Female reproductive and breast

Question 1

CIN

Answer 1

Cervical Intraepithelial neoplasia. CIN I is equivalent to low grade dysplasia. CIN II and CIN III are regarded as equivalent to high grade dysplasia.

Question 2

Cervical polyp

Answer 2

A benign overgrowth of connective tissue and epithelium of the cervix.

Question 3

Pap test

Answer 3

Cervical cytology.

Question 4

Cytology

Answer 4

Modern method of processing cervical cytology specimens from a liquid fixative.

Question 5

Fallopian tube

Answer 5

Ovarian tube connecting ovary with the endometrial cavity.

Question 6

PID

Answer 6

Pelvic Inflammatory Disease

Question 7

Ectopic pregnancy

Answer 7

Gestation occurring outside endometrial cavity. Most often within fallopian tube; may lead to rupture and bleeding.

Question 8

Dermoid cyst

Answer 8

A benign cystic teratoma-usually benign.

Question 9

Cystadenoma

Answer 9

A benign cystic neoplasm of epithelial origin.

Question 10

Cystadenocarcinoma

Answer 10

A malignant cystic neoplasm of epithelial origin.

Question 11

Torsion

Answer 11

Twisting of the tube and ovary on their pedicle, may cause venous infarction.

Question 12

Fibrocystic change

Answer 12

Benign changes including fibrosis, cyst formation, and epithelial hyperplasia. Hyperplasia of ‘usual type’ is low risk for later cancer.

Question 13

Atypical ductal hyperplasia

Answer 13

Epithelial hyperplasia with features overlapping with ductal carcinoma in situ, but not bad enough to call DCIS.

Question 14

Atypical lobular hyperplasia

Answer 14

Epithelial hyperplasia with features overlapping with lobular carcinoma in situ, but not bad enough to call LCIS.

Question 15

DCIS

Answer 15

Ductal carcinoma in situ. Abnormal proliferation of breast epithelium resembling ductal invasive breast cancer not yet invasive (may accompany invasive cancers).

Question 16

LCIS

Answer 16

Lobular carcinoma in situ. Abnormal proliferation of breast epithelium resembling lobular invasive breast cancer but not yet invasive (may accompany invasive cancers).

Question 17

Invasive ductal carcinoma

Answer 17

The commonest kind of invasive breast cancer. Sometimes referred to as being of ‘no special type’.

Question 18

Invasive lobular carcinoma

Answer 18

The second commonest kind of invasive breast cancer. Typically its cells are non-cohesive and lack E-cadherin.

Question 19

ER/PR status

Answer 19

Whether or not the carcinoma cells express oestrogen receptor (ER) or progesterone receptor (PR).

Question 20

HER2 status

Answer 20

Whether or not the carcinoma cells EITHER over-express Her protein OR have Her2 gene amplification. Without one of these the cancer is not a target for Herceptin.

Question 21

Grade

Answer 21

Bloom and Richardson grade as modified by Elston and Ellis. Grade III carcinomas are the most aggressive.

Question 22

Sentinel node

Answer 22

A node or noes in the axilla into which a tracer molecule first drains from the breast. If it is free of cancer cells involvement of other nodes in the axilla is unlikely.

Question 23

What is a radial scar?

Answer 23

Complex sclerosing lesions >10mm. Benign lesions characterised by fibrotic and elastotic core, trapped glands and a pseudo-infiltrative appearance.

Question 24

PASH

Answer 24

Pseudo-angiomatous stromal hyperplasia. A proliferation of myofibroblasts may cause a mass and may require biopsy to exclude malignancy.

Question 25

Diabetic fibrous mastopathy

Answer 25

Stromal fibrosis with infiltrating lymphocytes. it is associated with T1DM and may be clinically suspicious of carcinoma. It usually occurs in women but sometimes men.

Question 26

What is Poland's syndrome?

Answer 26

A combination of chest wall deformity and absent or hypoplastic pectoralis muscle and breast associated with shortening and brachysyndactylyl of upper limb.

Question 27

Acute (peurperal, lactational) mastitis

Answer 27

A cellulitis associated with breastfeeding. Skin fissures may let bacteria in, milk stasis, leading to infection. Sometimes causes abscesses that need to be drained.

Question 28

Plasma cell mastitis

Answer 28

Calcification of inspissated secretions in or immediately adjacent to ectatic beign ducts. Normally women over 60 y.o.

Question 29

Duct ectasia

Answer 29

Dilation of central lactiferous ducts, periductal chronic inflammation and scarring.

Question 30

Fibroadenoma

Answer 30

Characteristic outgrowth of epithelium and stroma resembling a giant lobule. Usually regarded as a benign neoplasm, hormone sensitive and regress after the menopause.

Question 31

Intraduct papilloma

Answer 31

Benign tumour of the epithelium lining of the mammary ducts. Solitary central papillomas are thought to be innocuous if no epithelial atypia. Multiple papillomas more likely to be associated with malignancy.

Question 32

What are the 2 layers of epithelium in glandular and duct tissue of the breast?

Answer 32

Inner layer is luminal, outer layer is myoepithelal.

Question 33

What conditions is breast hypoplasia associated with?

Answer 33

Ulnar-mammary syndrome, Poland's syndrome, Turner's syndrome and congenital adrenal hyperplasia.

Question 34

Idiopathic granulomatous mastitis

Answer 34

Lobule-centred non-necrotising granulomatous inflammatory process with a tendency to recurrence after excision.

Question 35

What type of epithelium lines the fallopian tube?

Answer 35

Ciliated columnar epithelium.

Question 36

What is salpingitis?

Answer 36

Inflammation of the fallopian tubes. Most commonly infective, mainly bacterial eg. chlamydia trachomatis. Usually considered an ascending infection.

Question 37

Complications of salpingitis

Answer 37

Adherence of tube to ovary; tubo-ovarian abscess. Adhesions increase risk of ectopic pregnancy. Ruptured tubal ectopic pregnancy can be potentially life-threatening. Damage to lumen may cause infertility.

Question 38

STIC

Answer 38

Serous Tubal Intraepithelial Carcinoma. Abnormal epithelium distal fallopian tube. Limited by BM so in situ. lIkely precursor for high grade serous carcinoma.

Question 39

What is Meig's syndrome?

Answer 39

Combination of ovarian fibroma, with ascites and pleural effusion. Removal of the tumour clears the problem.

Question 40

What are Brenner tumours?

Answer 40

These are uncommon mixed surface epithelial-stromal tumours. Usually benign, unilateral, size variable, solid, circumscribed, yellowish. Histologically, nests of transitional epithelial cells with longitudinal nuclear grooves and abundant fibrous stroma.

Question 41

What are some of the risk factors for breast cancer?

Answer 41

Early menarche, later menopause, OC use, HRT, obesity, denser breast tissue on mammography, alcohol, positive family history.

Question 42

Carcinoma in situ.

Answer 42

Ductal carcinoma in situ or lobular carcinoma in situ.: - Malignant looking proliferation of epithelial cells within the basement membrane. - No extension into breast stroma - No communication with blood vessels or lymphatics. - No possibility of metastates

Question 43

Basal-like carcinomas

Answer 43

Express genes associated with the basal/myoepithelial cells of the breast. They tend to be aggressive, and there is overlap with the cancers which occur in BRCA1 mutation carriers.

Question 44

What are the main classes of cancer chemotherapy drugs?

Answer 44

- Alkylating agents - Antimetabolites - Cytotoxic antibiotics - Microtubule inhibitors - Steroid hormones and antagonists