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40 Cards in this Set
- Front
- Back
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Herpes simplex (type II)
-mother to child infection |
Neonatal infection occurs during passage of fetus through birth canal and may be fatal
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Herpes simplex (type II)
-pathology findings (2) |
Multinucleated giant cells
Eosinophillic inclusions |
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Candidiasis
-carrier rate -symptoms -pathology findings |
Carrier rate up to 10% in non-pregnant women and 25% in pregnant women
Causes vulvovaginitis with itching and "curd-like" exudate Spores and pseudohyphae on wet mount prep or pap smear |
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Non-neoplastic epithelial disorders of vulvar skin and mucosa
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1. Lichen Sclerosus (most important)
2. Squamous cell hyperplasia 3. other dermatoses |
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Classification of vulvar intraepitheilal neoplasia
-squamous -non-squamous |
Squamous:
-VIN I: Mild dysplasia -VIN II: Moderate dysplasia -VIN III: Severe dysplasia Non-squamous: -Paget's disease (intraepithelial) -Melanoma in situ |
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Cervical Transformation Zone
-location, function -role in neoplastic changes |
Junction between the exocervix and the endocervix where endocervical glandular epithelium is transformed to squamous epithelium through metaplasia
Immature metaplastic epithelium is susceptible to HPV infection that results in neoplastic changes |
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Cervical Intraepithelial Neoplasia (CIN)
-characteristics (3) |
1. No invasion of stroma
2. Intra = within epithelium 3. Pre-invasive lesion |
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Cervical Intraepithelial Neoplasia (CIN) and Invasive Cervical Carcinoma
-risk factors (4) |
1. Multiple Sex Partners
2. Early age at first coitus 3. "High risk" males carrying HPV 4. Co-carcinogens (cigarettes) |
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Human Papilloma Virus (HPV)
-pure infection -low risk serotypes -high risk serotypes |
Pure infection --> condyloma and low grade SIL/CIN
Low risk serotypes (6,8,11) are episomal - loose viral genetic material in the cell nucleus High risk serotypes (16,18) integrate their genome in to patient DNA, leads to high grade CIN/SIL |
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Histological cell tropisms for different HPV serotypes
-6 -16 -18 |
HPV 6 always produces squamous lesions
HPV 16 produces squamous or glandular lesions HPV 18 is the most common serotype in glandular lesions |
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What specific cell type is associated with HPV infection?
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Koilocyte
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Bethesda System for cytopathology of epithelial cell abnormalities
-squamous cell abnormalities (4) |
Squamous cell abnormalities:
-Low grade SIL -High grade SIL -Atypical squamous cells -Invasive squamous carcinoma |
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Bethesda System for cytopathology of epithelial cell abnormalities
-glandular cell abnormalities (3) |
Glandular cell abnormalities:
-atypical glandular cells -endocervical adenocarcinoma in situ -invasive adenocarcinoma |
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Endometrial hyperplasia
-causes (4) |
1. Anovulatory cycles
2. Polycystic ovarian disease (PCO) 3. Estrogen producing tumors 4. Obesity |
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Endometrial Cancer
-type 1 |
Younger women with good prognosis
Most are estrogen related Low stage (little to no spread) Well differentiated Minimal to no myometrial invasion |
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Endometrial Cancer
-type 2 |
Older women with poor prognosis
No association with estrogen "Bad" histology (serous or clear cell) Often deeply invasive of myometrium |
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Endometrial Cancer
-pathologic parameters (5) |
1. Histologic type of tumor
2. Grade of the tumor 3. Depth of invasion into the underlying myometrium 4. Presence of cervical invasion 5. Presence of absence of vascular invasion (mets) |
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Myometrium Pathology
-neoplasias (3) |
1. Leiomyomas (fibroids)
2. Adenomyosis (presence of endometrial glands and stroma within the myometrium) 3. Leiomyosarcoma |
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Polycystic ovary disease (PCOD)
-triad of symptoms |
1. Obesity
2. Hirsutism 3. Amenorrhea/oligomenorrhea |
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Endometriosis
-definition -symptoms |
Presence of endometrial tissue outside the uterus, the ovary is a common site
Majority of patients are of reproductive age Symptoms include pain, dysmenorrhea, dyspareunia, irregular periods |
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Ovarian Tumors
-histological classification (4) |
1. Surface epithelial-stromal tumors
2. Sex cord-stromal tumors 3. Germ cell tumors 4. Mets to the ovary |
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Ovarian surface epithelial-stromal tumors
-overall frequency -proportion of ovarian malignancies -age group -types (4) |
-65-70% of ovarian tumors
-90% of malignancies -20+ yr olds -serous tumor -mucinous tumor -endometriod tumor -clear cell tumor |
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Ovarian germ cell tumors
-overall frequency -proportion of ovarian malignancies -age group -types (4) |
-15-20% of ovarian tumors
-3-5% of malignancies -0 to 25 yr olds -Teratoma -Dysgerminoma -Yolk Sac tumor -Embryonal carcinoma |
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Ovarian sex cord - stroma tumors
-overall frequency -proportion of ovarian malignancies -age group -types (3) |
-5-10% of ovarian tumors
-2-3% of malignancies -all ages -Fibroma -Granulosa-Theca cell -Sertoli-Leydig cell |
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Ovarian tumors - Serous tumors
-most common benign and malignant tumors -pathological feature |
Most frequent ovarian tumors, diagnosed between 30-40 years of age.
Psomma bodies Serous cystadenoma most common benign tumor Serous carcinoma most common malignant tumor |
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Ovarian tumors - Mucinous tumors
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80% are benign, infrequently bilateral
-when bilateral think mets Lining epithelium is endocervical or intestinal-type Benign, borderline or carcinoma Pseudomyxoma peritonei |
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Pseudomyxoma Peritonei
-definition |
Mucinous borderline tumor (ovarian) associated with enlarged abdomen filled with gelatinous material
Multiple tumor implants on peritoneum, associated with appendiceal mucinous tumor |
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What two ovarian neoplasms are associated with endometriosis?
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1. Clear Cell carcinoma
2. Endometroid carcinoma |
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Ovarian tumors - Clear Cell carcinoma
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Surface epithelial cell tumor
-most frequent epithelial tumor associated with endometroisis Associated pelvic endometroisis in 50-70% of cases and arising in an endometroitic cyst in 25% |
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Ovarian tumors - Granulosa cell tumors
-associated conditions -pathological features |
sex cord - stromal tumor most often seen in postmenopausal women
low grade malignancy associated endometrial hyperplasia/carcinoma Gall-Exner bodies & "coffee bean" nuclei |
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Coffee Bean nuclei
-associated tumor |
Granulosa Cell Tumor - Ovary
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Ovarian tumors - teratomas
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Most common germ cell tumor, 25% of all ovarian tumors, contains elements from all 3 germ cell layers (brain tissue, hair, muscle, etc...)
complications are torsion and malignant transformation (rare) |
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Ovarian tumors - Yolk Sac tumors
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Rare and highly malignant germ cell tumor.
Secretes alpha fetoprotein, attempts to recreate yolk sac. Schiller-Duval bodies |
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Disorders of the Placenta (4)
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1. Abnormalities of placentation
2. Maternal diseases 3. Infection 4. Gestational Trophoblastic disease |
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Abnormal Placentation
-different types (3) |
1. Placenta Accreta - abnormal adherence of placenta to uterine wall
2. Placenta Previa - implantation close to overlying cervix, failure to separate normally, postpartum hemorrhage and uterine rupture 3. Abruptio Placentae - premature separation of placenta from uterus |
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Placenta Accreta
-types (3) |
1. Accreta - superficial myometrial invasion
2. Increta - further invasion into the myometrium 3. Percreta - extension through uterine wall |
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Gestational Trophoblastic disease
-disease sub-types (3) |
1. Molar pregnancy
-complete hydatidiform mole -partial hydatidiform mole 2. Choriocarcinoma 3. Placental Site Trophoblastic Tumor |
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Complete Hydatidiform Mole
-characteristics -karyotype -embryonic tissue -villi -trophoblastic changes |
Cystically dilated chorionic villi resembling bunch of grapes
-diploid karyotype (46 XX) -fetus/embryo never present -all villi affected -trophoblastic hyperplasia/atypia |
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Partial Hydatidiform Mole
-villi -embryonic tissue -karyotype -trophoblastic changes |
-involves some of the villi
-embryonic/fetal tissue present -triploid karyotype (69 XXY) -minimal trophoblastic hyperplasia/atypia |
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Choriocarcinoma
-population -characteristics |
Uncommon in US, common in Asia/Africa
50% arise after complete hydatidiform mole, 25% after spontaneous abortion, 25% after term delivery Present as bloody discharge after abnormal pregnancy, chorionic villi NEVER present. May present as metastatic lesion, hCG used to monitor therapy |
