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Flashcards in Cervical Pathology Deck (6)
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1
Q

6 Common Infections (hallmarks of ea)

A

1- Chlamydia trachomatis - follicular cervicitis; red on exam

2- Candida - white cottage-cheese like d/c, fungal pseudohyphae and budding yeast

3- Trichomonas vaginalis - frothy, green/yellow d/c; strawberry cervix; pear shaped protozoa w/ flagella

4- Gardnerella - bacterial vaginosis, white/gray vaginal d/c w/ fishy odor; clue cells

5- HSV - clears vesicles; 3 M’s - multinucleated, molding, margination of chromatin

6- HPV - condylomas (warts), dysplasia, carcinomas, koilocytic change

2
Q

Overview of Cervical Cancer Categories

A
  • 70% squamous cell (from ectocervix)
  • *CIN –> invasive squamous cell carcinoma
  • 25% adenocarcinoma (from endocervix)
  • *adenocarcinoma in situ –> invasive adenocarcinoma
  • 3-5% adenosquamous carcinoma
3
Q

10 Risk Factors for Cervical Cancer

A
  • Early age first intercourse
  • Mult sex partners
  • Male partner w/ multiple past partners
  • Cancer-associated HPV
  • High viral load of HPV
  • Certain HLA and viral subtypes
  • Genital infections
  • Nicotine exposure
  • Altered immune status
  • Inc parity
4
Q

Pap Smear v. Biopsy for Cervix

A

Pap = cytology (CELLS)

  • LSIL - looking for larger nuclei, raisin-like nuclei and halos on specific cells of cytology; DNA has not integrated yet; 60% regress and 30% persist
    • Correlates w/ CIN I or II
  • HSIL - no halos but even more nuclei/ dec cytoplasm; 30% regress and 60% persist
    • Correlates w/ CIN III

Biopsy = architecture

  • CIN I - low grade dysplasia, disorganization in lower 1/3 of epithelium and koil changes on surface
  • CIN II - moderate dysplasia, disorganization of lower 2/3 of epithelium and koil changes on surface sometimes; mitotic activity
  • CIN III - severe dysplasia of full thickness; pleomorphic nuclei w/ hyperchromasia, no polarity and mitoses; inc nucleus:cyto
5
Q

HPV (low v. high risk)

A

-Dbl stranded DNA virus; 15/40 genital subtypes are oncogenic

  • Low risk (warts not pre-cancerous) - 6, 11
    • Condyloma acuminatum (flat, spiked and inverted warts)
  • High risk - 16, 18
    • Over-express E6 and E7
      • E6 binds/degrades p53
      • E7 binds/degrades RB so no cell cycle suppression

-Can cause both squamous cell and adenocarcinoma

6
Q

Clear Cell Adenocarcinoma of Cervix

A
  • associated w/ moms that used DES during pregnancy to prevent abortion/miscarriage