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Flashcards in Neoplastic Path of F Repro Tract Deck (73):
1

What are the low risk types of HPV? How is their DNA characterized?

6, 11 (episomal viral DNA)

2

What are the high risk types of HPV? How is their DNA characterized?

16, 18, 31, 33, 35, etc. (genomically integrated viral DNA, expression of viral oncogens)

3

What genes are important in development of high grade dysplasia and invasive cancer?

E6 and E7

4

What type of HPV has E6/E7?

16, 18

5

gene product binds to and causes degeneration of the p53

E6

6

gene product binds to and inactivates Rb protein

E7

7

How do E6 + E7 affect epithelial cells?

increase life span

8

found in 70% of invasive cervical cancers

HPV 16, 18

9

Allows up-regulation of Cyclin E and p16INK4 (prolif promoters)

E7 (occurs via binding to + inactivating Rb)

10

How is original squamous epithelium of cervix characterized (grossly)?

smooth, shiny and featureless

squamo-columnar junction separates the squamous epithelium from the villous endocervix

11

Application of ___ to cervix will identify CIN/SIL.

acetic acid

12

How is Invasive Squamous Cell Carcinoma
of cervix characterized (grossly)?

nodular, with bizarre vessels and areas of hemorrhage

13

How is CIN1characterized?

Flat Condyloma with Mild Atypia/dysplasia

basal layer slightly thickened

prominent koilocytes

14

How is CIN2 characterized?

moderate dysplasia

15

How is CIN3 characterized?

severe dysplasia >> carcinoma in situ

involves entire thickness of epithelium

16

What are the Features of Koilocytotic Changes in cervical epithelium?

Cytomegaly
Nucleomegaly
Perinuclear halo
Irreg nuclear mem
Stippled (coarse) chromatin
Increased mitotic activity

17

Where do viral particles reside within cervical epithelium?

intermediate layer

18

Features of Intraepithelial Dysplasia/ CIN/SIL?

1. Maturation arrest (decreased or missing superficial epithelial cells)
2. Blurred or missing distinction of basal cell layer
3. Loss of cellular orientation, polarity
4. Increased nuclear/cytoplasmic ratio
5. Hyperchromatic epithelium

19

This stain can be very helpful to differentiate between atypia associated with postmenopausal mucosal atrophy and true dysplasia:

Ki 67 immunostain

20

Histology of invasive squamous cell carcinoma demonstrates:

irregular tumor islands of sq cells
variable amount of keratinization
spindled cell stroma w/ inflmm cells

21

Survival of Cervical Invasive Squamous Cancer depends on:

clinical stage

22

Stages Cervical Squamous Cell Carcinoma:
I involves...
II involves...
III involves...
IV involves...

I = cervix
II = upper vagina
III = lower vagina, pelvic wall
IV = bladder, rectum, beyond

23

CIN Risk Factors:

1. Early age at 1st intercourse
2. Multiple sexual partners
3. male partner with multiple previous sexual partners
4. High parity, family hx, other viruses
5. Immune status

24

precursor of cervical cancer

CIN

25

Screening System for cervical cancer involves:

Exfoliative cytology of cervix
Bethesda nomenclature

26

Cervical cancer vaccine uses ____ to increase immunity.

Virus-like particles

27

Survival of Endometrial Cancer is related to:

Stage/Grade
age
progesterone R activity
depth of endometrial invasion

28

What factors correlate with a better prognosis in Endometrial Cancer?

High levels of estrogen and progesterone R in tumor

low levels of proliferative activity

29

Benign Tumors of the Uterine Corpus

leiomyoma (smooth muscle)
endometrial stromal nodule

30

Malignant Tumors of the Uterine Corpus

adenocarcinoma of endometrium (endometrioid, serous papillary)

mixed mullerian tumors

leiomyosarcoma

endometrial stromal sarcoma

31

most common tumor of the female genital tract

Leiomyoma

32

Epidemiology of leiomyoma?

>30

33

Histopath of leiomyoma?

markedly elongated smooth muscle cells
eosinophilic cytoplasm
elongated, cigar-shaped nuclei
mitotic figures absent or sparse

34

Abnormal Uterine Bleeding can be caused by:

hormonal abnormality or can be intrinsic to the uterus

35

Abnormal Uterine Bleeding can lead to:

severe anemia

36

cause of ab uterine bleeding in baby girls?

Maternal estrogen

37

cause of ab uterine bleeding in kids?

trauma or tumors

38

cause of ab uterine bleeding in adolescents?

Hypothalamic immaturity
inadequate luteal function
psychological + nutritional problems

39

Adenomyosis is:

presence of benign endometrial glands and stroma within the myometrium

40

Endometriosis is:

presence of benign endometrial glands and stroma outside the uterus

41

Adenomyosis, histo?

glands are proliferative, but can show secretory changes leading to repeated bleeding and cystic changes

42

Causes of endometriosis?

retrograde menstrual implantation, vascular dissemination and metaplasia

43

Endometriosis can cause:

1. infertility
2. fibrous adhesions or strictures impairing fallopian tube function
3. chocolate cysts” containing old altered blood, on the ovary

44

Why is ovarian cancer usually spread at time of dx?

Early detection is difficult

45

Classification of ovarian tissue is by:

tissue of origin

46

account for over 90% of ovarian neoplasms

Epithelial tumors

46

account for over 90% of ovarian neoplasms

Epithelial tumors

47

Large simple cyst, thin wall and serous fluid content

Benign Serous Cystadenoma

47

Large simple cyst, thin wall and serous fluid content

Benign Serous Cystadenoma

48

Histo of Serous Carcinoma of Ovary

Invasive cell nests forming papillary fronds; Psammoma bodies

49

types of Surface Epithelial Stromal Tumors

Serous
Mucinous
Endometrioid
Transitional cell

50

Granulosa cell tumor, gross pathology

tumor is mustard-yellow with areas of necrosis

51

most common ovarian cancers in kids

Germ cell tumors

52

tumor of germ cell origin that differentiates toward somatic structures

teratoma

53

highly malignant tumor of women under the age of 30 that histologically resembles the mesenchyme of the primitive yolk sac

yolk sac tumor (yeah, sorry)

54

Mature cystic teratoma, gross pathology

The cystic mass has sebaceous content, hair

55

Mature Cystic Teratoma, Microscopy

Keratin, skin, skin appendages and subcutaneous fat tissue

56

Mature Cystic Teratoma, Microscopy

Keratin, skin, skin appendages and subcutaneous fat tissue

57

Germ cell tumors tend to be malignant in:

children

58

types of germ cell tumors

Mature cystic teratoma
Immature teratoma
Dysgerminoma
Endodermal sinus tumor (yolk sac tumor)
Mixed germ cell tumor

59

Granulosa Cell Tumor: Microscopic Pathology

Coffee-bean shaped nuclei, nuclear grooves,
Call-Exner bodies (circular arrangement around sparsely cellular space recapitulating ovarian follicle)

60

When do most granulosa cell tumors occur?

after menopause

61

What do granulosa cell tumors secrete?

inhibin (+ associated w/ estrogen secretion)

62

types of sex cord-stromal tumors

Granulosa cell
Tumors of thecoma-fibroma group
Sertoli cell
Sex cord

63

Histology of benign serous cystadenoma

epithelium is cuboidal-low columnar, ciliated, single-celled layer

63

Serous papillary cystadenocarcinoma, gross pathology

Tan-yellow-white with papillary projections and solid areas.

63

Histo of Serous Carcinoma of Ovary

Invasive cell nests forming papillary fronds; Psammoma bodies

63

types of Surface Epithelial Stromal Tumors

Serous
Mucinous
Endometrioid
Transitional cell

63

Granulosa cell tumor, gross pathology

tumor is mustard-yellow with areas of necrosis

63

most common ovarian cancers in kids

Germ cell tumors

63

tumor of germ cell origin that differentiates toward somatic structures

teratoma

63

highly malignant tumor of women under the age of 30 that histologically resembles the mesenchyme of the primitive yolk sac

yolk sac tumor (yeah, sorry)

63

Mature cystic teratoma, gross pathology

The cystic mass has sebaceous content, hair