Pathoma Flashcards
(22 cards)
HPV leads to “______” change, characterized by a “crinkled” nucleus.
koilocytic
Genital condylomas are caused by which HPV types?
6 and 11
What are the HPV subtypes that are highest risk for the development of carcinoma? What type of carcinoma usually (but not always)?
16, 18, 31, 33. Usually squamous cell carcinoma.
What is “lichen sclerosis”?
Thinning of the epidermis and fibrosis of the underlying dermis; seen in postmenopausal women (>70 yo). Benign, but associated with a slightly increased risk of squamous cell carcinoma.
What is the difference between lichen sclerosis and lichen simplex chronicus with regards to risk of squamous cell carcinoma?
Lichen sclerosis is associated with a slightly increased risk, but lichen simiplex chronicus is not! Both are benign conditions.
What is lichen simplex chronicus?
Hyperplasia of the vulvar squamous epithelium with thick, leather-like vulvar skin, associated with chronic irritation and scratching.
An HPV infection takes how long to become carcinoma?
20-30 years to transform (through dysplasia steps)
What is the less common non-HPV related vulvar carcinoma caused by?
Long-standing lichen sclerosis (thinning of the epidermis with sclerosis of the dermis)
What is different between Paget’s disease of the breast and Paget’s disease of the vulva with regards to underlying carcinoma?
In Paget’s disease of the vulva, there is usually no underlying cancer (vs. Paget’s disease of the breast)
What would you expect on PAS, keratin, and S100 stains in a melanoma?
PAS-
keratin-
S100+
The lower 1/3 of the vagina is derived from ___________, while the upper 2/3 is derived from __________
1) lower 1/3: urogenital sinus (leading to squamous eptihelium lining)
2) upper 2/3: Müllerian duct (leading to columnar epithelium, that ultimately gets replaced by squamous)
What is “adenosis”?
The persistence of columnar epithelium in the vagina (derived from Müllerian duct, upper 2/3 of vagina). Should be replaced by the squamous epithelium of the lower 1/3. This rarely happens in a normal individual, but was seen in females exposed to DES (diethylsylbesterol) in utero. Can lead to clear cell carcinoma (gland cell carcinoma)
A bleeding and grape-like mass (“sarcoma batroides”) protruding from the vagina or penis of a child (<5) should make you think of ____________
rhabdomyosarcoma
Vaginal carcinoma from the lower 1/3 of the vagina metastasizes to which lymph nodes?
inguinal lymph nodes
Vaginal carcinoma from the upper 2/3 of the vagina metastasizes to which lymph nodes?
regional iliac lymph nodes
While the exocervix is lined by _______ epithelium, the endocervix is lined by _________ epithelium.
exocervix: squamous
endocervix: columnar
What proteins do the viruses that are “high risk” HPV have and what do they do?
E6 and E7
E6 increases the destruction of p53 (tumor suppressor)
E7 increases destruction of Rb (which usually suppresses E2F, which leads to progression of cell cycle)
What are the two most common types of cancer caused by HPV?
1) squamous cell carcinoma (exocervix)
2) adenocarcinoma (due to endocervix, columnar cells)
What is Ashermann syndrome?
Secondary amenorrhea due to loss of basalia (the regenerative layer) and scarring. A common cause is an overaggressive D&C. Without the basalis, you can’t regenerate the endometrium
What are common sites of endometriosis?
1) ovary (chocolate cyst)
2) fallobian tube mucosa (infertility; ectopic)
3) uterine ligaments (pelvic pain)
4) pain of Douglas (pain with defecation)
5) bladder wall (pain with urination)
6) bowel serosa (abdominal pain and adhesions)
Involvement of soft tissue by endometriosis creates brown, hemorrhagic areas, known as __________
gunpowder lesions
What is “adenomyosis”?
Endometriosis that involves the myometrium
