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Pathology > Exam 10 > Flashcards

Exam 10 Flashcards

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1
Q

Unilateral, painful cystic lesion at lower vestibule region.

A

Bartholin Cyst

-Women of reproductive age

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2
Q

Warty neoplasm of of vulvar skin.

A

Condyloma (acuminatum)

–Due to LR HPV (6, 11)

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3
Q

Leukoplakia with “parchment-like” vulvar skin.

A

Lichen Sclerosis

  • -Thinning of epidermis and sclerosis of dermis
  • -Slight increased risk of SCC
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4
Q

Leukoplakia with “thick, leathery” vulvar skin.

A

Lichen Simplex Chronicus

  • -Hyperplasia of vulvar squamous epithelium
  • -NO increased risk of SCC
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5
Q

Carcinoma arising from squamous epithelium lining the vulva.

A

Vulvar Carcinoma

  • -Presents as leukoplakia
  • -Two major etiologies:
    1. HR HPV (16, 18)-women of reproductive age; arises from vulvar intraepithelial neoplasia (VIN)
    2. Non-HPV related-elderly women; due chronic lichen sclerosis
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6
Q

Erythematous, pruritic, ulcerated vulvar skin.

A

Extramammary Paget Disease

  • -Malignant epithelial cells in the epidermis of the vulva
  • -NO association with an underlying carcinoma
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7
Q

Seen in females who were exposed to diethylstilbestrol (DES) in utero.

A

Adenosis

–Focal persistence of columnar epithelium in upper vagina

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8
Q

Rare complication of DES-associated vaginal adenosis.

A

Clear Cell Adenocarcinoma

–Malignant proliferation of glands with clear cytoplasm

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9
Q

Presents as bleeding and a “grape-like” mass protruding from the vagina.

A

Embryonal Rhabdomyosarcoma (Sarcoma Botryoides)

  • -Malignant mesenchymal proliferation of immature skeletal muscle
  • -Children (usually < 5 y/o)
  • -Rhabdomyoblast (characteristic cell)
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10
Q

Carcinoma arising from squamous epithelium lining the vaginal mucosa.

A

Vaginal Carcinoma

  • -Related to HR HPV (16, 18)
  • -Precursor lesion is Vaginal Intraepithelial Neoplasia (VAIN)
  • -Lymph node spread:
    1. Lower 1/3 of vagina: inguinal nodes
    2. Upper 2/3: regional iliac nodes
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11
Q

Infection most often involving the endocervix.

A

Cervicitis

  • -Often asymptomatic
  • -May manifest with cervical discharge
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12
Q

Infection is usually eradicated by acute inflammation.

A

HPV

  • -HR HPV produce E6 and E7 proteins, which result in increased destruction of p53 and Rb, respectively
  • -Persistent infection leads to increased risk of Cervical Intraepithelial Neoplasia (CIN)
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13
Q

Invasive carcinoma that arises from the cervical epithelium.

A

Cervical Carcinoma

  • -Middle-aged females (50-60 y/o)
  • -Vaginal bleeding, postcoital bleeding, cervical discharge
  • -Associated with HR HPV
  • -Common subtypes are SCC (80%) and Adenocarcinoma (15%)
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14
Q

Lack of ovulation.

A

Anovulatory Cycle

  • -Estrogen-driven proliferative phase w/o progesterone-driven secretory phase
  • -Dysfunctional uterine bleeding during menarche or menopause
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15
Q

Bacterial infection presenting with fever, abnormal uterine bleeding, and pelvic pain.

A

Acute Endometritis

–Usually due to retained products of conception

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16
Q

Chronic inflammation presenting with abnormal uterine bleeding, pain, and infertility.

A

Chronic Endometritis

–Characterized by plasma cells (and lymphocytes)

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17
Q

Hyperplastic protrusion of endometrium.

A

Endometrial Polyps

  • -Presents as abnormal uterine bleeding
  • -Can arise as a side effect of tamoxifen
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18
Q

Endometrial glands and stroma outside of the uterine endometrial lining.

A

Endometriosis

  • -Presents as dysmenorrhea and pelvic pain
  • -“Chocolate cysts” seen with ovary involvement (most common site)
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19
Q

Endometriosis involving the uterine myometrium.

A

Adenomyosis

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20
Q

Hyperplasia of endometrial glands relative to stroma.

A

Endometrial Hyperplasia

  • -Due to unopposed estrogen
  • -Classically presents as postmenopausal uterine bleeding
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21
Q

Malignant proliferation of endometrial glands.

A

Endometrial Carcinoma

  • -Most common invasive carcinoma of female genital tract
  • -Two distinct pathways:
    1. Hyperplasia-75%; 60 y/o; endometroid; associated with PTEN mutation
    2. Sporadic-25%; 70 y/o; seropapillary structure; associated with p53 mutation
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22
Q

Benign neoplastic proliferation of smooth muscle arising from the myometrium.

A

Leiomyoma

  • -Most common tumor in females
  • -Related to estrogen exposure
  • -Premenopausal women, multiple, enlarges during pregnancy, shrinks after menopause
  • -Well-defined, white, whorled masses
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23
Q

Malignant proliferation of smooth muscle arising from the myometrium.

A

Leiomyosarcoma

  • -Arises DE NOVO
  • -Postmenopausal women
  • -Necrosis, mitotic activity, cellular atypia
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24
Q

Classically presents as a young obese woman with infertility, oligomenorrhea, and hirsutism.

A

Polycystic Ovarian Disease

  • -Characterized by increased LH and decreased FSH
  • -Increased risk of endometrial carcinoma
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25
Most common type of ovarian tumor.
Surface Epithelial Tumors - -CA-125 is useful serum marker 1. Serous tumors 2. Mucinous tumors 3. Endometroid tumors 4. Brenner tumors
26
Benign cystic surface epithelial tumor.
Cystadenoma - -Single cysts with a simple, flat lining - -Premenopausal women (30-40 y/o)
27
Malignant cystic surface epithelial tumor.
Cystadenocarcinoma - -Complex cysts with thick, shaggy lining - -Postmenopausal women (60-70 y/o)
28
Malignant surface epithelial tumor composed of endometrial-like glands.
Endometroid tumor - -May arise from endometriosis - -15% associated with an independent endometrial carcinoma
29
Benign surface epithelial tumor composed of bladder-like epithelium.
Brenner tumor
30
Second most common type of ovarian tumor usually occurring in women of reproductive age.
Germ Cell Tumors
31
Most common germ cell tumor in females.
Cystic Teratoma - -Benign - -Composed of fetal tissue from two or three embryologic layers
32
Teratoma composed primarily of thyroid tissue.
Struma Ovarii | --Monodermal type
33
Testicular counterpart is a seminoma.
Dysgerminoma - -Composed of large cells with clear cytoplasm and central nuclei - -Responds to radiotherapy; good prognosis
34
Most common germ cell tumor of children.
Endodermal Sinus Tumor - -Malignant tumor that mimics the yolk sac - -Schiller-Duval bodies (glomerulus-like structures) - -Increased AFP
35
Malignant tumor composed of trophoblasts in women.
Choriocarcinoma - -High Beta-hCG is characteristic - -Early hematogenous spread - -Poor response to chemotherapy
36
See precocious puberty in children and endometrial hyperplasia with uterine bleeding in postmenopausal women.
Granulosa-Theca Cell Tumor | --Call-Exner bodies
37
See Reinke crystals.
Sertoli-Leydig Cell Tumor | --Associated with hirsutism and virilization
38
Benign sex cord-stromal tumor of fibroblasts.
Fibroma | --Meigs Syndrome: when associated with pleural effusions and ascites
39
Metastatic mucinous tumor that involves both ovaries.
Krukenberg Tumor - -Most commonly due to metastatic gastric carcinoma - -"Signet-ring" cells
40
Massive amount of mucus in the peritoneum.
Pseudomyxoma Peritonei | --Due to mucinous tumor of the appendix
41
Implantation of fertilized ovum at site other than the uterine wall.
Ectopic Pregnancy - -Most common site is lumen of the fallopian tube - -Scarring is major risk factor
42
Implantation of the placenta in the lower uterine segment.
Placenta Pervia | --Presents in third-trimester bleeding
43
Separation of placenta from the decidua prior to delivery of the fetus.
Placental Abruption | --Presents with third-trimester bleeding and fetal insufficiency
44
Improper implantation of placenta into the myometrium.
Placenta Accreta | --Presents with difficult delivery and postpartum bleeding
45
Pregnancy-induced hypertension, proteinuria, and edema.
Preeclampsia | --Eclampsia: preeclampsia with seizures
46
HELLP
- -Preeclampsia with thrombotic microangiopathy involving the liver - -Hemolysis, Elevated Liver enzymes, Low Platelets
47
Clinically presents in second-trimester with passage of grape-like masses.
Hydatidiform Mole - -Abnormal conception characterized by swollen and edematous villi with proliferation of trophoblasts - -Uterus is much larger than normal - -Beta-hCG much higher than normal - -"Snowstorm" appearance on ultrasound
48
Partial verus Complete Mole
``` Partial: --Normal ovum, XXY69 --Fetal tissue present --Some villi, focal proliferation, minimal risk of choriocarcinoma Complete: --Empty ovum, XX46 --Fetal tissue absent --Most villi, diffuse proliferation, 2-3% risk of choriocarcinoma ```
49
Opening of urethra on the inferior surface of penis.
Hypospadias
50
Opening of urethra on the superior surface of penis.
Epispadias
51
Most common testicular tumor.
Seminoma | --Malignant tumor of large cells with clear cytoplasm and central nuclei
52
Benign germ cell tumor in females but malignant in males.
Teratoma
53
Causes precocious puberty in male children and gynecomastia in male adults.
Leydig Cell Tumor | --Reinke crystals
54
Prostate is tender and boggy and patient presents with dysuria, fever, and chills.
Acute Prostatitis
55
Associated with dihydrotestosterone (DHT).
Benign Prostatic Hyperplasia - -Present in most men by 60 y/o - -Problems starting/stopping, impaired emptying, dribbling
56
Most common cancer in men.
Prostate Adenocarcinoma - -Often clinically silent - -Increased PSA
57
Classically arises in women of late childbearing age and is associated with HLA-DR4.
Rheumatoid Arthritis - -Hallmark is synovitis leading to pannus - -Symmetric involvement of PIPJs (swan-neck deformity) - -Rheumatoid factor: IgM autoAb against Fc portion of IgG
58
Characterized by triad of arthritis, urethritis, and conjunctivitis.
Reiter's Syndrome | --Young male adults
59
Bloody nipple discharge in premenopausal women.
Intraductal Papilloma
60
See "indian file" pattern on histology.
Infiltrating Lobular Carcinoma
61
Presents in adolescence as sudden testicular pain and absent cremasteric reflex.
Testicular Torsion

Pathology (3 decks)

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