Uterine Pathology II Flashcards Preview

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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

fallopian adenocarcinoma

possible source of high grade serous carcinoma of ovary