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85 Cards in this Set
- Front
- Back
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Unilateral, painful cystic esion at lower vestibule
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Bartholin cyst
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HPV appearance of nucleus
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Koilocytic change (nucleus looks like a raisin)
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Low risk HPV sub types
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6 or 11
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High risk HPV
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16, 18, 31 or 33
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Risk of HPV 6 and 11
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Condyloma
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Risk of HPV 16, 18, 31, 33
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Progression to dsyplasia and carcinoma
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Thinning of the epidermis and fibrosis of the dermis presenting as leukplakia with parchment-like vulvar skin
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Lichen Sclerosis
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Thickening of the vulvar squamous epithelium preseting as leukoplakia with thick, leathery vulvar skin.
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Lichen simplex chronicus
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Lichen sclerosis vs lichen simplex chronicus...which one can lead to squamous carcinoma?
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Lichen sclerosis, while bening, can rarely pogres to squamous cell ca while lichen simplex chronicus cannot.
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Age of presentation of vulvar carcinoma in HPV related versus non-HPV related disease
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HPV related: 40-50yo
Non HPV related: >70yo |
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Malignant epithelial cells in the epidermis of the vulva
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Extramammary Paget Disease
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Distinguishing Pagets from melanoma
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Paget cells are PAS+, keratin + and S100 -
Melanoma is PAS-, keratin-, and S100+ |
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Paget disease of nipple vs. Paget disease of vulva
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Paget disease of vulva: usually no underlying cancer of deeper tissue
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Focal persistence of columnar epithelium in upper 1/3 of vagina
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Adenosis
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Adenosis increased incidence in those exposed to this chemical in utero
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Diethylstilbestrol (DES)
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DES associated vaginal adenosis formed this type of cancer
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Clear Cell Adenocarcinoma
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Grape-like mass protruding from the vagina or penis of a child
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Sarcoma botryoides/Embryonal rhabdomyosarcoma
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Cytoplasmic cross striations, desmin and myoglobin positive
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Embryonal rhabdomyosarcoma
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Carcinoma arising from squamous epithelium lining the vaginal mucosa,usually related to high risk HPV
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Vaginal intrapeithelial neoplasia (VAIN) progresses to Vaginal Carcinoma
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Lymph node spread in vaginal carcinoma
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Lower 1/3: Inguinal nodes
Upper 2/3: Regional iliac |
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Epithelium in cervix
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Exocervix: Nonkeratinizing squamous epithelium
Endocervix: single layer of columnar cells |
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What kind of virus is HPV?
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DNA virus
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Key place in lower genital tract that HPV likes to infect
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Transformation zone of cervix
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Ehat do E6 and E7 do?
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Proteins made by high risk HPV. E6 destroys p53. E7 destroys Rb.
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Key feature distinguishing dysplasia from carcinoma
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Carcinoma in situ is not reversible
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Carcinoma in situ vs invasive carcinoma
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Invasive carcinoma invades through basement membrane
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AIDS defining illness
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Cervical carcinoma
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Common cause of death in advanced cervical carcinoma
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Hydronephrosis with post renal failure
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Limitations of Pap smear
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Inadequate sampling of transofmration zone resulting in false negative. Limited efficacy in screening for adenocarcinoma.
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Reason why pap smears are still necessary
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HPV vaccine only covers types 6, 11, 16, 18
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Secondary amenorrhea due to loss of basalis and scarring
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Asherman syndrome
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Major cause of Asherman syndrome
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Overaggressive dilation and curettage
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Common causes of acute endometritis
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Retained products of conception
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Characteristic cell seen in endometritis
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Plasma cell
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Side effect of tamoxifen that causes abnormal uterine bleeding
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Endometrial polyp
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Theories about cause of endometriosis
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Retrograde menstrual theory; Metaplastic theory; Lymphatic dissemination
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Classic problem of endometriosis in the ovary
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Chocolate cyst
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Classic problem of endometriosis in soft tissue
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Gun powder nodule
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Endometriosis in the uterine myometrium
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Adenomyosis
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Leads to endometrial hyperplasia
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Unopposed estrogen
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If endometrial hyperplasia is present, what is the most important predictor for progression to carcinoma?
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Atypia
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Two pathways leading to endometrial carcinoma
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Hyperplasia (estrogen risks)
Sporadic (no precursor lesion, related to p53) |
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Psammoma body formation
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Papillary thyroid cancer, Papillary serous carcinoma, Mesthelioma, Meningioma
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Multiple, well-defined, white wholy masses from myometrium
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Leiomyoma
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Single, hemorrhagic, necrosed, postmenopausal mass in myometrium
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Leiomyosarcoma
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Functional unit of ovary
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Follicle
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Characteristic hormone levels in PCOD
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Increased LH and low FSH (LH:FSH >2)
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Two high yield associations with PCOD
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Type 2 DM
Endometrial carcinoma |
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Cell types in ovary
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Surface epithelium, germ cells, and sex cord stroma
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Two most common subtypes of surface epithelial tumors
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Serous and mucinous tumors
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Mutation that increases risk for serous carcinoma
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BRCA1 mutation
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Ovarian tumor composed of bladder like epithelium
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Brenner tumor
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Malignant tumor of surface eptithelium of ovary composed of endometrial like glands
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Endometrioid tumors
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Use of CA-125
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Good for monitoring treatment and screening for recurrence
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Five major germ cell tumors from four germ cell tissue types
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Fetal tissue: cystic teratoma and embryonal carcinoma
Oocytes: dysgerminoma Yolk sac: endodermal sinus tumor Placental tissue: choriocarcinoma |
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Cystic teratomas are usually benign, but presence of one of these two types of tissue may indicate malignant potential
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-Immature tissue (usually neural)
-Somatic malignancy (usually squamous cell carcinoma) |
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Teratoma composed primarily of thyroid tissue that can cause hyperthyroidism
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Struma ovarii
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Most common malignant germ cell tumor
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Dysgerminoma
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Dysgerminoma equivalent in the testicle
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Seminoma
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Most common germ cell tumor in children
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Endodermal sinus tumor
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Classic histology of endodermal sinus tumor
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Glomerulus-lke structures (Schiller-Duval Bodies)
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Characteristic hormonal finding of choriocarcinoma
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High beta-HCG levels
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Poor chemotherapy response
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Chorioarcinoma
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Large primitive cells; aggressive with early metastasis
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Embryonal carcinoma
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Hormonal sign of Granulosa-theca cell tumor
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Signs of estrogen excess
Precocious puberty Menorrhagia or metrorrhagia Postmenopausal uterine bleeding |
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Pink cells containing crystals
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Reinke crystals in Sertoli-Leydig Cell Tumor of ovary.
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Meigs syndrome
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Benign tumor of fibroblasts (fibroma) + pleural effusions + ascites
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Metastatic diffuse type gastric carcinoma in ovaries
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Krukenberg tumor
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Distinguish metastases from primary mucinous carcinoma of the ovary
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Metastases are usually bilateral
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Muscinous tumor of appendix with metastasis to the ovary
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Pseudomyxoma peritonei
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Key risk factor for ectopic pregnancy
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Scarring (pelic inflammatory disease, endometriosis)
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Miscarriage of fetus occurring before 20 weeks gestation
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Spontaneous abortion
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Patient that has recurrent pregnancy loss due to hypercoagulable state
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Lupus patients
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Implantation of placenta in lower uterine segment, presents as third trimester bleeding
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Placenta previa
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Separation of plaenta from decidua prior to delivery of fetus
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Placental abruption
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Common cause of stillbirth
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Placental abruption
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Improper implantation of placenta into myometrium
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Placenta accreta
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Placenta accreta often requires this
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Hysterectomy
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Fibrinoid necrosis in lacenta
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Preeclampsia
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Preclampsia with seizures
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Eclampsia
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HELLP
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Preeclampsia with thrombotic microangiopath of liver: Hemolysis, Elevated Liver enzymes, Low Platelets
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Gross abnoromalities of hydatidiform mole
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Uterus will bigger than normal and beta hCG will be greater than normal.
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Grape like masses passed
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Hydatidiform mole without prenatal care
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Classic ultrasound finding for hydatidiform mole
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Snowstorm appearance
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Major fear of mole pregnancy
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Choriocarcinoma
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