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Unit 5: Path - The Femal Reproductive System, the Peritoneum, and Pregnancy > Endometrial Tumors > Flashcards

Endometrial Tumors Flashcards

1
Q

What is an endometrial polyp?

A

Benign stromal neoplasm in the endometrial cavity

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2
Q

Where do most endometrial polyps occur?

A

In the fundus of the uterus

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3
Q

An endometrial polyp is shown. What is typical clinical presentation?

A

Intermestrual bleeding

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4
Q

What is the cause of benign endometrial hyperplasia?

A

Abnormal estrogenic stimulation

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5
Q

By what is BEH characterized?

A

Diffuse, randomly distributed, architectural and cytologic changes

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6
Q

What are the 3 types of Endometrial Hyperplasia? What are the characteristics of each type?

A
  1. Simple Hyperplasia - Minimal glandular complexity/crowding and no cytologic atypia
  2. Complex Hyperplasia - Marked glandular complexity/crowding and no cytologic atypia
  3. Atypical hyperplasia - Cytologic atypia and marked glandular crowding
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7
Q

What are the two discrete entities of endometrial hyperplasia?

A
  1. Benign endometrial hyperplasia
  2. Endometrial Intraepithelial Neoplasia
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8
Q

What is endometrial intraepithelial neoplasia?

A

Monoclonal neoplasic growths of genetically altered cells with greatly increased risk of becoming the endometrioid type of endometrial adenocarcinoma

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9
Q

Endometrial Intraepithelial Neoplasia is shown. What are typical findings?

A

Tight clusters of ctyologically altered neoplastic endometrial glands with abundant cytoplasm and rounded nuclei

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10
Q

How are endometrial carcinoma classified?

A

Two types:

  1. Type I tumors (endometrioid carcinoma)
  2. Type II tumors (Nonendometrioid carcinoma)
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11
Q

Of two endometrial adenocarcinoma, which is more lethal?

A

Type II tumors (nonendometrioid)

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12
Q

What is the primary genetic driver for type I tumors? Type II tumors?

A

Usatellite instability; p53 alterations and loss of heterozygosity

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13
Q

What five main molecular alterations play a role in type I endometrial tumorgenesis?

A
  1. Usatellite instability
  2. PTEN (tumor suppressor) mutation
  3. k-RAS mutation
  4. Beta-catenin
  5. PIK3CA mutations
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14
Q

What three molecular changes contribute to type II endometrial tumorgenesis?

A
  1. p53 mutations
  2. Her2/neu amplification
  3. LOH on several chromosomes
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15
Q

Endometrioid adenocarcinoma is shown. Describe the grading scheme.

A

Grades 1-3 with 3 being the worst. The greater the solid tumor/glandular tumor ratio, the worse differentiation and the higher the grade

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16
Q

If an endometrioid adenocarcinoma contains squamous elements, what is the Dx?

A

Endometrioid Adenocarcinoma with squamous differentiation

17
Q

Which type of endometrioid adenocarcinoma has the best Px? Why?

A

Endometrioid adenocarcinoma, secretory type; Probably because it is so well differentiated

18
Q

What types of endometrial adenocarcinoma are associated with estrogen exposure?

A

Endometrioid, NOT nonendometrioid

19
Q

Squamous cells are seen within an endometrioid adenocarcinoma. What is the Dx?

A

Endometrioid Adenocarcinoma with Squamous Differentiation

20
Q

A Clear cell adenocarcinoma is shown. What do the clear cells contain? What other cells are seen?

A

Glycogen; Hobnail cells (Bulbous nuclei lining glandular lumina)

21
Q

Carcinosarcoma is shown. What types of cells are intermingled?

A

Pleomorphic epithelial cells intermingled with cells of mesenchymal differentiation

22
Q

What are the two major categories of endometrial stromal sarcoma?

A

Expansile or infiltrating

23
Q

What are expansile lesions? What are infiltrating lesions?

A

Benign stromal nodules; Stromal sarcomas

24
Q

What markers are used to ID endometrial stromal sarcomas?

A

CD-10 and Estrogen/Progesterone receptors

25
Q

Periglandular cuffing by atypical stroma with mitotic activity is shown. Dx?

A

Uterine Adenosarcoma

26
Q

What is the most common tumor of the female genital tract?

A

Leiomyoma

27
Q

What are leiomyomas?

A

Benign tumors of smooth muscle origin

28
Q

Leiomyoma is shown. How is it differentiated from the surrounding myometrium?

A

Leiomyoma and surrounding myometrium are cytologically identical but leiomyomas are distinguished by their circumscription, nodularity and denser cellularity

29
Q

What is Intravenous Leiomyomatosis? What is the Px if it metastasizes?

A

Benign smooth muscle grows w/i uterine and pelvic veins; it does not metastasize

30
Q

What is Leiomyosarcoma? How does it compare to Leiomyoma?

A

Malignancy of smooth muscle; Much less common than leiomyoma

31
Q

Leiomyosarcoma is shown. What are typical findings that lead to Dx?

A
  • Gross: Soft, necrotic
  • Histo: Geographical necrosis, > 10 mitoses/HPF, nuclear atypia

Unit 5: Path - The Femal Reproductive System, the Peritoneum, and Pregnancy (25 decks)

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