

Lichen sclerosus

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3
Q

Lesion characterized by acanthosis, hyperkeratosis, dermal lymphocytic infiltrate with evident mitosis; not considered premalignant.

A

Squamous hyperplasia

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4
Q

Lesions of the anogenital area that 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 koilocytic atypia: hallmark of HPV infection; not precancerous.

A

Condyloma acuminata

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5
Q

HPV subtypes associated with condyloma acuminata.

A

HPV 6 and 11

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6
Q

Most common histology of vulvar carcinoma.

A

Squamous cell carcinoma (Note: most vulvar Cas are non-HPV related (70%))

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7
Q

Clinically presents as eczematoid lesion on the vulva; characterized by proliferation of malignant epithelial cells within the epidermis; usually not associated with underlying carcinoma, unlike its breast counterpart; PAS-positive (positive for mucin), unlike vulvar melanoma.

A

Vulvar Paget disease

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8
Q

Most common histology of vaginal carcinoma.

A

Squamous cell carcinoma

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9
Q

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

A

Sarcoma botryoides (Embryonal rhabdomyosarcoma)

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10
Q

Condition characterized by Areas of columnar mucinous epithelium (endocervical-like); 35-90% of patients with in utero exposure to DES; associated with clear cell CA of vagina.

A

Vaginal adenosis

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11
Q

Premalignant lesion of the cervix; can be low-grade (I; <1/3 of the entire epithelium), moderate (II; up to 2/3 of the entire epithelium), and severe (III or CIS; full-thickness of epithelium without invasion of the basement membrane).

A

Cervical intraepithelial neoplasia (CIN)

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12
Q

Another term for CIN I in the recent two-tiered classification system; regresses in 60% of cases.

A

Low-grade squamous intraepithelial lesion (LSIL)

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13
Q

Another term for CIN II and III in the recent two-tiered classification system; persists in 60% of cases, with 10% of cases progressing to carcinoma within 10 years.

A

High-grade squamous intraepithelial lesion (HSIL)

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14
Q

High-risk HPV implicated in the development of cervical carcinoma.

A

HPV 16, 18, 31 and 33

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15
Q

Viral oncoprotein responsible for koilocytic atypia in HPV-infected cells.

A

E5

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16
Q

HPV viral gene products that promote tumorigenesis and the tumor suppressor genes they inactivate.

A

E6 (inactivates p53) and E7 (inactivates Rb)

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17
Q

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; most common histology is squamous cell carcinoma (80%), followed by adenocarcinoma (15%) and neuroendocrine carcinoma (5%); all of the types are caused by HPV.

A

Invasive cancer of the cervix

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18
Q

Most common cause of death in cervical cancer.

A

Uremia

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19
Q

Most common cause of dysfunctional uterine bleeding.

A

Anovulatory cycle

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20
Q

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.

A

Adenomyosis

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21
Q

Characterized by the presence of endometrial glands and stroma in a location outside the myometrium.

A

Endometriosis

22
Q

Exophytic masses that project into endometrial cavity; may be clinically silent or may cause abnormal uterine bleeding.

A

Endometrial polyp

23
Q

Tumor suppressor gene commonly mutated in atypical endometriosis, endometrial hyperplasia and endometrial carcinomas; also mutated in endometrioid and clear cell carcinomas of the ovary.

A

PTEN

24
Q

Precursor lesion of endometrial carcinoma secondary to prolonged and marked increased estrogen to progestin ratio; can be simple or complex, with or without atypia.

A

Endometrial hyperplasia

25
Q

Atypical hyperplasia is now also called endometrial intraepithelial neoplasia (EIN).

A

Endometrial hyperplasia

26
Q

Most common malignancy of the female genital tract.

A

Endometrial carcinoma

27
Q

Most common histology of endometrial carcinoma found in 80% of cases; associated with atypical hyperplasia; maybe exophytic or infiltrative; histologically resembles endometrial glands to solid sheets, depending on differentiation; low-grade nuclei is a usual feature.

A

Endometrioid carcinoma (Type I)

28
Q

Accounts for 15% of cases of endometrial carcinoma; forms small tufts and papillae with high nuclear grade.

A

Serous carcinoma (Type II)

29
Q

Common gene mutated in leiomyomas and leiomyosarcomas.

A

MED12

30
Q

Most common benign tumor in females; grossly appears as sharply circumscribed firm gray white masses with a characteristic whorled cut surface; histologically similar to normal smooth muscle cells.

A

Leiomyoma

31
Q

Malignant counterpart of leiomyoma; grossly appears as soft, hemorrhagic, necrotic masses; diagnostic features include: tumor necrosis, cytologic atypia and mitotic activity; necrosis being the most important criterion among the three.

A

Leiomyosarcoma

32
Q

Most common major type of ovarian tumors; 90% of which are malignant.

A

Surface epithelial-stromal tumors (65-70%)

33
Q

Most common ovarian epithelial tumors; tumors with tubal-like epithelium; most are benign or borderline (70%).

A

Serous tumors

34
Q

Grossly appears as large, spherical structures with smooth glistening serosal covering with less papillary projections; histologically, with a single layer of tall columnar epithelial cells without atypia and invasion; usually with Psammoma bodies.

A

Serous cystadenoma

35
Q

Serous cystadenoma with micropapillary architecture and epithelial stratification, mild nuclear atypia but without invasion of stroma.

A

Bordeline serous tumor

36
Q

Grossly appears as large, spherical structures with nodular serosal covering with prominent papillar projections; histologically, with layers of anaplastic epithelial cells and invasion; usually with Psammoma bodies; cancers are divided into low-grade (well-differentiated) or high-grade (moderately-differentiated or poorly-differentiated), based on general architecture, nuclear atypia and severity of stromal invasion.

A

Serous cystadenocarcinoma

37
Q

Mutations associated with low-grade serous carcinomas.

A

KRAS, BRAF, ERBB2

38
Q

Mutation associated with high-grade serous carcinomas.

A

TP53

39
Q

Mucin-containing cystic masses; can be benign or malignant, but most of them are benign; tend to be larger, multicystic and unilateral; can rupture into the peritoneum and produce mucinous ascites (pseudomyxoma peritonei).

A

Mucinous tumors

40
Q

Most consistent mutation in mucinous tumors.

A

KRAS

41
Q

Tumors are usually malignant; 15-20% coexist with endometriosis; histologic hallmark is presence of tubular glands resembling benign or malignant endometrium.

A

Endometrioid tumors

42
Q

Metastatic mucinous adenocarcinoma of the ovary from a gastrointestinal primary; often produces bilateral ovarian masses.

A

Krukenberg tumor

43
Q

Cystic, lined by skin-like structures; usually occur in reproductive age women; histologically, derivatives from more than one germ layer can be seen; generally benign.

A

Mature teratoma

44
Q

Solid masses that usually occur in younger women and children; histologically composed of neuroepithelium; generally malignant.

A

Immature teratoma

45
Q

A type of teratoma that produces hyperthyroidism due to presence of mature thyroid tissue.

A

Struma ovarii

46
Q

Ovarian tumor that may elaborate large amounts of estrogen; two thirds occur in post-menopausal women; potentially malignant; histologically composed of mixture of cuboidal granulosa cells in cords, sheets, or strands and spindled or plump lipid-laden theca cells; granulosa elements may recapitulate ovarian follicle as Call-Exner bodies.

A

Granulosa cell tumor

47
Q

Sex cord tumor that recapitulates development of testis with tubules or cords and plump pink Sertoli cells; masculinizing and rarely malignant.

A

Sertoli-Leydig cell tumor

48
Q

Sex cord stromal tumor composed of solid gray fibrous cells to yellow (lipid-laden) plump thecal cells; rarely malignant; associated with hydrothorax and ascites (Meig syndrome).

A

Thecoma-fibroma

49
Q

A type of hydatidiform mole with the following features: diploid karyotype with diffuse villus edema and trophoblast proliferation; markedly elevated hCG with increased risk of developing subsequent choriocarcinoma.

A

Complete hydatidiform mole

50
Q

A type of hydatidiform mole with the following features: triploid karyotype with focal villus edema and trophoblast proliferation; less elevated hCG with rare chance of developing subsequent choriocarcinoma.

A

Incomplete (Partial) hydatidiform mole

51
Q

Complete moles that are more invasive locally but do not have the aggressive metastatic potential of a choriocarcinoma.

A

Invasive mole

52
Q

Main difference between ovarian and gestational choriocarcinoma.

A

Ovarian chorioCAs are more difficult to treat

Pathology 2017 (27 decks)

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