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48 Cards in this Set
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- Back
- 3rd side (hint)
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How do non-GC infections differ from GC infections by their method of extension?
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Non-GC infections spread by lymphatics or venous channels where as GC does so by superficial mucosal spread. Consequently, non-GC results in deeper infections
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How may GC infection differ in children vs adults with respect to their location?
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In adults the vagina and edometrium are usually spared. May see vulvovaginitis is children.
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Describe some associated cytologic findindings in trichomonas infection.
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May see perinuclear halos, increased PMN's, mucoid background. Often associated with Liptotrix a long filamentous nonpathogenic bacteria
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Describe gross findings of trichomonas infection.
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Strawberry cervix, frothy foul smelling discharge, motile organisms on wet prep.
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Is lichen sclerosis a premalignancy condition?
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No, but it is associated with well differentiated SCC
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T/F Lichen Sclerosis may be associated with autoimmune diseases.
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True
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True/False the pathogenesis of VIN is the same in women of all ages.
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False. In younger women, it is associated with HPV, tends to be mutlifocal, associated with smoking and CIN. In older women it is not. Instead it is associated with P53 mutations, tends to be unifocal, associated with inflammatory disease (LS) and well diff VIN.
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What is the Splendore-Hoepple phenomenon?
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Antigen antibody complexes, tissue debris and fibrin that results in formation of "asteroid body" around organisms or foreign material. Results in impaire phagocytosis and perpetuates chronic infecton.
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What organisms are commonly associated with Splendore-Hoepple phenomenon?
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bacteria such as, Actinomycetes, Nocardia, Botryomycosis, parasites such as strongyloides, schistosoma, orbital pythiosis, non infections conditions such as hypereosinophilic syndrome, allergic conjuctival granulomas,
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How may one differentiate between Nocardia and Actinomycetes?
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Both are filamentous and gram positive. Nocardia is acid fast and Actinomyces is not.
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True/False lichen sclerosis unlike squamous metaplasia is not considered a premalignant condition
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False. Neither are considered a pre-malignany condition. They are often associated with SQCC though. They exception is if there is also VIN present, then they are considered premalignant.
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True/False Bowenoid papulomatosis may spontaneously regress
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True, bownoid papulamatosis has a high rate of spontaneous regression. It is a VIN III that occurs in young women as small erythematous/white macules/papules.
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Compare and contrast Paget's disease of the vulva versus breast.
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Vulvar is only associate with invasive cancer in 1/3 of cases vs breast in 2/3 of cases. Both are postive for mucin, CEA, CK7, and GCDFP15.
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Compare and contrast primary vulvar pagets from secondary anorectal CA pagets.
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Unlike primary vulvar, it is CK20 positive while negative for CK7 and GCDFP-15.
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Compare and Contrast primary pagets to seconcary urothelial CA.
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LIke primary pagets, urothelial is + for CK7. Unlike primary vulvar, urothelial is + for CK20 and UPlakin-III while negative for GCDFP-15.
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Compare and contrast angiomyofibroblastoma and aggressive angiomyxoma.
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Angiomyofibroblastoma is more circumscribed, cellular, and more vascular. Aggressive angiomyxoma thicker blood vessles, has RBC exstravasation, more mucin, less cellular, less plump or atypical stromal cells. Both are ER/PR +, but aggressive is SMA and HHF35 + as well.
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What immunostain are mesonephric remanants positive for?
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CD10
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Where is vaginal adenosis typically found and what is a known risk factor?
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anterior upper 1/3 of of vaginal wall. DES is a known risk factor (in utero). Seen in young women and 20% often have congenital anomalies of cervix as well. comprised of bland glandular epithelium with metaplasia.
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True/False Merkel cell CA may be associated with Bowen's disease.
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True
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What is the most common malignant soft tissue tumor in children and adolescents and what are its subtypes?
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Raybdomyosarcoma, embryonal (botyroid, which occurs in vagina and has grape-like clusters that prturde from vagina), aveolar, anaplastic, pleomorphic, sclerosing. alveolar has a worse prognosis than botyroid.
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What tranlocations are seen in the most common malignant soft tissue tumor of children?
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Alveolar has t(2;13) and t(1;13) which corresponds to PAX3-FOXO1(FKHR) and PAX7-FOXO1(FKHR) respectively. Both are transcription factors.
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PAX3 is esential for early striated muscle development. FOXO1 is essential to glycogenolysis and gluconeogenosis regulation as well as adipogenesis
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When should screening for cervical cancer begin?
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3 years after woman starts having vaginal intercourse, but no later than age 21
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How often should screening for cervical cancer be done until age 30, after age 30, and after age 70?
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1. Women 30 and under should be screened Q2yrs with pap
2. Over 30 with 3 normal paps shoud be screened Q2-3yrs with pap or Q3yrs with HPV test. 3. Women over 70 with 3 normal pap tests and no abnormal pap in 10 years can stop screening. |
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What percentage of ASC-US regress, progress to HSIL, and /or progress to invasive cancer?
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1. 68% regress
2. 7% go to HSIL 3. 0.25% go to CA |
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What percentage of LSIL regress, go to HSIL, and or go to invasive cancer?
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1. Acording to Cytology 3rd edition 47% but according to Osler notes 66%.
2. 21% go to HSIL (per Cytology) 3. 0.15% go to invasive CA (per Cytology) |
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What percent of HSIL regress and or progress to invasive cancer?
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1. 35% regress according to Cytology 3rd edition, but most regress according to Osler notes.
2. 1.4% (Cytology), and 33% in Osler notes |
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True/False endometrial CA is more common in the western world than cervical CA
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True. In other parts of the world though cervical cancer is more common
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What are the most valuable prognositic factors in cervical SqCC?
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Size and extntt of invasion
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Adenocarcioma accounts for what percent of cervical cancer?
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5 to 15%.
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1. What stains are helpful in delineating cervical AIS from normal endocervix?
2. What stains are negative in AIS of endocervix? |
1. CEA, P16, Cdc6, MIB1
2. ER, PR, vmentin, bcl2 |
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True/False, the rate of metastasis for micorinvasive cervical SqCC (defined as size<5mm) is the same.
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False. Although the rate of mets is low, size does matter. Tumors 3mm metastasize less than 1% of the time and tumors 3-5mm metastasize less thatn 10% of the time.
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1. Peutz-Jegher syndrome is associated with what gyn cancer?
2. What non-gyntumors are also seen? |
1. Adenoma malignum (minimal deviateion CA) of cervix. Has same gene mutation too (STK11). Also see sex cord tumors with anula tubules, and uterine CA.
2. Breast (bilateral), pancreas, lung, mucinous tumors, gastric adeno, wulfian tumors, small intestines, colon (all Peutz Jerger |
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T/F minimal deviatjion CA of cervix is usually HPV negative
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True
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What stains are positive/neg in adenoma malignum?
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1. + stains are PAS-Alcian blue 2.5, CEA (variable)
2. neg stains are CD10, p53, calretinin |
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What are the features of glassy cell CA of the cervix
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1. Distinct more aggressive poorly differentiated adneosquamous CA that occurs in younger age (mean 41).
2. Associated with pregnancy HPV 16/18 3. May have peripheral blood esosinophilia. |
1. Positive stains: PAS (cell wall), vimentin, focal mucin, focal CEA
2. Negative stains: p62, HMB$%, ER/PR usually |
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compare and contrast endometroid CA and serous cancer of the EM
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Endometroid:
1. Post menopausal, but younger age than serous 2. Associated with hyperestrogen states 3. p53 neg 4. ER/PR positive |
Serous:
1. Older age, 10 years older than average EM CA 2. Associated with atrophy 3. Associated with P53 mutation (p53 + so is clear cell CA) 4. ER/PR negative |
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1. what is the criteria for STUMP in paucicellar tumors without atypia?
2. What if the specimen is hypercellular? 3. What if there is atypia, ginat cell transformation, epithelioid pattern, or necorsis? 4. What if the mits fall short and ther is necrosis or abnormal mits? |
1. >15 mits per 10HPF.
2. 5-10 mits per 10HPF. |
3. 2-5 mits per 10 HPF.
4. Call it a STUMP |
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What are the criteria for leiomyosarcoma
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Nuclear atypia at low power or mits >10 per 10HPF
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1. List in order the most common sites for endometriosis.
2. What cancers may arise in endometriosis? |
Ovary>uterine ligaments> rectovaginal septum> pelvis> surgical incision sites...
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Can give rise to endometrioid CA, clear cell CA, stromal CA
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An ooporectomy specimen is remarkable for mutliple leutinized follicles and or theca llutein cysts. What are some possible causes of this finding?
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Increased gonadotropin stimulation endogenous/exogenous. Trophoblastic disease can cause massive bilateral theca letein cysts.
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Theca lutein cysts have prominent theca interna
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Stromal hyperthecosis may lead to increase in what hormone?
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androstenedione, testosterone
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What percentage of serous tumors (all types) are bilateral?
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1. 10% of serous cystadenoma
2. 25% of borderline 3. 66% (2/3) of serous cancer |
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T/F serous borderline tumors with micropapillary pattern are more likely to be bilateral and have peritoneal implants.
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True
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T/F mucinous tumors may be associated with Brenner tumors.
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True.
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Of the mucinous borderline tumors, which type is more common and which is more liekly to be associated with endometriosis?
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85% are intestinal type. The endocervical type is often accompanied by endometriosis (the intestinal type is not)
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Describe the CK7 CK20 staining pattern of ovarian serous, mucinous, and apendiceal mucinous tumors
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Ovarian serous CK7+ CK20-
Ovarian mucinous CK7+CK20+ Appendix CK7- CK20+ |
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T/F clear cell carcinomas of the ovary are rarely seen in association with endometriosis.
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False. They can even arise within endometriosis
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Describe some characteristics of ovarian Brenner tumors
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Gossly they resemble fibromas but can be cystic. Have transitional epithelium with grooved/coffee bean shaped nuclei with central mucin/mucinous cells. Have alot of fibrosis. CK7+ CK20-
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Note: bordeline Brenner tumors have high grade nuclei, but no invasion. Malignant Brenner has stromal invasion
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