Uterine Pathology II

Question 1

type 1 endometrium epithelium adenocarcinoma

Answer 1

glandular - endometroid

Question 2

type 2 endometrium epithelium adenocarcinoma

Answer 2

surface - non-endometroid

-papillary serous carcinoma
MMMT - carcinomcarcinoma

Question 3

myometrium neoplasms

Answer 3

leiomyoma

leiomyosarcoma

Question 4

endometroid adenocarcinoma

Answer 4

type 1

80% of endometrial cancer

peak age 45-55yo
with conditions of unopposed estrogen

Question 5

mutations of endometroid adenocarcinoma

Answer 5

type 1

PTEN - mutation

KRAS - microsatellite instability

Question 6

conditions of unopposed estrogen

Answer 6

exogenous estrogen 10 years
endogenous - ovarian tumor
estrogen from peripheral conversion of androgen - PCOS, obesity, androgen tumor
infertility
diabetes
HTN

Question 7

abnormal bleeding, prolonged periods of 6 month duration

Answer 7

endometroid adenocarcinoma - type 1

Question 8

grade of endometroid adenocarcinoma

Answer 8

based on number of lumens

Question 9

tamoxifen

Answer 9

risk fx for type 1 - endometroid adenocarcinoma of uterus

Question 10

absence of PTEN stain

Answer 10

type 1 - endometroid adenocarcinoma

Question 11

non-endometroid adenocarcinoma

Answer 11

type 2

• all high grade and aggressive**
• early lymph spread

papillary serous carcinoma

15% of endometrial carcinomas

post-menopausal disease**

Question 12

cancer of endometrium post-menopause

Answer 12

type 2

Question 13

mutation in p53

Answer 13

non-endometroid adenocarcinoma of endometrium - type 2

Question 14

MMMT

Answer 14

malignant mixed mullerian tumor
carcinosarcoma

bulky polypoid mass

distinct epithelial and mesenchymal components**

Question 15

papillary architecture

Answer 15

serous carcinoma - type 2 non-endometroid adenocarcinoma

Question 16

positive p53

Answer 16

non-endometroid adenocarcinoma

Question 17

precursor to type 1

Answer 17

hyperplasia / EIN

Question 18

precursor to type 2

Answer 18

endometrial intraepithelial carcinoma

Question 19

african america, thin, atrophy

Answer 19

type 2 endometrial cancer

Question 20

grade and stage of endometrium cancer

Answer 20

grade - differentiation
1 - well
2 - moderate
3 - poor

stage - location
1 - corpus uteri
2 - corpus and cervix
3 - extends outside uterus 
4 - outside true pelvis or mucosa of bladder/rectum

Question 21

all type II nonendometroid carcinomas

Answer 21

high grade

Question 22

carcinosarcoma

Answer 22

MMMT

adenocarcinoma and sarcoma together

bad - aggressive

Question 23

surgery for uterine carcinoma

Answer 23

unless grade 1 type 1 endometroid adenocarcinoma

and fertility preservation
or poor surgical candidate

Question 24

trial for hormone therapy

Answer 24

type 1 endometroid adenocarcinoma
fertility preservation
poor surgical candidate

do therapy instead of surgery**

Question 25

post-menopausal bleeding

Answer 25

common presentation of type 1 endometroid adenocarcinoma

Question 26

omenectomy

Answer 26

if non-endometroid adenocarcinoma (type 2) - serous | OR carcinosarcoma

Question 27

ifosfamide

Answer 27

adjuvant therapy - if carcinomsarcoma with rhabdomyosarcoma elements

Question 28

candidate for lynch syndrome screening

Answer 28

``` age <50 bethesda guieline criteria tumor with lymphocytes lower uterine origin concurrent ovarian cancer ```

Question 29

stroma cancer of uterus

Answer 29

B9 stromal nodule endometrial stroma sarcoma adenosarcoma 2 and 3 - bad - malignant

Question 30

large sessile polyp protruding through cervical os

Answer 30

adenosarcoma

Question 31

endometrial stromal nodule

Answer 31

benign - but need to differentiate from sarcoma

Question 32

spindle cell neoplasma

Answer 32

endometrial stromal sarcoma 5 year survival 50%

Question 33

CD10 IPX stain

Answer 33

endometrial stromal sarcoma

Question 34

sheets of blue cells

Answer 34

stromal cells | -endometrial stromal sarcoma

Question 35

MED12 mutation

Answer 35

unique to smooth m -leiomyoma and leiomyosarcoma

Question 36

leiomyoma

Answer 36

benign smooth muscle neoplasm fibroid

Question 37

leiomyoma vs. leiomyosarcoma

Answer 37

both have MED 12 mutation distinguish by number of mitotic figures**

Question 38

mets for leiomyosarcoma

Answer 38

blood vessels - hematogenous spread

Question 39

location of leiomyoma

Answer 39

determines the symptoms - bleeding - submucosa - pelvic fullness - large mass - urinary frequency - pressure against bladder - infertility and miscarriage may occur

Question 40

MED12 with numerous mitotic figures on histo

Answer 40

leiomyosarcoma

Question 41

dilation and curettage

Answer 41

dilation of cervix | scraping of uterine wall

Question 42

salpingitis

Answer 42

inflammation of fallopian tube with PID

Question 43

acute bacterial salpingitis

Answer 43

suppurative - pus 60% gonnococcus 40% chlamydia -differentiate with culture

Question 44

pyosalpinx and hydrosalpinx

Answer 44

tube scar shut - with salpingitis

Question 45

complications of saplingitis

Answer 45

adhesions infertility ectopic pregnancy

Question 46

paratubal cysts

Answer 46

arise in mullerian remnants at fimbriated end of tube or in broad ligament translucent, thin walled, unicameral aka hydatid cysts of morgagni

Question 47

ectopic pregnancy

Answer 47

abnormal implantation -with PID, adhesions, or endometriosis tube ruptures 12 weeks - hemorrhage life threatening section of tube - shows chorionic villi

Question 48

most common site of ectopic

Answer 48

ampulla of tube 70%

Question 49

endometrium hypersecretory with no chorionic vili

Answer 49

possible ectopic pregnancy

Question 50

high risk for ectopic

Answer 50

``` previous ectopic tubal surgery tubal ligation IUD use PID multiple sex partners smoking ```

Question 51

methotrexate

Answer 51

tx option for ectopic - destroys fetal tissue

Question 52

fallopian adenocarcinoma

Answer 52

possible source of high grade serous carcinoma of ovary