Pathology Flashcards Preview

Reproductive > Pathology > Flashcards

Flashcards in Pathology Deck (22)
Loading flashcards...
1
Q

Possible gynae causes for abdominal pain

A
  1. Mittleschmerz + rupture CL
  2. Ruptured ectopic
  3. Cx of ovarian cyst
  4. Acute salpingitis
  5. Ovarian tumour (rarely)
2
Q

Ovarian tumours

A

= 80% benign
- Most commonly 20-45yo
- Most common Sx = abdominal pain / abdominal
enlargement

3
Q

Classification of ovarian tumours

A
  1. Germ cell - mostly benign cystic teratoma
  2. Stromal - thecae / granulosa
  3. Surface epithelial -> most common
  4. Metastatic - most commonly tumours of
    paramesonephric origin
4
Q

Types of surface epithelial tumours

A
  1. Serous - most common
  2. Mucinous
  3. Endometroid (close resemblance to endometrial
    tissue)
5
Q

Peritoneal spread of ovarian tumours

A
  • All serial surfaces are diffusely seeded w/ 0.5cm

nodules of tumour

6
Q

Metastatic locations in ovarian malignancy

A
  • Liver
  • Lungs
  • GI tract
  • Opposite ovary (poor prognostic factor)
7
Q

Endometriosis

A

= ectopic endometrial tissue, usually glands + stroma

8
Q

Locations of endometriosis

A

In descending order of frequency:
1. Ovaries

  1. Uterine ligaments
  2. Rectovaginal septum
  3. Cul de sac
  4. Rectovaginal septum
  5. Large + small bowel / appendix
  6. Mucosa of cervix, vagina, f tubes
  7. Laparotomy scars
9
Q

Theory of endometrial spread

A
  1. Metastatic

2. Metaplastic

10
Q

Macro appearance of endometriosis

A
  • Nodules of red/blue to yellow/brown appearance on
    OR beneath the mucosal +/or serosal surface
  • Extensive disease -> organising haemorrhage ->
    extensive fibrous adhesions
11
Q

Micro appearance of endometriosis

A
  • Straightforward - endometrial glands + stroma
12
Q

HPV causing cervical Ca

A

16 + 18

13
Q

HPV pathogenesis

A
  • Infects immature basal cells
  • Cervix is particularly vulnerable because of large areas of immature squamous metaplastic epithelium
  • Replication of HPV occurs in mature SCCs -> manifests
    as koilocytic atypic (nuclear atypic + cytoplasmic
    perniculear halo)
  • Actives cell replication by interfering w/ p53 + Rb via
    E6-7 toxins
14
Q

Classification of premalignant cervical lesions

A
  1. LSIL = mild dysplasia, atypic confined to lower 1/3 of
    epithelium, 10% progress to HSIL
  2. HSIL = moderate dysplasia to CIS, 10% progress to Ca
15
Q

Cervical Ca

A
  • Most common type is SCC (80%)

- ~ age = 45yo

16
Q

Macro appearance of cervical Ca

A
  • Exophytic / infiltrative
17
Q

Micro appearance of cervical Ca

A
  • Nests / tongues of malignant squamous epithelium

- Can be keratinising or non-keratinising

18
Q

Spread of cervical Ca

A
  • Direct spread to involve contiguous tissues
  • Local / distant Las are also involved
  • Can spread to = liver, lung, bone (late)
19
Q

Staging of cervical Ca

A

0 = HSIL

I = confined to cervix (95% 5yr)

  • Ia - only on micro
  • Ib - invasive Ca confined to cervix

II = extends beyond cervix but not the pelvic wall
(75% 5yr)

III = extends to pelvic wall, involves lower 1/3 of the
vagina (<50% 5yr)

IV = extends beyond the true pelvis OR involving
bladder / rectal mucosa (<50% 5yr)

20
Q

Testicular Ca

A
  • Uncommon
  • 20-40yo
  • 95% = germ cell
    • Seminoma = 70%, NSGCT = 30%
21
Q

Seminoma

A
  • Arises from seminiferous tubules, relatively low grade
22
Q

Metastatic spread of seminoma

A
  • Usually LNs

- May involve lungs (cannonball mets)