Flashcards in Uterine Pathology II Deck (52):
1
type 1 endometrium epithelium adenocarcinoma
glandular - endometroid
2
type 2 endometrium epithelium adenocarcinoma
surface - non-endometroid
-papillary serous carcinoma
MMMT - carcinomcarcinoma
3
myometrium neoplasms
leiomyoma
leiomyosarcoma
4
endometroid adenocarcinoma
type 1
80% of endometrial cancer
peak age 45-55yo
with conditions of unopposed estrogen
5
mutations of endometroid adenocarcinoma
type 1
PTEN - mutation
KRAS - microsatellite instability
6
conditions of unopposed estrogen
exogenous estrogen 10 years
endogenous - ovarian tumor
estrogen from peripheral conversion of androgen - PCOS, obesity, androgen tumor
infertility
diabetes
HTN
7
abnormal bleeding, prolonged periods of 6 month duration
endometroid adenocarcinoma - type 1
8
grade of endometroid adenocarcinoma
based on number of lumens
9
tamoxifen
risk fx for type 1 - endometroid adenocarcinoma of uterus
10
absence of PTEN stain
type 1 - endometroid adenocarcinoma
11
non-endometroid adenocarcinoma
type 2
-all high grade and aggressive**
-early lymph spread
papillary serous carcinoma
15% of endometrial carcinomas
post-menopausal disease**
12
cancer of endometrium post-menopause
type 2
13
mutation in p53
non-endometroid adenocarcinoma of endometrium - type 2
14
MMMT
malignant mixed mullerian tumor
carcinosarcoma
bulky polypoid mass
distinct epithelial and mesenchymal components**
15
papillary architecture
serous carcinoma - type 2 non-endometroid adenocarcinoma
16
positive p53
non-endometroid adenocarcinoma
17
precursor to type 1
hyperplasia / EIN
18
precursor to type 2
endometrial intraepithelial carcinoma
19
african america, thin, atrophy
type 2 endometrial cancer
20
grade and stage of endometrium cancer
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
21
all type II nonendometroid carcinomas
high grade
22
carcinosarcoma
MMMT
adenocarcinoma and sarcoma together
bad - aggressive
23
surgery for uterine carcinoma
unless grade 1 type 1 endometroid adenocarcinoma
and fertility preservation
or poor surgical candidate
24
trial for hormone therapy
type 1 endometroid adenocarcinoma
fertility preservation
poor surgical candidate
do therapy instead of surgery**
25
post-menopausal bleeding
common presentation of type 1 endometroid adenocarcinoma
26
omenectomy
if non-endometroid adenocarcinoma (type 2) - serous
OR carcinosarcoma
27
ifosfamide
adjuvant therapy - if carcinomsarcoma with rhabdomyosarcoma elements
28
candidate for lynch syndrome screening
age <50
bethesda guieline criteria
tumor with lymphocytes
lower uterine origin
concurrent ovarian cancer
29
stroma cancer of uterus
B9 stromal nodule
endometrial stroma sarcoma
adenosarcoma
2 and 3 - bad - malignant
30
large sessile polyp protruding through cervical os
adenosarcoma
31
endometrial stromal nodule
benign - but need to differentiate from sarcoma
32
spindle cell neoplasma
endometrial stromal sarcoma
5 year survival 50%
33
CD10 IPX stain
endometrial stromal sarcoma
34
sheets of blue cells
stromal cells
-endometrial stromal sarcoma
35
MED12 mutation
unique to smooth m
-leiomyoma
and leiomyosarcoma
36
leiomyoma
benign smooth muscle neoplasm
fibroid
37
leiomyoma vs. leiomyosarcoma
both have MED 12 mutation
distinguish by number of mitotic figures**
38
mets for leiomyosarcoma
blood vessels - hematogenous spread
39
location of leiomyoma
determines the symptoms
-bleeding - submucosa
-pelvic fullness - large mass
-urinary frequency - pressure against bladder
-infertility and miscarriage may occur
40
MED12 with numerous mitotic figures on histo
leiomyosarcoma
41
dilation and curettage
dilation of cervix
scraping of uterine wall
42
salpingitis
inflammation of fallopian tube
with PID
43
acute bacterial salpingitis
suppurative - pus
60% gonnococcus
40% chlamydia
-differentiate with culture
44
pyosalpinx and hydrosalpinx
tube scar shut - with salpingitis
45
complications of saplingitis
adhesions
infertility
ectopic pregnancy
46
paratubal cysts
arise in mullerian remnants
at fimbriated end of tube or in broad ligament
translucent, thin walled, unicameral
aka hydatid cysts of morgagni
47
ectopic pregnancy
abnormal implantation
-with PID, adhesions, or endometriosis
tube ruptures 12 weeks - hemorrhage life threatening
section of tube - shows chorionic villi
48
most common site of ectopic
ampulla of tube 70%
49
endometrium hypersecretory with no chorionic vili
possible ectopic pregnancy
50
high risk for ectopic
previous ectopic
tubal surgery
tubal ligation
IUD use
PID
multiple sex partners
smoking
51
methotrexate
tx option for ectopic - destroys fetal tissue
52