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49 Cards in this Set

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What are the associations of mammary duct ectasia?
Dilated duct.
May be associated with breast secretions. Resembles cancer clinically on gross appearance and mammogram.
What are the associations of fat necrosis of the breast?
follows trauma, surgery, or radiation to the breast.
Gross morphology: hemorrhage progresses to necrosis, chalky white area.
Micro: necrotic fat surrounded by lipid-laden macrophages
What are the associations of lymphocytic lobulitis?
palpable mass in persons with type I DM and AI thyroiditis
What are the associations of granulomatous mastitis?
systemic granulomatous disease: TB infection
lactation sensitization
Foreign bodies: prosthesis, piercings
What are "blue dome" cysts?
fibro-cystic change cysts that are brown/blue externally and contain greenish turbid fluid. Micro: apocrine metaplastic cells
what is the increased risk for breast cancer in non-proliferative (fibrocystic change)?
None!
What is the increased risk for breast cancer in proliferative epithelial lesions without atypia? (including sclerosing adenosis, florid hyperplasia, papillomas, radial scars)?
1.5 to 2x the risk
What is the increased risk for breast cancer in proliferative epithelial lesions with atypia? (including atypical ductal or lobular hyperplasia)?
4-5x increased risk
What is the increased risk of breast cancer in carincoma in situ? (DCIS/LCIS)
8x the risk
What is the special type of balanoposthitis?
Balanitis xerotica obliterans - inflammation followed by sclerosis of the prepuce
What is Balanitis Xerotica Obliterans analogous to?
Lichen sclerosis of the vulva
Describe Bowenoid Papulosis.
Age is younger, sexually active adults.
Multiple, pigmented or violatious papular lesions, some verrucoid.
Lesions unlikely to invade; virtually always regress spontaneously.
No visceral cancer association
Describe Bowen's Disease.
Most common age >35 years
Males involves shaft of penis and scrotum.
Solitary plaque, usually thick gray white or velvety, reddened on glans penis.
May ulcerate.
Risk for progression to invasive squamous cell carcinoma </= 10%.
Pt may have visceral carcinoma
What is the most common anomaly of the testis?
cryptorchidism
What is the significance of intratubular germ cell tumor?
Precursor lesion of germ cell tumors of adults (testis)
What markers are expressed in intratubular germ cell tumors?
OCT 3/4 transcription factor
NANOG transcription factor
PLAP
What cytogenic marker is present in almost all germ cell malignancies, male/female?
isochromosome 12
What is a marker for cell necrosis used for assessing tumor burden in testicular germ cell tumors?
LDH
What germ cell tumor serological markers do we use?
LDH - level correlates w/ tumor burden.
Alpha-Fetoprotein (AFP) - synthesized by fetal gut, liver and yolk sac. Falls to undetectable low level by age 1. Produced by yolk sac cells in germ cell tumors.
HCG - produced by syncytiotrophoblasts. Beta subunit is specific. Alpha unit shared with other glycoprotein hormones (TSH, FSH, etc)
What serological markers are present in a seminoma?
OCT-4
c-KIT
PLAP
(minority express localized HCG)
What is the morphology of a seminoma ?
Micro: larege monomorphous polyhedral cells with watery cytoplasm, prominent nucleoli.
Gross: large, gray homogenous stuff replaces testss
What serum tumor markers are found in a NSGCT/Embryonal carcinoma of the testis?
AFP or HCG or both (>80% have these)
What is another name for the yolk sac tumor?
endodermal sinus tumor
What is the serological marker for the yolk sac tumor?
AFP present
What is the buzzword microscopic morphology of a yolk sac tumor?
Schiller-Duval Glomeruloid bodies
What is the serological marker for choriocarcinoma?
HCG
What is the morphology of a Leydig cell tumor?
gross: distinctive golden brown color
Micro: crystalloids of Reinke
What is the morphology of Sertoli cell tumors?
Micro: neoplastic cells arranged in tubular structures
What are 2 histologic types of testicular lymphomas?
1. Diffuse large B cell type (most common)
2. NK/T cell type (Associated with EBV)
What is the most common testicular cancer over age 60?
Lymphoma of the testis
What is Paget disease?
breast cancer involving nipple and aerola, appears as eczematous rash over breast with crusting, scaling or erosion
Prognosis for breast cancer is determined by pathologic exam of what 2 things?
Why?
Primary carcinoma
Axillary lymph nodes
3 reasons why:
1) used to choose appropriate tx 2) counsel pt about likely outcome, and 3) for accurately classifying groups of similar pts for clinical trials
What is the name of the benign nodular neoplasm of the vulva? What does it resemble
Papillary hidradenoma
Histologicaly identical to intraductal papilloma of the breast
What is vaginal clear cell adenocarcinoma associated with?
DES exposure in utero
What vaginal malignancy occurs in children?
embyronal rhabdomyosarcoma (AKA sarcoma botryoides)
What is the most common ovarian tumor in patients under 20?
Germ cell tumors
What is the most common ovarian tumor in patients over 20?
surface epithelial cell tumors
What is the most common malignancy of the ovary?
serous tumors
What is the genetic risk for endometrioid carcinoma of the ovary?
HNPCC mutation
What is the tumor marker for surface epithelial cell tumors of the ovary?
CA-125
What is the morphology of a granulosa cell tumor of the ovary?
gross: yellow color of cut surface
micro: Call-Exner bodies (gland-like structures with eosinophilic material at center suggestive of immature follicles)
What is Meig's syndrome?
ovarian fibroma (benign).
Hydrothorax, usually right sided.
Ascites.
May be associated with the basal cell nevus syndrome
What cell is the morphologic hallmark of endometritis not present in normal endometrium?
Plasma cells
What is adenomyosis?
basal layer of endometrial glands grow deep within the myometrium
What 3 symptoms does endometriosis cause?
infertility
dysmenorrhea
pelvic pain
What are the 3 potential explanations for the origin of endometriosis?
regurgitation
metaplastic
vascular/lymphatic
What is the most common tumor in women?
leiomyoma (fibroids)
What is the morphology of fibroids?
whorled pattern of smooth muscle.
Gross: sharply circumscribed, discrete, round, firm, gray-white
What is the most common invasive cancer of the female genital tract?
endometrial carcinoma