XIX - Female Genital System and the Breast Flashcards Preview

Pathology PLE 2015 > XIX - Female Genital System and the Breast > Flashcards

Flashcards in XIX - Female Genital System and the Breast Deck (173):
1

Lesion of the female vulva characterized by thinning of the epidermis and disappearance of rete pegs, hydropic degeneration of basal cells, superficial hyperkeratosis, dermal fibrosis with scant perivascular, mononuclear inflammatory cell infiltrate. Occurs most commonly in postmenopausal women.

Lichen sclerosus(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 713

2

This disorder of the vulva is marked by epithelial thickening, expansion of the stratum granulosum, significant surface hyperkeratosis and pronounced leukocytic infiltrate. Appears clinically as an area of leukoplakia.

Lichen simplex chronicus(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 713

3

These are flat, moist, minimally elevated lesions that occur in secondary syphilis.

Condyloma lata(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 713

4

Lesions of the anogenital area which may be papillary and distinctly elevated or may be somewhat flat and rugose. Characteristic cellular morphology is the presence of cytoplasmic vacuolization with nuclear angular polymorphism and koilocytosis. Hallmark of HPV infection.

Condyloma acuminata(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 713

5

Red, scaly plaque, microscopically characterized by the spread of malignant cells within the epithelium, occasionally with invasion of underlying dermis. May have underlying carcinoma of a vulvar or perineal gland.

Paget disease of the Vulva(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 715

6

A soft polypoid mass, which is a rare form of primary vaginal cancer. Usually encountered in infants and children less than 5 y/o.

Sarcoma botryoides (embryonal rhabdomyosarcoma)(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 716

7

Most commonly develops in the transformation zone of the cervix. Produces a "barrel cervix" if the tumor encircles the cervix and invades the underlying stroma.

Invasive carcinoma of the cervix(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 719

8

Protruding polypoid masses which are inflammatory in origin, soft, yields to palpation, and have a smooth, glistening surface with underlying cystically dilated spaces filled with mucinous secretion.

Endocervical polyp(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 721

9

Refers to the growth of the basal layer of the endometrium down to the myometrium. Nests of endometrial stroma, glands or both are found in the myometrium, in between muscle bundles.

Adenomyosis(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 721

10

Characterized by the presence of endometrial glands and stroma in a location outside the endomyometrium. Undergoes cyclic bleeding. Also called "chocolate cysts".

Endometriosis(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 722

11

These are sharply circumscribed, firm, gray-white masses of the uterus, with "whorled" cut surface.

Leiomyoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 721

12

Solitary tumors of the uterus which arise de novo from the mesenchymal cells of the myometrium. Characterized byvtche presence of tumor necrosis, cytologic atypia and mitotic activity.

Leiomyosarcomas(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 725

13

Type of endometrial carcinoma associated with estrogen excess and endometrial hyperplasia.

Endometroid carcinoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 727

14

Type of endometrial carcinoma which occurs in older women and is usually associated with endometrial atrophy.

Serous carcinoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 727

15

Small, fluid-filled cysts which originate from the unruptured graafian follicles or in follicles that have ruptured and immediately sealed.

Follicle and luteal cysts(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 728

16

Triad of oligomenorrhea, infertility and obesity in young women secondary to excessive production of estrogens and androgens.

Polycystic ovaries(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 728

17

Other name for polycystic ovary syndrome?

Stein-Leventhal syndrome(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 728

18

Two most important risk factors for development of ovarian cancer.

Nulliparity and family history(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 729

19

Mutation of this gene is associated in the development of both ovarian and breast cancers.

BRCA 1(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 729

20

Mutation of this gene is associated with the development of breast cancer only,

BRCA 2(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 729

21

Benign lesion of the ovary most commonly seen in women 30-40 years old. Most frequent of the ovarian tumors. Serosal covering is smooth and glistening. Characterized histologically by tall, columnar epithelium and the presence of Psammoma bodies.

Serous tumor of the ovary(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 730

22

Large, multilocular tumors of the ovaries, without psammoma bodies. Composed of mucin-producing epithelial cells.

Mucinous Tumors (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 731

23

Metastasis of mucinous tumor of the gastrointestinal tract to the ovaries is called?

Krukenberg tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 731

24

A rare, solid, unilateral ovarian tumor consisting of an abundant stroma containing nests of transitional-like epithelium resembling that of the urinary tract.

Brenner Tumor (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

25

Unilateral ovarian tumor composed of sheets or cords of large cleared cells separated by scant fibrous strands. Stroma may contain lymphocytes and occasional granuloma. Usually occur on the 2nd-3rd decade of life.

Dysgerminoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

26

Unilateral ovarian tumor which occur during the 1st 3 decades of life. Characterized by small, hemorrhagic focus with syncitiothrophoblast and cytotrophoblast. Metastasize early.

Choriocarcinoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

27

Sex cord tumor seen as small, gray to yellow-brown, and solid lesions. May resemble development of testis with tubules, or cords and plump pink Sertoli cells. May be masculinizing or defeminizing.

Sertoli-Leydig cell tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

28

Microscopically, the distinguishing feature is a variety of immature or barely recognizable areas of differentiation toward cartilage, bone, muscle, nerve, and other structures. Found early in life.

Immature Malignant Teratomas (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 733

29

Tumor of the ovary composed entirely of mature thyroid tissue. May hyperfunction and produce hyperthyroidism. Appear as small, solid, unilateral brown ovarian masses

Struma ovarii (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 733

30

A voluminous mass of swollen, sometimes cystically dilated, chorionic villi, appearing grossly as grapelike structures.

Hydatidiform Mole (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 735

31

This type of H. mole shows hydropic swelling of chorionic villi and virtual absence of vascularization of villi. No fetal parts seen.

Complete mole (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 736

32

This type of H. mole shows villous edema that involves only some of the villi and the trophoblastic proliferation is focal and slight, with characteristic irregular scalloped margin. Fetal parts/embryo may be seen.

Partial mole(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 736

33

These are complete moles that are more invasive locally but do not metastasize. Microscopically, the epithelium of the villi is marked by hyperplastic and atypical changes, with proliferation of both cuboidal and syncytial components.

Invasive Mole (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 736

34

Appear as very hemorrhagic, necrotic masses within the uterus. The tumor is purely epithelial, composed of anaplastic cuboidal cytotrophoblast and syncytiotrophoblast, chorionic villi are not formed. High propensity for metastasis.

Choriocarcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 737

35

Term used to describe hyperplasia that cytologically resemble lobular carcinoma in situ, but the cells do not fill or distend more than 50% of the acini within a lobule.

Atypical lobular hyperplasia (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 739

36

The lumen of the ducts, ductules, or lobules of the breast is filled with a heterogeneous population of cells of different morphologies. Irregular slit-like fenestrations are prominent at the periphery.

Epithelial Hyperplasia (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 739

37

These lesions are characterized by proliferation of lining epithelial cells and myoepithelial cells in small ducts and ductules, yielding masses of small gland patterns within a fibrous stroma. The acini are arranged in a swirling pattern, and the outer border is usually well circumscribed.

Sclerosing Adenosis (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 741

38

A nonbacterial chronic inflammation of the breast associated with inspissation of breast secretions in the main excretory ducts.

Mammary duct ectasia (periductal or plasma cell mastitis) (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 742

39

The lesion is small, often tender, rarely more than 2 cm in diameter, and sharply localized, with a central focus of necrotic fat cells surrounded by neutrophils and lipid-filled macrophages. Caused by some antecedent trauma to the breast.

Traumatic fat necrosis (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 742

40

Small lobulated and cystic lesion of the breast that may grow rapidly. Exhibit "leaflike" clefts and slits on gross section.

Phyllodes Tumor (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 743

41

A neoplastic papillary growth within a duct, usually solitary and less than 1 cm in diameter, consisting of delicate, branching growths within a dilated duct or cyst.

Intraductal Papilloma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 743

42

A type of noninvasive carcinoma of the breast that tends to fill, distort, and unfold involved lobules and thus appears to involve ductlike spaces.

Ductal Carcinoma in Situ(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 745

43

A type of noninvasive carcinoma of the breast expands but does not alter the underlying lobular architecture. Cells are monomorphic with bland, round nuclei and occur in loosely cohesive clusters in ducts and lobules. Tend to be bilateral, and increases risk for development of breast CA.

Lobar Carcinoma in Situ(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 746

44

Caused by the extension of DCIS up to the lactiferous ducts and into the contiguous skin of the nipple.

Paget disease of the nipple (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 746

45

This type of cancer produces a desmoplastic response, replacing normal breast fat and forms a hard, palpable mass. Advanced cancers may cause dimpling of the skin, retraction of the nipple, or fixation to the chest wall.

Invasive ductal carcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747

46

Breast cancer defined by the clinical presentation of an enlarged, swollen, erythematous breast, usually without a palpable mass. The blockage of numerous dermal lymphatic spaces by carcinoma results in the clinical appearance (e.g peau d' orange)

Inflammatory carcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747

47

Breast cancer which consists of cells morphologically identical to the cells of LCIS. Occasionally they surround cancerous or normal-appearing acini or ducts, creating a so-called "bull's-eye pattern."

Invasive lobular carcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747

48

A rare subtype of carcinoma consisting of sheets of large anaplastic cells with pushing, well-circumscribed borders, with a pronounced lymphoplasmacytic infiltrate.

Medullary carcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747

49

A rare subtype of carcinoma which appear grossly as a soft and gelatinous mass which abundant quantities of extracellular mucin that dissects into the surrounding stroma.

Colloid (mucinous) carcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747

50

Usually present as irregular mammographic densities. Microscopically, the carcinomas consist of well-formed tubules with low-grade nuclei. Lymph node metastases are rare, and prognosis is excellent.

Tubular carcinomas (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 747

51

Grossly, appears as a button-like, subareolar swelling. in bilateral breasts of males.

Gynecomastia (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 750

52

Large, multilocular tumors of the ovaries, without psammoma bodies. Composed of mucin-producing epithelial cells.

Mucinous Tumors (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 731

53

Metastasis of mucinous tumor of the gastrointestinal tract to the ovaries is called?

Krukenberg tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 731

54

Unilateral ovarian tumor composed of sheets or cords of large cleared cells separated by scant fibrous strands. Stroma may contain lymphocytes and occasional granuloma. Usually occur on the 2nd-3rd decade of life.

Dysgerminoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

55

Unilateral ovarian tumor which occur during the 1st 3 decades of life. Characterized by small, hemorrhagic focus with syncitiothrophoblast and cytotrophoblast. Metastasize early.

Choriocarcinoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

56

Sex cord tumor characterized by solid gray fibrous cells to yellow (lipid-laden) plump thecal cells. Most hormonally inactive.

Thecoma-fibroma tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

57

Sex cord tumor seen as small, gray to yellow-brown, and solid lesions. May resemble development of testis with tubules, or cords and plump pink Sertoli cells. May be masculinizing or defeminizing.

Sertoli-Leydig cell tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

58

On transection, filled with sebaceous secretion and matted hair, bonw and cartilage, nests of bronchial or gastrointestinal epithelium, and other recognizable lines of development are also present.

Benign (Mature) Cystic Teratomas / Dermoid Cyst(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 733

59

Microscopically, the distinguishing feature is a variety of immature or barely recognizable areas of differentiation toward cartilage, bone, muscle, nerve, and other structures. Found early in life.

Immature Malignant Teratomas (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 733

60

Appear as very hemorrhagic, necrotic masses within the uterus. The tumor is purely epithelial, composed of anaplastic cuboidal cytotrophoblast and syncytiotrophoblast, chorionic villi are not formed. High propensity for metastasis.

Choriocarcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 737

61

A cystic dilation of an obstructed duct that arises during lactation.

Galactocele (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 739

62

Multifocal, bilateral blue-brown cysts ("blue dome cysts") of the breast, measuring 1-5 cm diameter, filled with serous turbid fluid. Occurs normally in the menstrual cycle.

Simple fibrocystic change of the breast(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 739

63

Term used to describe hyperplasia that cytologically resemble lobular carcinoma in situ, but the cells do not fill or distend more than 50% of the acini within a lobule.

Atypical lobular hyperplasia (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 739

64

The lumen of the ducts, ductules, or lobules of the breast is filled with a heterogeneous population of cells of different morphologies. Irregular slit-like fenestrations are prominent at the periphery.

Epithelial Hyperplasia (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 739

65

These lesions are characterized by proliferation of lining epithelial cells and myoepithelial cells in small ducts and ductules, yielding masses of small gland patterns within a fibrous stroma. The acini are arranged in a swirling pattern, and the outer border is usually well circumscribed.

Sclerosing Adenosis (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 741

66

A nonbacterial chronic inflammation of the breast associated with inspissation of breast secretions in the main excretory ducts.

Mammary duct ectasia (periductal or plasma cell mastitis) (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 742

67

The most common benign neoplasm of the female breast.

Fibroadenoma(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 742

68

A discrete, usually solitary, freely movable nodule, 1 to 10 cm in diameter, easily "shelled out" lesion of the breast. Histologically there is a loose fibroblastic stroma containing ductlike, spaces lined by a layer of epithelium that are regular and have a well-defined, intact basement membrane.

Fibroadenoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 742

69

A type of noninvasive carcinoma of the breast that tends to fill, distort, and unfold involved lobules and thus appears to involve ductlike spaces.

Ductal Carcinoma in Situ(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 745

70

A type of noninvasive carcinoma of the breast expands but does not alter the underlying lobular architecture. cells are monomorphic with bland, round nuclei and occur in loosely cohesive clusters in ducts and lobules. Tend to be bilateral, and increases risk for development of breast CA.

Lobar Carcinoma in Situ(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 746

71

Morphology: large macrophages with granular PAS positive cytoplasm and several dense, round Michaelis Gutmann bodies.

Malacoplakia (TOPNOTCH)

72

In gonococcal infection of the female reproductive system, inflammatory changes will appear about how many days after the inoculation of the organism?

2-7 days (TOPNOTCH)

73

These cells are distinguised by a clear separation "halo" from the surrounding epithelial cells and a finely granular cytoplasm containing mucopolysaccharide that stains with PAS, Alcian Blue, and Mucicarmine

Paget cells (TOPNOTCH)

74

What is the probable precursor of vaginal adenocarcinoma?

Vaginal adenosis (TOPNOTCH)

75

What do you call the glandlike structures filled with an acidophilic material similar to immature follicles that are seen in Granulosa Theca Cell tumors?

Call Exner bodies (TOPNOTCH)

76

Presence of these structures characterize serous tumors of the ovaries

Psammoma bodies (TOPNOTCH)

77

These tumors are distinguished from serous and mucinous tumors of the ovaries by the presence of tubular glands that resemble the endometrium

Endometriod tumor (TOPNOTCH)

78

A key factor in the development of endometrial hyperplasia and related cancers is the inactivation of what tumor suppressor gene?

PTEN (TOPNOTCH)

79

What is the most common location of vaginal adenocarcinoma?

Anterior wall of the upper third of Vagina (TOPNOTCH)

80

This is a condition in which glandular columnar epithelium of mullerian type either appears beneath the squamous epithelium or replaces it

Vaginal Adenosis (TOPNOTCH)

81

What are the 4 cardinal histologic features of Lichen Sclerosus of the Vulva or Chronic atrophic vulvitis?

Atrophy of the epidermis with disappearance, of the rete pegs, hydrophic degeneration of the basal cells, replacement of the underlying dermis by dense collagenous fibrous tissue, and monoclonal band like lymphocytic infiltrate (TOPNOTCH)

82

Morphology: acanthosis of the vulvar squamous epithelium frequently with hyperkeratosis

Lichen SImplex Chronicles (TOPNOTCH)

83

Morphology: presence of large tumor cells lying singly or in small lusters within the epidermis and its appendages

Extra mammary Paget Disease (TOPNOTCH)

84

Morphology: tumor cells resemble tennis racket with small protrusions of cytoplasms from one end

Embryonal Rhabdomyosarcoma (TOPNOTCH)

85

Clustering of tumor cells in a so called "Cambium Layer" is seen in what type of rhabdomyosarcoma?

Embryonal Rhabdomyosarcoma (TOPNOTCH)

86

On histological examination of the cervix, epithelial spongiosis is associated with what type of infection?

T. vaginal infection (TOPNOTCH)

87

On histological examination of the cervix, epithelial ulcers with intranuclear inclusions within the epithelial cells and lymphocytic infiltration is associated with what type of infection?

HSV (TOPNOTCH)

88

Morphology: these are composed of dense fibrous stroma covered with endocervical columnar epithelium

Endocervical polyp (TOPNOTCH)

89

What is considered the most important agent in cervical oncogenesis?

HPV (TOPNOTCH)

90

Koilocytic atypia is considered what type of CIN lesion?

CIN I (TOPNOTCH)

91

What is the most common pattern seen in invasive cervical carcinoma?

Fungating (TOPNOTCH)

92

On histological examination of the endometrium, what is the earliest morphological evidence of ovulation?

Basal vacuolation (TOPNOTCH)

93

Morphology: ectopic endometrial glands and stroma with numerous macrophages containing hemosiderin

Endometriosis (TOPNOTCH)

94

The combination of ovarian tumor, hydrothorax, and ascites is designated as

Meigs Syndrome (TOPNOTCH)

95

What type of ovarian cancer is best considered as the counterpart of the seminoma of the testes?

Dysgerminoma (TOPNOTCH)

96

About 1% of the dermoids undergo malignant transformation of any one of the component elements present, but most commonly, they differentiate into what type of carcinoma?

Squamous Cell Carcinoma (TOPNOTCH)

97

Morphology: characterized by a lining of tall columnar epithelial cells with apical mucin and the absence of cilia, resembling cervical or intestinal epithelium

Mucinous tumors (TOPNOTCH)

98

Morphology: lined by a rim of bright yellow luteal tissue containing luteinized granulosa cells

Luteal cyst (TOPNOTCH)

99

Morphology: characterized chiefly by dilations of ducts, inspissation of breast secretions, and marked periductal and interstitial chronic granulomatous reaction

Mammary Duct Ectasia (TOPNOTCH)

100

What are the 3 principal patterns of morphologic changes seen in Fibrocystic Changes of the breast?

1. Cyst formation with apocrine metaplasia2. Fibrosis3. Adenosis (TOPNOTCH)

101

Morphology: proliferation of intralobular stroma surrounding and often pushing and distorting the associated epithelium. The border is sharply delimited from the surrounding tissue

Fibroadenoma (TOPNOTCH)

102

What is the most important prognostic factor useful as a predictive factor for the response of therapy in patients with breast cancer?

Presence of estrogen and progesterone receptors (TOPNOTCH)

103

Morphology: characterized by solid syncytium like sheets occupying 75% of the tumor , prominent lymphoplasmacytic infiltrate and a non inflitrative border

Medullary carcinoma of the breast (TOPNOTCH)

104

The histologic hallmark of this tumor is the pattern of single infiltrating tumor cells, often only one cell in width, or in loose clusters or sheets

Invasive lobular carcinoma (TOPNOTCH)

105

This is a rare manifestation of breast cancer and presents as a unilateral erythematous eruption with a scale crust

Paget disease (TOPNOTCH)

106

These are stellate lesions characterized by a central nidus of entrapped glands in a hyalinized stroma

Complex Sclerosing Lesion or Radial Scar (TOPNOTCH)

107

Morphology: composed of multiple branching fibrovascular cores, each having a connective tissue axis lined by luminal and myoepithelial cells

Papillomas (TOPNOTCH)

108

What is the most common clinical presentation of breast disease

Pain (TOPNOTCH)

109

The principal mammographic signs of breast carcinoma

Densities and calfications (TOPNOTCH)

110

Morphology: the main histologic feature is keratinizing squamous epithelium extending to an abnormal depth into the orifices of the nipple ducts

Periductal mastitis (TOPNOTCH)

111

Mammographic appearance: Large lobulated "popcorn" calcifications

Fibroadenoma (TOPNOTCH)

112

Morphology: characterized by solid sheets of pleomorphic cells with high-grade nuclei and central necrosis detected mamographically as clusters or linear and branching microcalcifications

Comedocarcinoma (TOPNOTCH)

113

Morphology: Terminal ducts (without lobule formation) are lined by a multilayered epithelium with small papillary tufts and surrounding periductal hyalinization and fibrosis.

Gynecomastia (TOPNOTCH)

114

Morphology: terminal duct lobular unit is enlarged, and the acini are compressed and distorted within the lumens. Calcifications are often present within the lumens.

Sclerosing adenosis(TOPNOTCH)

115

Morphology: central fibrovascular core extends from the wall of a duct. The papillae arborize within the lumen and are lined by myoepithelial and luminal cells

Intraductal papilloma(TOPNOTCH)

116

Cellular proliferation resembling ductal carcinoma in situ or lobular carcinoma in situ but lacking sufficient qualitative or quantitative features for a diagnosis of carcinoma in situ

Atypical hyperplasia(TOPNOTCH)

117

Refers to a proliferation of cells identical to those of LCIS but the cells do not fill or distend more than 50% of the acini within a lobule.

Atypical Lobular hyperplasia(TOPNOTCH)

118

Recognized by its histologic resemblance to ductal carcinoma in situ, including a monomorphic cell population, regular cell placement, and round lumina. However, the lesions are characteristically limited in extend, and the cells are not completely monomorphic in type or they fail to completely fill ductal spaces

Atypical hyperplasia(TOPNOTCH)

119

What are the two major risk factors for breast carcinoma?

Hormonal and Genetics/family history(TOPNOTCH)

120

This is a subtype of DCIS which is recognized by bulbous protrusions without a fibrovascular core, often forming complex intraductal patents.

Micropapillary DCIS(TOPNOTCH)

121

Earliest lesions consist of red papules progressing to vesicles then to painful coalescent ulcers on the vulvar or vaginal area. Smears shows multinucleated squamous cellswith basophilic viral inclusion with a ground-glass appearance. This is caused by:

HSV (TOPNOTCH) Robbins Basic Pathologym 9th ed, p. 993

122

Presents with pearly, dome-shaped papules with a dimpled center. Central waxy core contains cells with cytoplasmic viral inclusion. The lesion described is:

Molluscum contagiosum(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 993

123

Manifests with vulvovaginal pruritus, erythema, swelling, and curdlike vaginal discharge. Wet KOH mount of discharge shows pseudospore or filamentous fungal hyphae.

Candidiasis(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 994

124

Presents with yellow, frothy vaginal discharge, vulvovaginal discomfort, dysuria, and dyspareunia. The vaginal and cervical mucosa typically has a fiery red appearance, with marked dilatation of cervical mucosal vessels ("strawberry cervix"). The cause is:

Trichomonas vaginalis(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 994

125

Presents with thin, green-gray, fishy vaginal discharge. Pap smear reveal squamous cells covered with a shaggy coating coccobacilli.

Bacteria vaginosis(caused by Gardnerella vaginalis)(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 994

126

This infection is characterized by marked acute inflammation of mucosa; smears of inflammatory exudate shows phagocytosed gram-negative diplococci within neutrophils.

Gonococcal infection(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 995

127

Most common site of vaginal carcinoma

Upper vagina, posterior wall at the junction with ectocervix(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1000

128

True or False: All HSILS are considered to be at high risk for progression to carcinoma.

True(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1003

129

Viral proteins implicated in the ability of HPV to act as carcinogen by interfering with the activity of tumor suppressor proteins.

E6 and E7(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1002

130

Most common histologic subtype of cervical carcinoma

Squamous Cell Carcinoma (TOPNOTCH)

131

Most common high-risk HPV type causing cervical precursor lesions and cervical carcinomas.

HPV-16.(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1007

132

Most frequent cause of dysfunctional bleeding

Anovulation(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1009

133

Disease of women in active reproductive life; causes infertility, dysmenorrhea, pelvic pain. Endometrial glands and stroma outside of the uterus.

Endometriosis (TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1012

134

An important cause of abnormal uterine bleeding; frequent precursor to endometrial carcinoma; most commonly caused by by unopposed estrogen stimulation.

Endometrial hyperplasia (TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1013

135

Most common invasive cancer of the female genital tract

Endometrial carcinoma(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1013

136

True or False. Malignant transformation of leiomyoma to leiomyosarcoma is rare.

True(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1020

137

The majority of ovarian neoplasm arise from?

Mullerian epithelium(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1023

138

The most common primary malignant ovarian tumor

Serous adenocarcinoma(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1023

139

Most common germ cell tumor of the ovary in women of reproductive age

Mature cystic teratoma/dermoid cyst(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1031

140

Glomerulus-like structure composed of a central blood vessel enveloped by tumor cells within a space lined by tumor cells

Schiller-Duval body(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1031

141

Characteristic histologic feature of Yolk Sac Tumor

Schiller-Duval body(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1031

142

Ovarian tumor that may elaborate large amounts of estrogen; Two thirds occur in post-menopausal women; potentially malignant

Granulosa cell tumor(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1032

143

Biomarker useful for identifying granulosa an other sex cord-stromal tumors, and monitoring treatment.

Serum inhibin(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1032

144

Serum marker for ovarian carcinoma

CA-125(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1029

145

Ovarian tumor that often functional and commonly produce masculinization or defeminization; peak incidence 20-30 y/o; cut surface is usually solid, gray to golden brown in appearance.

Sertoli-Leydig cell tumor(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. `033

146

Most common extra-mullerian tumors metastatic to the ovary

Carcinoma of the breast and GIT(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1034

147

Systemic syndrome characterized by widespread maternal endothelial dysfunction that presents during pregnancy with hypertension, edema, and proteinuria.

Preeclampsia(TOPNOTCH) Robbins Basic Pathology, p. 1034

148

Morphology: placental infarcts, retroplacental hematoma, abnormal decidual vessels, fibrin thrombi in the portal capillaries and hemorrhagic necrosis of the liver, kidney glomeruli show marked swelling of endothelial cells, mesangial cell hyperplasia, amorphous dense deposits on the endothelial side of basement membrane.

Preeclampsia(TOPNOTCH) Robbins Basic Pathology, p. 1039

149

Choriocarcinoma is most often preceded by:

Complete H. mole(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1041

150

Most common cause of acute bacterial mastitis

Staphylococcus aureus(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1046

151

Most important risk factors of breast cancer

Estrogenic stimulation and age(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1057

152

Most common molecular subtype of invasive breast cancer

ER-positive, HER2-negative, low proliferation(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1060

153

Histologic hallmark: presence of discohesive infiltrating tumor cells, often including signet-ring cell containing mucin droplets.

Lobular carcinoma of the breast(TOPNOTCH)Robbins Basic Pathology, 9th ed., p. 1065

154

Most important prognostic factor for invasive carcinoma of the breast in the absence of lymph node status.

Axillary lymph node status(TOPNOTCH) Robbins Basic Pathology, 9th ed., p. 1066

155

A 44 year old G3P3 has a routine Pap smear, which reported "LSIL." A colposcopy showed a reddish area in the posterior cervix. Biopsy showed an intact squamous epithelium with some cells showing dark, angulated nuclei surrounded by a clear cytoplasm. The biopsy will be read as (A) normal (B) CIN I (C) CIN II (D) CIN III

CIN I (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 718-719

156

A 38 year old G2P2 presents with dysmenorrhea and menorrhagia. Ultrasound shows a symmetrically enlarged uterus, with a 4 cm thick myometrium, and endometrium with normal thickness. She opts to have a hysterectomy. The histopathology showed nests of endometrial glands and stroma in the myometrium between the muscle bundles. The endometrium is described as "proliferative." She has (A) a leiomyoma (B) adenomyosis (C) endometrial stromal sarcoma (D) endometrial carcinoma

Adenomyosis(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 721

157

A 42 year old G4P4 has had a 20 year history of dysmenorrhea. An ultrasound shows a right adnexal cyst. She undergoes a right salpingoophorectomy. The right ovary has been converted to a 10 cm diameter brown cystic mass, filled with dark brown fluid. The internal surface is shaggy. Microscopic examination shows hemorrhage and hemosiderin deposits, and occasional endometrial glands and stroma. This lesion (A) contains nonfunctioning endometrium (B) probably originated from retrograde implantation of menstrual endometrium (C) is malignant (D) all of the above

probably originated from retrograde implantation of menstrual endometrium (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 722

158

Which of the following is associated with endometrial hyperplasia? (A) Stein-Leventhal syndrome (B) granulosa-theca cell tumors (C) obesity (D) all of the above

all of the above (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 723

159

Which of the following has the highest risk of developing endometrial carcinoma? (A) cystically dilated endometrial glands, with single layer of endometrial cells (B) crowded branched endometrial glands, with tall, columnar epithelium exhibiting stratification and nuclear atypia (C) nests of closely packed glands with single layer of endometrial cells (D) regularly spaced endometrial glands, with epithelium exhibiting supranuclear vacuoles, and stromal edema

crowded branched endometrial glands, with tall, columnar epithelium exhibiting stratification and nuclear atypia (complex hyperplasia with atypia) (A- disordered endometrium; C - hyperplasia without atypia; D - secretory endometrium) (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 723-724

160

A 48 year old G0P0 woman has menorrhagia. Ultrasound shows multiple sharply circumscribed myometrial and submucosal masses. She undergoes hysterectomy. Histopathology showed whorled bundles of smooth muscle cells, with rare mitoses, and no necrosis. These masses (A) commonly transform into sarcomas (B) may shrink postmenopausally (C) are polyclonal (D) all of the above are true

may shrink postmenopausally (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 724

161

Which of the following is a risk factor for endometrial carcinoma? (A) obesity (B) diabetes mellitus (C) hypertension (D) all of the above

all of the above (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 725

162

In endometrial carcinomas, which histologic pattern is associated with p53 mutations, arises in a background of endometrial atrophy, and has a poor prognosis? (A) serous (B) mucinous (C) endometrioid (D) adenosquamous

serous (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 726

163

A 22 year old presents with signs of acute abdomen. On history, she has been amenorrheic for 8 weeks. Pelvic examination showed a tender right adnexal mass. She undergoes emergency laparotomy with right salpingectomy. At histopathology, the fallopian tube is dilated with a point of rupture. The lumen is filled with blood clots. Which of the following histopathologic findings proves tubal pregnancy? (A) decidualized tubal epithelium (B) infiltrates of neutrophilic agreggates and necrosis (C) diffuse hemorrhage and fibrin deposition (D) chorionic villi

chorionic villi (TOPNOTCH) (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 734

164

Which of the following statements on ovarian cancer is true? (A) the risk is higher in BRCA 2 mutations than in BRCA1 (B) multiparity is a risk factor (C) oral contraceptives somewhat reduces the risk (D) all of the above

oral contraceptives somewhat reduces the risk (A - higher in BRCA1, B - nulliparity is a risk) (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 729

165

Epithelial tumors of the ovary can be benign, borderline, or malignant. Which histologic type is more likely to be malignant than benign? (A) serous (B) mucinous (C) endometrioid

endometrioid (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 731

166

A 17 year old female presents with a 10 cm left ovarian cyst and undergoes oophorectomy. On histopathology, the cyst is filled with sebum and hair. There is a solid area with a gritty cut surface. Which of the following histologic findings characterizes the tumor as immature? (A) islands of cartilage and bone (B) nests of pseudostratified epithelium (C) sheets of round cells with scant cytoplasm, some forming rosettes (D) foci of glial cells admixed with neuropil

sheets of round cells with scant cytoplasm, some forming rosettes (neuroepithelial differentiation) (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 733

167

Which of the following ovarian tumors can produce virilizing signs and symptoms? (A) granulosa cell tumor (B) thecoma (C) sertoli-leydig tumor (D) dysgerminoma

Sertoli-Leydig cell tumor(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 732

168

Which of the following trophoblastic lesions has a triploid karyotype? (A) complete mole (B) partial mole (C) invasive mole (D) placental site trophoblastic tumor

Partial mole(TOPNOTCH) Robbins Basic Pathology, 8th ed., p 735-736

169

Which of the following tumors is most responsive to chemotherapy? (A) gonadal choriocarcinoma (B) gestational choriocarcinoma (C) placental site trophoblastic tumor

gestational choriocarcinoma (TOPNOTCH) Robbins Basic Pathology, 8th ed., p 737

170

A 32 year old female presents with a 5 year history of a right breast lump. A core needle biopsy is performed. Which of the following findings represents a lesion that can progress to ductal carcinoma? (A) small and large cysts with cuboidal to columnar epithelium and surrounding fibrous stroma (B) lymphocytes and plasma cells infiltrating the periductal stroma (C) loose fibroblastic stroma with compressed, slit-like epithelium lined spaces (D) expanded ducts with proliferating monomorphic epithelial cells, with rigid, round fenestrations

expanded ducts with proliferating monomorphic epithelial cells, with rigid, round fenestrations (atypical ductal hyperplasia) (A - fibrocystic changes; B - chronic mastitis; (C) - fibroadenoma) (TOPNOTCH) Robbins Basic Pathology, 8th ed., pp 739-743

171

A 39 year old female presents with bloody discharge from the right nipple. A subareolar lump is palpated. It is excised and submitted to histopathology, which showed multiple papillae with connective tissue cores and lined by an outer cuboidal epithelial layer, and an inner myoepithelial layer. This lesion (A) is also known as cystosarcoma phyllodes (B) is malignant (C) usually arises in a lactiferous duct (D) all of the above

usually arises in a lactiferous duct (intraductal papilloma) (TOPNOTCH) Robbins Basic Pathology, 8th ed., p743

172

A 45 year old female presents with a right breast lump. An excision is performed, showing an ill-defined firm mass. Histopathology shows cells invading individually into the stroma, some forming aligned strands or chains. Other cells encircle normal-appearing ducts, forming a bull's eye pattern. This carcinoma (A) is almost always associated with HER2/NEU overexpression (B) frequently metastasizes into CSF, serosal surfaces and gastrointestinal tract (C) consists more than 80% of breast carcinomas (D) all of the above are true

frequently metastasizes into CSF, serosal surfaces and gastrointestinal tract (invasive lobular carcinoma) (A - Her2/Neu overexpression very rare; C - uncommon type,

173

Which of the following breast carcinomas has the worst prognosis? (A) pure medullary carcinoma (B) mucinous carcinoma (C) tubular carcinoma (D) ductal carcinomas of no special type

ductal carcinoma of no special type (TOPNOTCH) Robbins Basic Pathology, 8th ed., pp 748-749