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73 Cards in this Set
- Front
- Back
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What epithelium covers the Exocervix?
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Squamous epithelium
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Mucus-secreting Columnar Cells
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What epithelium covers the Endocervix?
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Squamo-Columnar Jxn = Transition Zone in the Cervix
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What is this?
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Normal Squamous Epithelium of the Exocervix
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WHat is this?
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Normal Endocervical Columnar epithelium that secretes mucus
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What is this?
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Pap Smear
-Left = normal Squamous cells -Right = normal Endocervical cells |
What are these?
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Chronic Cervicitis
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What is this picture showing?
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Endocervical Polyp
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What is this picture showing?
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Cervical Intraepithelial Neoplasia:
1. CIN I = ? 2. CIN II = ? 3. CIN III = ? |
1. Mild dysplasia = lower 1/3
2. Moderate dysplasia = lower 2/3 3. Severe Dysplasia / Carcinoma In situ = full thickness |
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Mild Squamous Dysplasia = CIN I
*basal layer is at the top |
Cervix biopsy...what is it showing?
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Moderate Squamous Dysplasia = CIN II
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Cervix biopsy...what is the diagnosis?
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Sever Squamous Dysplasia = CIN
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Cervical biopsy...what is the diagnosis
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Glandular epithelium has turned into Squamous epithelium which then turned into Dysplasia
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Endocervix biopsy - what has happened?
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Mild Squamous Dysplasia
- somewhat enlarged nuclei |
Pap smear showing Cervical cells - what is the diagnosis?
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Moderate Squamous Dysplasia
-nuclei:cytoplasm ratio is increased |
Pap smear with Cervix cells...what is the diagnosis?
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Severe Squamous Dysplasia = CIN III
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Pap smear showing Cervix cells...what is the diagnosis?
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Severe Squamous Dysplasia
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The left is pap smear and the right is histology...what is the diagnosis?
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What are the risk factors for Cervical Intraepithelial Neoplasia?
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1. HPV infection (higher #'s)
2. multiple sex partners 3. Early age of first intercourse |
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What does Squamous Cell Carcinoma of the Cervix usually evolve from?
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CIN
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What is the histology of Squamous Cell Carcinoma of the Cervix?
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Invasive Squamous cells in the Stroma
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What are the clinical presentations of Squamous Cell Carcinoma of the Cervix?
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1. Post-coital bleeding
2. painful intercourse 3. Malodorous discharge |
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Where does Cervical Carcinoma most typically occur?
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Squamo-Columnar Jxn = Transition zone
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What are the 3 treatment options for Cervical Carcinoma?
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Conization
Radical hysterectomy Radiation therapy |
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Cervical Cancer at the Squamocolumnar jxn
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What is this showing?
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Cervical Carcinoma
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What is this showing?
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Non-invasive Carcinoma In-situ = CIN III
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What is this showing?
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Cervical carcinoma that only invades < 3 mm with no vascular or lymphatic invasion
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Microinvasive Squamous Cell Carcinoma
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This comprises 10% of Cervical Carcinomas and is related to HPV 16 and 18
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Adenocarcinoma
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Cancer that has a 75% decrease in incidence and mortality over the past 50 years
However, it is the 2nd most common cause of cancer related morbidity and mortality among women in developing countries |
Adenocarcinoma of the Cervix
**85% of cervical cancers are Squamous Cell Carcinoma |
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Types of HPV that account for 80% of Cervical Cancers?
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16 & 18
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Endocervical Adenocarcinoma
-back to back glands -stromal invasion -Anaplastic nuclei |
What is this showing?
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What affects the Proliferative Phase of the Menstrual Cycle?
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Estrogen
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What is the most variable phase of the Menstrual Cycle?
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Proliferative phase
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Describe the histology of the Proliferative Phase of the menstrual cycle
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Tubular glands
Monomorphic stroma |
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What affects the Secretory Phase of the Menstrual Cycle?
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Progesterone
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Describe the histology of the Secretory phase of the Menstrual Cycle
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Coiled Glands
Edematous Stroma |
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What are the causes of Dysfunctional Uterine Bleeding in:
1. New borns 2. Childhood 3. Adolescents 4. Reproductive age 5. Menopause |
1. maternal withdraw of estrogen
2. tumors secreting estrogen 3. psychogenic, stress, nutritional, tumor 4. same as 3 5. Estrogen secreting tumors |
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What is the definition of Dysfunctional Uterine Bleeding?
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Abnormal uterine bleeding due to Extra-Uterine causes
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What are the typical causes of Acute Endometritis?
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1. Ascending infection from Cervix
2. Abortion 3. Instrumentation |
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What are the typical causes fo Chronic Endometritis?
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Intrauterine devices (IUDs)
Pelvic Inflammatory Disease Abortion |
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How do you differentiate between Acute and Chronic Endometritis?
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Acute = PMN's
Chronic = Plasma Cells |
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Acute Endometritis
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What is this showing?
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Chronic Endometritis
presence of Plasma cells |
Endometrium biopsy:
What is this showing? How do you know? |
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Where do Endometrial Polyps usually occur?
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Fundus
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What does the histology of an Endometrial Polyp contain?
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1. Endometrial glands, cysts, hyperplasia
2. Fibromatous stroma 3. Thick-walled blood vessels |
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Endometrial Polyps
Benign Inter-menstrual bleeding |
What are these showing?
Are they malignant or benign? How do they typically present clinically? |
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Endometrial Polyp
Menorrhagia / Dysfunctional Uterine bleeding |
What are these?
What can they result in? |
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Endometrial Polyp -> thick-walled blood vessel
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Biopsy taken from the Endometrium...what is the diagnosis?
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What is the treatment for Endometrial Polyps
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Curettage = cutting out the polyp with a spoon-like device
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Simple Hyperplasia
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Endometrium biopsy...what is the diagnosis?
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Simple Hyperplasia = increased # of dilated glands
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Endometrium biopsy...what is the diagnosis?
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Complex Hyperplasia = glands appear crowded and are surrounded by relatively scant stroma
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Endometrial biopsy...what is the diagnosis?
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Atypical Hyperplasia = glands appear crowded and have an irregular shape, with stratification of cells that often protrude into the lumen
- nuclear atypia |
Endometrial biopsy...what is the diagnosis?
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Cystic Hyperplasia = Swiss Cheese Hyperplasia
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Endometrial biopsy...what is the diagnosis?
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Endometrial Polyp with Complex Hyperplasia
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What is this picture showing?
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What is Endometrial Hyperplasia a precuror of?
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Endometrial Carcinoma
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What is Endometrial Hyperplasia most often clinically manifested as?
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Postmenopausal bleeding
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What are some things that can cause Endometrial Hyperplasia?
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1. Estrogen secreting tumor
2. Obesity = fat cells store estrogen 3. Polycystic Ovary disease 4. Estrogen therapy |
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What is the most common cancer of the Female Genital Tract?
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Endometrial Adenocarcinoma
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What is the cause of Endometrial Adenocarcinoma?
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prolonged Estrogen exposure
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What are 7 risk factors for Endometrial Adenocarcinoma?
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1. Diabetes
2. Nulliparity (no births) 3. Smoking 4. Estrogen secreting tumor 5. HTN 6. Late Menopause = prolonged exposure to estrogen 7. Genetics |
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What is the gross appearance of Endometrial Adenocarcinomas?
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Polypoid, infiltrative, necrosis and hemorrhage
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Endometrial Carcinoma
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What is this showing?
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FIGO I Endometrial Carcinoma
- back to back glands with no stroma |
Endometrial biopsy...what is it showing?
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FIGO III = poorly differentiated
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What is the classification of this Endometrial Carcinoma?
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FIGO II
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What is the classification of this Endometrial Carcinoma?
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Villo-glandular Adenocarcinoma
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Endometrial biopsy...what is teh diagnosis?
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Papillary Serous Adenocarcinoma
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Endometrial biopsy...what is the diagnosis?
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Adenocarcinoma with Squamous differentiation
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Endometrial biopsy...what is the diagnosis?
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Clear cell adenocarcinoma
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Endometrial biopsy...what is the diagnosis?
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Secretory Adenocarcinoma
- could be confused with Secretory Phase BUT there is NO stroma |
Endometrial biopsy...what is the diagnosis?
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How does Endometrial Adenocarcinoma usually present clinically?
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Abnormal Peri and Post Menopausal bleeding
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What is the treatment for Endometrial Adenocarcinoma?
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Radical Hysterectomy
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