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51 Cards in this Set
- Front
- Back
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These ovarian tumors are grossly yellow and nodular with potential endocrine function including estrogenic stimulation which may lead to hyperplasia or carcinoma of the endomedtium. Rarely, these tumors lead to Meig's syndrome.
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Fibrothecoma
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What is Meig's syndrome?
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A rare complication of fibrothecoma or fibroma of the ovary where patients get associated ASCITES and RIGHT HYDROTHORAX.
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Breslow thickness is measured from where to where?
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Top of the granular cell layer to deepest part of invasion.
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How is depth of invasion measured in SCC of the vulva, vagina, or cervix?
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Measured from the adjacent basement membrane of the closest dermal papilla to the deepest part of tumor.
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This endometrial lesion is characterized by occasionally cystically dilated gland in a background of proliferative endometrium.
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Disordered proliferation due to unopposed estrogen usually associated with anovulation.
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Mutation in what gene has been associated with endometrial hyperplasia and carcinoma?
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PTEN (these tend to stain negative for PTEN by IHC)
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This finding in the cervix is characterized by lobular groups of glandular spaces lined by flattened epithelium.
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Endocervical tunnel clusters
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This tumor marker may be elevated in serous carcinomas of ovary.
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CA-125
NOTE: CA-125 may also be elevated in benign conditions such as endometriosis. |
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This tumor marker may be elevated in yolk sac tumor.
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Alpha-fetoprotein
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This tumor marker may be elevated in choriocarcinoma.
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hCG
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This tumor marker may be elevated in mucinous tumors of the ovary.
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CEA
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What is the most common malignancy arising in mature teratoma?
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SCC
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How is endometrioid endometrial carcinoma graded?
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Endometrioid Endometrial Carcinoma:
Grade 1: 0-5% solid Grade 2: 6-50% solid Grade 3: >50% solid NOTE: Severe nuclear atypia can upgrade architectural Grade 1 or 2 by 1 grade. |
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What elements constitute gonadoblastoma?
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Gonadoblastoma contains cells resembling those of dysgerminoma and immature Sertoli cells.
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This mixed germ cell and sex cord stromal tumor tends to occur in intersex conditions or mixed gonadal dysgenesis.
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Gonadoblastoma
NOTE: some have Y chromosome, some are hermaphrodites |
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Do gonadoblastoma metastasize?
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No
NOTE: While themselves benign, gonadoblastoma may undergo malignant transformation into a malignant germ cell tumor,most commonly being overgrown by dysgerminoma |
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What age group is more commonly affected by lichen sclerosis of the vulva?
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Children and postmenopausal women
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What ethnic group os more commonly affected by lichen sclerosis of the vulva?
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Whites
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This severely pruritic vulvar lesion has a characteristic white "cigarette paper" appearance. On biopsy, these lesions show loss of rete pegs, dermal homogenization and variable dermal chronic inflammatory infiltrate. There is a small risk for non-HPV associated vulvar SCC.
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lichen sclerosis
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This entity is characterized by hypersecretory endometrium with nuclear atypia in hobnail cells. Mitotic activity and even atypical mitoses may occur. The cells may show cytoplasmic clearing.
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Arias-Stella reaction
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What is the classic location of Bartholin's duct cyst?
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4:00 and 8:00 positions at the introitus of the vulva
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What is the location of Skene's duct cysts?
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Paraurethral area
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What is the location of Gartner's (wolffian) duct cysts?
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Anterolateral vaginal wall
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This vulvar lesion is unrelated to HPV, characterized by minor cytologic atypia, often confined to the basal layers, with keratin pearls and prominent nucleoli. Intercellular bridges tend to be conspicuous. It can easily be mistaken for squamous cell hyperplasia due to the frequent parakeratosis and acanthosis. This lesion has a greater risk for progression to SCC.
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Differentiated vulvar intraepithelial noeplasia (VIN)
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What age group is affected by embryonal rhabdomyosarcoma arising from the vagina? What about embryonal rhabdomyosarcoma arising from the cervix?
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Vagina: under 5 years old
Cervix: teenage and young adults |
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How does the FIGO define microinvasive SCC of the cervix?
How does the Gynecologic Oncology Group define microinvasive SCC of the cervix? |
FIGO Microinvasive SCC:
1. FIGO Stage IA1: < 3 mm deep; < 7 mm wide 2. FIGO Stage IA2: 3-5 mm deep; < 7 mm wide GOG Microinvasion: stromal invasion 3 mm deep |
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How is depth for cervical SCC measured when arising from endocervical glands?
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Measure from basement membrane of the superficial involved gland to the deepest point of invasion.
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What is salpingitis isthmica nodosa?
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A lesion of unknown etiology, salpingitis isthmica nodosa is characterized by multiple blind outpouchings of mucosa into the muscularis of the tube. This is a risk for ectopic pregnancy.
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What is follicular salpingitis?
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Follicular salpingitis is one of the potential manifestations of chronic salpingitis, and is characterized by the fusion of the delicate epithelial folds of the tube with the formation of multiple cystic spaces, a risk factor for ectopic pregnancy.
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What is hyperreactio luteinalis?
What is luteoma? What do hyperreactio luteinalis and luteoma have in common? (3) |
Hyperreactio luteinalis: Multiple luteinized follicles (theca lutein cysts), associated with high hCG and GTD, but can be seen in normal gestations.
Luteoma: Luteoma is a pregnancy associated lesion, characterized by solid ovarian enlargements consisting of sheets of large eosinophilic luteinized cells. In common: 1. Both are associated with pregnancy and regress after pregnancy 2. Both bilateral 3. Mother may be masculinized in both |
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Most common ovarian mass in a teenager.
Most common ovarian neoplasm in a teenager? Most common ovarian germ cell malignancy in a teenager? |
Most common mass: functional cyst
Most common neoplasm: Germ cell tumor (especially benign cystic teratoma) Most common malignancy: Dysgerminoma |
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How do you grade immature teratoma?
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Immature Teratoma:
Grade 1: immature neuroepithelium occupying less than 1 low power field (4X) on the worst slide Grade 2: immature neuroepithelium occupying no more than 3 low power fields on the worst slide Grade 3: immature neuroepithelium occupying more than 3 low power fields on any slide |
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What is the most, second most, and least common twin placenta?
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Most common: Diamniotic dichorionic
- Monozygotic or dizygotic twins - Dividing membrane: 1 chorion between 2 amnion Second most common: Diamniotic monochorionic - Monozygotic only - Dividing membrane: 2 amnion back to back without chorion in the middle Least common: Monoamniotic monochorionic - Monozygotic only - Dividing membrane: absent |
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Cervical cancer accounts for what percentage of cancer deaths in women? What is its rank? How many people die per year?
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Cervical Cancer:
- 5% of cancer deaths in women - 6th leading cause of cancer death in women - 7000 die per year |
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What do E6 and E7 inactivate?
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E6: p53
NOTE: E6 binds p53 causing it to be degraded faster by ubiquitin. E7: Retinoblastoma gene NOTE: E7 competes for retinoblastoma protein (pRb) binding, freeing the transcription factor E2F to transactivate its targets, thus pushing the cell cycle forward. |
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Adenocarcinoma of cervix accounts for what percentage of cervical carcinomas?
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5-15%
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For an endometrial carcinoma to be classified as "mixed" what is the minimal percentage of the minor portion?
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10%
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Allowable mitoses:
1. Endometrial stromal nodule 2. Endometrial stromal sarcoma, low-grade 3. Endometrial stromal sarcoma, high-grade |
Allowable mitoses:
1. Endometrial stromal nodule: <10 per 10 HPF 2. Endometrial stromal sarcoma, low-grade: up to 10 per 10 HPF 3. Endometrial stromal sarcoma, high-grade: > 10 per 10 HPF |
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This endometrial stromal lesion is characterized by bland stromal cells, pushing borders without lymphovascular invasion.
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Endometrial stromal nodule
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This endometrial stromal lesion is characterized by bland stromal cells, infiltration of the myometrium and lymphovascular invasion (bag of worms feel grossly).
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Endometrial stromal sarcoma, low grade
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Endometriosis is found in what % of women undergoing ex-lap for infertility?
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33%
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What percentage of mucinous borderline tumors of the ovary are of the intestinal type?
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85%
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In what tumor are crystals of Reinke found?
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Leydig cell tumors
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Dysgerminoma can present with what tumor marker?
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hCG (usually low)
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This germ cell tumor occurs most commonly in childhood and adolescence but is rare in people over 40.
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Yolk sac
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Most common lymphoma in the ovary?
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Burkitt
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What is the prevalence of ectopic pregnancy?
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1/150
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What is the prevalence of hydatidiform mole in the US? In Southeast Asia?
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US: 1/2000
Southeast Asia: 1/120 |
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True or False: Choriocarcinoma can develop from normal pregnancy.
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True (but not common)
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What is placenta accreta, increta, and percreta?
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Accreta: superficial myoinvasion
Increta: deep myoinvasion but not through and through Percreta: invasion through the uterus to at least the serosal layer |
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What length of umbilical cord is considered normal?
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Between 30-75 cm.
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