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45 Cards in this Set
- Front
- Back
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What are the structures in the lower genital tract?
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Vulva
Vagina Cervix |
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What are the pathologic conditions that can affect the vulva?
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Lichen sclerosus
Squamous carcinoma |
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What's the most common malignancy of the vagina?
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Metastatic carcinoma
Extension of carcinoma from the uterus or the vulva. |
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What's the cause of SCC in the vulva in younger patients? Older?
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Younger: HPV
Older Not HPV |
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What is leukoplakia?
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White plaques
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What are the vulvar dermatoses?
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Lichen sclerosus
Squamous hyperplasia |
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What are the atypical lesions of the vulva?
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VIN1
VIN 2-3 Paget's disease |
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What's another name for lichen sclerosis?
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Atrophic vulvitis
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Who gets lichen sclerosis?
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Postmenopausal women
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What are the complications from Lichen sclerosis?
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Atrophy
Fibrosis Scarring Associated with SCC |
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WHat happens to the skin in LIchen sclerosis?
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Thinning of the epidermis: parchment!
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What's the cause of lichen sclerosis?
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AI
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What's the triad in Lichen sclerosus?
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Epidermal thinning
Collagenized upper dermis Lichenoid lymphocytic imfiltrate |
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What are the findings in lichen simplex chronicus?
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Acanthosis
Hyperkeratosis |
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What is the presentation of extramammary pagets?
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Puritic, red, crust, sharply demarcated area on the labia majora
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Who gets extramammary pagets?
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Elderly women
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What's the treatmnet for extramammary pagets?
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Wide local excision
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What is a congenital vaginal neoplasm?
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Sarcoma botryoides
Grape-cluster appearance |
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Who gets clear cell adenocarcinoma?
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People who have an exposure to intrauterine DBS
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Where is clear cell adenocarcinoma found?
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Vagina
Cervix |
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What HPV is associated with SCC of the vagina?
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HPV16
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Who gets infected wtih HPV?
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Young, sexually active women
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What is the structure of the HPV virus?
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Non-enveloped
dsDNA virus |
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What are the oncogenic HPV viruses?1
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16
18 |
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What are the non-oncogenic HPV strains?
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6
11 |
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What kind of cervical carcinoma is associated with HPV 18?
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Endocervical adenocarcinoma
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What kind of cervical carcinoma is associated with HPV 16?
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SCC
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What conditions are associated with HPV 6 and 11?
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External genital warts
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What is required for the development of cervical cancer?
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HPV infection
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What are risk factors for the development of cervical cancer?
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Smoking
# of sexual partners Age of first intercourse Immune compromised |
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What is the natural history of an HPV infection?
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Great majority are cleared: 80%
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What is the mechanism of the clearance of HPV?
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Cell-mediated immune response is developed
Development of TYPE SPECIFIC antibodies (if you have Abs against 16, 18 can still get you!) |
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How long does it take to progress from a wart to a carcinoma in situ with HPV?
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10 years
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How long does it take to progress from CIS to carcinoma in HPV?
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10 years
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What are the low grade HPV infections?
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INfection
Condyloma Mild dysplasia Grade 1 neoplasia |
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What are the high grade HPV infections?
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Modreate dysplasia
Severe dysplasia |
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What's the characteristic histological feature of a condylomata?
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Koilocyte:
Nuclear enlargement with halo around it |
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Why are young women more susceptible to HPV?
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Virus needs to get to the basal layer to cause cancer.
In young women, the transformation zone (where there's a short distance to the basal layer) is wider, where a lot of damage and repair occurs |
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What is the transformation zone?
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Place where there's squamo-columnar junctions
This expands at puberty from the os, then goes back at menopause. |
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Why is there such a cycle of damage and repair at the transormation zone in women going through puberty?
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1. Increased estradiol
2. Increased glycogen storage 3. Increased bacteria 4. More acidic pH 5. Columnar cells can't take the pH, so they transform to squamous This happens every cycle: it's easy for HPV to get to the basal cell layer, where it wants to get to. |
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How does HPV cause problems in the cell?
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Integrates its own DNA into the host, which then can cause problems with cell cycle regulation
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What genes in HPV are responsible for causing dysplasi?
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E6
E7 |
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What is the action of the gene E6 from HPV?
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Transformation
Targets the degradation of the p53 tumor suppressor |
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What is the action of the gene E7 from HPV?
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Transformation
Binds to the RB protein, a tumor promotor |
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What makes something CIN3?
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If there's full thickness dysplasia
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