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45 Cards in this Set
- Front
- Back
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What is endometrial hyperplasia?
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Non-physiologic, non-invasive proliferation of endometrium
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What is the cause of endometrial hyperplasia?
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Increased, unopposed estrogen effect
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What is the clinical presentation of endometrial hyperplasia?
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Abnormal bleeding
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What is the main protective factor from endometrial hyperplasia?
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Progesterone
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What is seen on an ultrasound in endometrial hyperplasia?
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Increased size of endometrial stripe
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What are the 4 main histologic features of hyperplasia?
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1. Increased gland-to-stroma ratio (more glands)
2. Irregularities in gland shape 3. Variation in gland size 4. Mitotic Activity |
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What are the 2 classifications of endometrial hyperplasia?
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1. Hyperplasia W/O atypia
2. Hyperplasia W/ atypia |
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Within the 2 main classifications, what are the 2 sub-classifications?
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1. Simple
2. Complex |
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What are the 3 features of simple hyperplasia?
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1. More glands
2. Variable size/shape of glands 3. Normal nuclei |
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What are the 4 features of compelx hyperplasia?
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1. More glands
2. Decreased stroma 3. Branching, irregular glands 4. Normal nuclei |
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What are 3 histoligical characteristics of hyperplasia with atypia?
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1. Loss of normal nuclear polarity
2. Enlarged, rounded nuclei with coarse chromatin 3. Prominent nucleoli |
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What there an observed benefit to having a hysterextomy right after being diagnosed with hyperplasia?
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NO
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Is it easy to differentiate between hyperplasia and carcinoma?
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No, grey zone in between which can make diagnosis difficult
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What characteristic is definite for cancer?
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Myometrial invasion
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What are 3 criteria seen in terms of "invasion of endometrial stroma" in carcinoma?
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1. Irregular infiltration of glands associated with altered fibroblastic stroma
2. Confluent glandular pattern uniterrupted by stroma (like honeycomb cereal) 3. Extensive papillary pattern |
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What is seen wrt to stromal cells in endometrial carcinoma?
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Stromal cells get more elongated
No stroma seen between the glands Extensive papillary growth pattern |
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Is endometrial carcinoma relatively common?
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Yes, most common malignant tumor of the female genital tract
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What is most deadly pelvic cancer?
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Ovarian cancer
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How do patients often present with endometrial carcinoma?
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Abnormal bleeding
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What are the risk factors for endometrial carcinoma?
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Same as hyperplasia
Biggest: Increased estrogen |
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What are the types of endometrial carcinoma?
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Type I - estrogen dependent
Type II - not estrogen dependent |
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Which type is more common?
More deadly? |
Type I - 80-85%
Type II - more deadly |
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What 3 genetic mutations are seen in Type I carcinoma?
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1. PTEN mutation
2. K-ras mutation 3. Microsatellite instability |
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What genetic mutation is associated with Type II carcinoma?
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P53 mutation
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The endometrioid type of carcinoma is what type?
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Type I
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What describes endometrial carcinoma, Endometrioid type (Type I), histologically?
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1. Way too many glands
2. Looks like hyperplasia but has cribiforming |
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What 3 items are seen in endometrial carcinoma, Type II?
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1. Complex papillaie or irregular gaping glands
2. Marked nuclear atypic 3. Calcifications |
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How many stages are there for endometrial carcinoma?
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I-IV
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What characterizes stage I?
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Confined to uterus
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What characterizes stage II?
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Cervical involvement
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What describes stage III?
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Uterine serosa, adnexa, positive cytology, vaginal or pelvic LN metastases
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What describes stage IV?
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Invasion of bladder or bowel muscosa or distant metastases
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What is the overall survival for endometrial carcinoma?
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75-80%
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What is the main type of cervical cancer?
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90% squamous
5% adenocarcinoma |
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What is the main risk factor for cervical cancer?
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HPV infection
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What HPV strains cause warts?
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6&11
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What is a typical cell characteristic seen in HPV infection?
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"Halo cells" with clear cytoplasm surrounding them
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Where does HPV infection usually happen within the cervix?
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At the transformation zone, infects squamous epithelial
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What specific types of HPV are associated with cancer?
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16 and 18
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What viral genes cause high risk HPV?
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Viral E6 and E7 genes
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What is needed in terms of HPV infection to progress to cancer?
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HPV persistence
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What is required for HPV infection persistence?
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Viral genome integration
But more changes needed to progress to cancer |
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What is the site of first preneoplastic lesions?
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Squamocolumnar junction (transformation zone)
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What is the second leading cause of women death (20-39 yrs)?
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Invasive cervical cancer
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What is the classical gross appearance of cervical cancer?
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"Barrel Cervix"
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