Pathology of the female reproductive tract 2 Flashcards
Over 80% of women with endometrial cancer present with which symptom?
post menopausal bleeding
What is the endometrium composed of?
glands in a specialised stroma with a specialised blood supply. growth, maturation and regression of all three components is co-ordinated during each menstrual cycle.
What are the different morphological subtypes of endometrial adenocarcinoma?
Endometrioid - show differentiation that resembles endometrial glands.
Serous - resembles fallopian tube epithelium.
Clear cell - have clear cytoplasm.
Mixed (components of the previous 3).
Undifferentiated / differentiated
Carcinosarcomas
What are the risk factors for endometrial cancer?
Endogenous hormones and reproductive factors Excess body weight Diabetes mellitus and insulin Exogenous hormones and modulators Ethnicity Familial (Cowden’s syndrome; HNPCC) Early menarche and late menopause
What reduces the risk of endometrial cancer?
Pregnancy and parity. mechanism includes the break from unopposed oestrogen during pregnancy and removal of abnormal cells at delivery.
How are neoplasms graded?
Reflects how much tumour resembles parent tissue. fraction of tumour forming glands is estimated percentage.
Grade 1 - well differentiated
Grade 2 - moderately differentiated
Grade 3 - poorly differentiated
estimates degree to which neoplasm matures + informs prognosis and treatment.
How are neoplasms staged?
TNM system:
Tumour: local spread
Nodes: lymph node deposits
Metastasis: metastatic deposits
FIGO system is used for gynaecological tumours.
demonstrates extent to which a neoplasm has spread and informs prognosis and treatment.
How does endometrial carcinoma spread?
Because endometrium has its own stroma, initially malignant glands invade endometrial stroma, then spreads into the myometrium down into the cervix where it reaches vessels and spreads via lymphatics or veins to nodes or vagina.
What is the precursor lesion of endometrial cancer?
atypical hyperplasia
