Pathology of the RS
Quiz yourself by thinking what should be in
each of the black spaces below before clicking
on it to display the answer.
Help!
|
|
||||
|---|---|---|---|---|---|
| What are the causes of endometritis? | 1) Pelvic inflammatory disease
2) Miscarriage/Delivery
3) IUD
🗑
|
||||
| What are the consequences of endometritis? | Fever, abdominal pain, menstrual abnormalities, infertility, and ectopic pregnancy
🗑
|
||||
| Where does adenomyosis occur? | In the endometrial stroma, glands, or both embedded
in myometrium
🗑
|
||||
| What are the clinical manifestations of adenomyosis? | Menorrhagia, dysmenorrhea
No cyclical bleeding
🗑
|
||||
| Where does endometriosis occur? | Endometrial glands and stroma in a location outside the uterus
Multifocal, multiple tissues in pelvis
🗑
|
||||
| What are the clinical manifestations of endometriosis? | Dysmenorrhea, and pelvic pain
Present as a pelvic mass filled with degenerating blood (chocolate cyst)
Cyclic bleeding
Fibrosis
Sealing of fimbriated ends
Distortion of ovaries
🗑
|
||||
| What are the three possible pathogeneses of endometriosis? | 1) Regurgitation theory, proposes menstrual backflow through the fallopian tubes
2) Metaplastic theory --> endometrial differentiation of coelomic epithelium
3) Vascular or lymphatic dissemination
🗑
|
||||
| What are the 3 diagnostic criteria of endometriosis? | 1) Endometrial glands
2) Endometrial stroma
3) Hemosiderin pigment
🗑
|
||||
| What are the causes of Dysfunctional Uterine bleeding? | 1) Failure of ovulation - Due to hormonal dysfunction, malnutrition, obesity, and stress
2) Endomyetrial disorders- infection, polyps, hyperplasia, and cancer
🗑
|
||||
| What is the cause of endometrial hyperplasia? | Excess of estrogen relative to progestin
🗑
|
||||
| How is severity of Endometrial hyerplasia staged? | 1) Simple
2) Complex
3) Atypical --> leads to cancer
🗑
|
||||
| What are the manifestations of benign endometrial polyps? | Sessile or pedunculated lesions that are 0.5 to 3 cm in diameter
🗑
|
||||
| What is the morphology of benign endometrial polyps? | Endometrial cystically dilated glands, with small muscular arteries and fibrotic stroma
🗑
|
||||
| What are the types of endometrial carcinoma? | 1) Endometroid
2) Serous
🗑
|
||||
| What are the two clinical settings in endometrial carcinoma? | Perimenopausal women --> estrogen excess
Older women -->endometrial atrophy
🗑
|
||||
| What is the most frequent cancer in the female genital tract? | Endometrial carcinoma
🗑
|
||||
| What are the risk factors of Endometroid carcinoma? | Obesity, DM, HT, Infertility, HRT, and Estrogen secreting ovarian tumors
🗑
|
||||
| What is the 5 year survival late for Stage 1, Stage 2, Stage 3 and 4 Endometroid carcinoma? | Stage 1 --> 90%
Stage 2 -->30-50%
Stage 3 and 4--> 20%
🗑
|
||||
| What are the genetic mutations in Endometroid carcinoma? | DNA mismatch repair genes
PTEN
🗑
|
||||
| What are the genetic mutations in Serous endometrial carcinoma? | p53 mostly
🗑
|
||||
| What is the most common benign tumor in females? | Leiomyomas
🗑
|
||||
| What are the types of Leiomyomas? | 1) Intramural
2) Submucosal
3) Subserosal
🗑
|
||||
| What is the morphology of Leimyomas? | Circumscribed, firm gray-white masses with whorled cut surface
Hemorrhage and cystic softening, and after menopause they may become calcified
🗑
|
||||
| What are the clinical manifestations of Leimyomas? | Mostly asymptomatic
Possible menorrhagia
NEVER transform into sarcoma
🗑
|
||||
| What is the morphology of Leiomyosarcoma? | Soft, hemorrhagic, and necrotic
Have infiltrative borders
🗑
|
||||
| What are the diagnostic criteria of Leiomyosarcoma? | Coagulative necrosis,cytologic atypia, and mitotic activity
🗑
|
||||
| What is the 5-year survival rate of Leiomyosarcoma? | 40%
🗑
|
||||
| What are the clinical manifestations of Stein-Leventhal syndrome/Polycystic ovaries? | Oligomenorrhea, hirsutism, infertility, and obesity
🗑
|
||||
| What is the pathogenesis of Stein-Leventhal syndrome/Polycystic ovaries? | Excessive production of androgens; high concentrations of LH, and low concentrations of FSH
🗑
|
||||
| What is the morphology of Stein-Leventhal syndrome/Polycystic ovaries? | Bilateral enlarged ovaries, fibrotic outer surface
Subcortical cysts <1 cm
🗑
|
||||
| What is the 5th most common cancer deaths in women? | Ovarian tumors
🗑
|
||||
| What are the causes of ovarian tumors? | Nulliparity and family history
BRCA-1 and BRCA-2
p53 MOSTLY
HER2/NEU
K-Ras
🗑
|
||||
| What are the types of surface epithelial ovarian tumors? | 1) Serous
2) Mucinous
3) Endometroid
4) Clear cell
5) Brenner
🗑
|
||||
| What are the most frequent and most common malignant ovarian tumors? | Serous tumors
🗑
|
||||
| What are the types of Ovarian tumors? | 60% benign, 15% borderline, and 25% malignant
Benign in 30 - 40 years
Malignant in 45 - 65 years.
🗑
|
||||
| What are the genetic mutations in serous tumors? | Borderline/Low grade --> KRAS and BRAF
High-grade--> BRCA1 and p53
🗑
|
||||
| What is the general morphology of serous tumors? | Psammoma bodies in the tips of papilla
🗑
|
||||
| What is the morphology of the different types of serous tumors? | 1) Benign -->large, cystic, filled with fluid, and a single layer of columnar epithelium
2) Borderline -->Mild cytologic atypia, no stromal invasion
3) Malignant -->Anaplasia of cells and invasion of the stroma
🗑
|
||||
| What are the types and prevalence of Mucinous tumors? | 80% benign.
10% low malignant potential (borderline)
10% malignant
🗑
|
||||
| What are the mutations in ovarian endometroid carcinoma? | PTEN tumor suppressor gene
🗑
|
||||
| What are Benign (Mature) Cystic Teratomas? | Tumor of totipotential germ cells into mature tissues of all
three germ cell layers
🗑
|
||||
| What percentage of Benign Cystic teratomas are unilateral? | 90%
🗑
|
||||
| What is the morphology of Benign Cystic teratomas? | Cyst filled with sebaceous secretion and hair; bone and cartilage; epithelium, or teeth
🗑
|
||||
| Torsion occurs in what percentage of Benign Cystic teratomas? | 10-15%
🗑
|
||||
| What are the clinical manifestations of Ovarian tumors? | Pain, gastrointestinal complaints, urinary frequency, torsion producing severe abdominal pain, and Ascites
🗑
|
||||
| What are the causative agents of Salpingitis? | Chlamydia, Mycoplasma , coliforms, (postpartum), strept. and staph.
🗑
|
||||
| What are the clinical manifestations of Salpingitis? | Fever, lower abdominal or pelvic pain, tubo-ovarian abscess, adhesions of tubal plicae (risk of ectopic pregnancy), and permanent sterility
🗑
|
||||
| What is the most common tubal malignancy? | Serous carcinoma
🗑
|
||||
| What are the risk factors of tubal malignanacy? | BRCA mutations
🗑
|
||||
| Where does ectopic pregnancy occur? | 90% -->fallopian tubes
Ovaries and abdominal cavity
🗑
|
||||
| What are some predisposing factors for ectopic pregnancy? | Tubal obstruction (50%) PID, tumors, endometriosis, and IUCD
🗑
|
||||
| What are the clinical manifestations of ectopic pregnancy? | Intratubal hematoma (hematosalpinx) and intraperitoneal hemorrhage
Acute abdomen
🗑
|
||||
| What are the two forms of Hydatid moles? | 1) Complete --> an empty egg is fertilized by two spermatozoa --> diploid
2) Partial --> a normal egg is fertilized by two spermatozoa --> triploid
🗑
|
||||
| Which hydatid mole permits embryogenesis? | Partial
🗑
|
||||
| What is the morphology of the hydatid mole? | Cystically dilated chorionic villi (grapelike structures) with cytologic atypia
🗑
|
||||
| What is the incidence of hydatid moles? | 1/2000
Higher in asian countries
In women younger than 20 and older than 40
🗑
|
||||
| How is a hydatid mole diagnosed clinically? | Elevations of hCG in the maternal blood and absence of fetal parts or fetal heart sounds
🗑
|
||||
| What is the prognosis for hydatid moles? | complete moles:
80% to 90%--> no recurrence
10% --> invasive mole (invades myometrium)
2% to 3% --> choriocarcinoma.
Partial moles --> better prognosis
🗑
|
||||
| What is a choriocarcinoma? | very aggressive malignant tumor arises from gestational chorionic epithelium or from gonads
🗑
|
||||
| What is the incidence of choriocarcinoma? | 1/30,000
Risk greater before age 20 and after age 40
🗑
|
||||
| What percentage of choriocarcinomas arise in complete hydatid moles? | 50%
🗑
|
||||
| What percentage of choriocarcinomas arise after abortion? | 25%
🗑
|
||||
| How is choriocarcinoma diagnosed? | Bloody, brownish discharge and very high titer of hCG in blood and urine
🗑
|
||||
| What is the morphology of choriocarcinomas? | Very hemorrhagic, necrotic masses within the myometrium
Tumor is composed of anaplastic cytotrophoblast and syncytiotrophoblast
🗑
|
||||
| What is the prognosis of choriocarcinomas? | Widespread dissemination via blood to lungs (50%), vagina, brain, liver, and kidneys.
Good response to chemo
🗑
|
||||
| What is the most common cause of breast lumps? | Fibrocystic changes
🗑
|
||||
| What may decrease the risk of fibrocystic changes? | OCPs
🗑
|
||||
| Fibrocystic changes are found in what percentage of women in autopsy? | 60-80%
🗑
|
||||
| What is the most common benign neoplasm of female breast? | Fibroadenoma
🗑
|
||||
| When does fibroadenoma occur? | In the third decade of life
🗑
|
||||
| What is the morphology of a fibroadenoma? | A discrete, solitary, freely movable nodule
Enlarges during pregnancy and late menstrual cycle
Regresses and calcifies after menopause
🗑
|
||||
| What is the neoplastic element of Fibroadenoma? | Stromal cells
🗑
|
||||
| What is the most common cancer in females? | Carcinoma of the breast
🗑
|
||||
| What is the second most common cause of cancer death in females? | Carcinoma of the breast
🗑
|
||||
| What percentage of patients with breast carcinoma are over 50? | 75%
🗑
|
||||
| What is the pathogenesis of breast carcinoma? | Familial --> BRCA
Sporadic -->HER2/NEU
Increased exposure to estrogen
Environmental variables
Premenopausal family history
🗑
|
||||
| What are the risk factors in breast carcinoma? | Premenopausal and bilateral family history
Increased age
Prolonged exposure to exogenous estrogens
Ionizing radiation in early life
🗑
|
||||
| What are the most common locations for breast carcinomas? | Upper outer quadrant 50%
Central portion 20%
Lower outer quadrant, and upper and lower inner quadrant --> 10% each
🗑
|
||||
| What groups are breast cancers classified into: | 1) Noninvasive (confined by a basement membrane and do
not invade into stroma or lymphovascular channels)
2) Invasive (infiltrating)
🗑
|
||||
| What are the types of noninvasive breast cancers? | Ductal carcinoma in situ (DCIS)
Lobular carcinoma in situ (LCIS)
🗑
|
||||
| What are the types of invasive breast cancers? | Invasive ductal carcinoma – NOS
Invasive lobular carcinoma
Medullary carcinoma
Colloid (mucinous) carcinoma
Tubular carcinoma
🗑
|
||||
| What is the morphology of Comedu DCIS? | High-grade nuclei with extensive central necrosis
Calcification is common
🗑
|
||||
| What is the prognosis of DCIS? | Excellent
97% survival post mastectomy
🗑
|
||||
| How is DCIS treated? | Surgery, radiation, and tamoxifen
🗑
|
||||
| What is the most common invasive breast carcinoma? | Invasive ductal carcinoma - NOS
Not otherwise specified
🗑
|
||||
| What is the precancerous lesion of invasive ductal carcinoma? | DCIS
🗑
|
||||
| How does invasive ductal carcinoma present clinically? | A hard mass on the mammogram
Retraction of the nipple and fixation of the nipple to the chest wall in advanced stages
🗑
|
||||
| What receptors are expressed by invasive ductal carcinoma? | 2/3 express ER or PR
1/3 overexpresses HER2/NEU
🗑
|
||||
| What percentage of all breast carcinoma does invasive lobular carcinoma make up? | <20%
🗑
|
||||
| What is the precancerous lesion in most cases of invasive lobular carcinoma? | LCIS
🗑
|
||||
| Invasive lobular carcinoma presents as multicentric and bilateral masses in: | 10-20% of cases
🗑
|
||||
| How does invasive lobular carcinoma present clinically? | As palpable masses or mammographic densities
🗑
|
||||
| What is the difference between receptors expression in Invasive lobular carcinoma and invasive ductal carcinoma? | Almost all of these carcinomas express ER and PR, but HER2/NEU overexpression is usually absent in lobular
🗑
|
||||
| How does breast cancer spread? | Lymph and blood
Mostly to the lungs, skeleton, liver, and adrenals
Less commonly, brain spleen pituitary
🗑
|
||||
| How do we screen for the spread of breast cancer? | Mammographs and MRI
🗑
|
||||
| Which factors determine the prognosis of breast carcinomas? | 1) Size
2) LN involvement
3) Distant met.
4) Grade
5) Histology
6) Presence/Absence of estrogen and progesterone receptors
7) Proliferation rate
8) Aneuploidy
9) HER2/NEU overexpression
🗑
|
||||
| What are the causes of gynecomastia in the male? | 1) Physiologic --> with age and at puberty
2) Pathologic -->cirrhosis of the liver; Klinefelter syndrome; estrogen-secreting tumors; estrogen therapy; digitalis therapy.
🗑
|
||||
| What is the ratio of breast carcinomas in males to females? | 1:125
🗑
|
||||
| Why is carcinoma of the male breast severe? | Scant amount of breast substance in male, lead to the tumor rapidly infiltrating overlying skin and underlying thoracic wall
Half have lymph node and distant metastasis by time of involvement
🗑
|
||||
| What are the most common tumors in men? | Testicular neoplasms
🗑
|
||||
| What age group is most likely to be affected with testicular neoplasms? | 15-24 tears of age
🗑
|
||||
| What are the two main types of testicular nsubclassifiedeoplasms? | 1) Germ cell tumors (95%) --> Malignant
2) Sex cord stromal tumors --> Benign
🗑
|
||||
| What are the risk factors for testicular neoplasms? | 1) White race
2) Cyptorchidism
3) Intersex syndromes
4) Family history
5) Cancer in one testes
6) i2p --> all germ cell tumors
7) Intratubular germ cell neoplasia
8)
🗑
|
||||
| The testicular germ cell tumors are sub-classified into: | 1) Seminomas
2) Non Seminomas
Or histologically: Pure (60%) and mixed (40%)
🗑
|
||||
| 30-40% of testicular tumors are: | Seminomas
Most common
🗑
|
||||
| What are the clinical mainfestations of Seminomas? | Progressive painless enlargement of the testis
🗑
|
||||
| What is the morphology of Seminomas? | Soft, well-demarcated tumors
Usually without hemorrhage
🗑
|
||||
| What is the morphology of Embryonal carcinoma? | Ill-defined, invasive masses containing foci of hemorrhage and necrosis
Microscopically: Large and primitive cells with a basophilic cytoplasm
🗑
|
||||
| The most common primary testicular neoplasm in children younger than 3 yr: | Yolk sac tumors
🗑
|
||||
| What is the morphology of Yolk sac tumors? | Composed of cells forming Microcysts, Lacelike patterns.
A distinctive feature is the presence of Schiller-Duvall bodies
🗑
|
||||
| What substance is elevated in yolk sac tumors? | AFP
🗑
|
||||
| What cells make up choriocarcinomas? | Trophoblastic cells
🗑
|
||||
| What percentage of testicular neoplasms do choriocarcinomas make up? | 5%
🗑
|
||||
| What is the morphology of choriocarcinoma? | Composed of sheets of (cytotrophoblasts) irregularly intermingled with large multinucleated cells ( syncytiotrophoblasts)
🗑
|
||||
| What substance is elevated in choriocarcinoma? | HCG
🗑
|
||||
| What is the second most common testicular neoplasm in children after yolk sac tumors? | Teratomas
🗑
|
||||
| What is the difference between teratomas in adults and in children? | Children --> Pure
Adults --> Mixed
🗑
|
||||
| What is the prognosis of teratomas? | Prepubertal males --> benign
Postpubertal males --> Malignant
🗑
|
||||
| What are the clinical manifestations of all testicular germ cell neoplasms? | 1) Painless mass
2) Contraindicated biopsy
3) Seminomas --> better prognosis than non-seminomas
4) Increased LDH --> Wider spread of tumor
5) Increased HCG --> Choriocarcinoma
6) Increased AFP --> Yolk sac tumor
🗑
|
||||
| How are testicular germ cell neoplasms treated? | Seminomas --> radiosensitive
Nonn-seminomas -->agressive chemotherapy
Pure choriocarcinomas --> Likely deadly
🗑
|
||||
| At what age is the patient likely to have prostate glandular hyperplasia? | 40
🗑
|
||||
| What is the cause of benign prostatic hyperplasia? | Androgen-dependent proliferation of both stromal and epithelial elements, with enlargement of gland
🗑
|
||||
| What are the clinical manifestations of benign prostatic hyperplasia? | Lower Urinary Tract obstruction (hesitancy; urgency, frequency, and nocturia)
Increased risk of UTIs
🗑
|
||||
| What age group is affected with carcinoma of the prostate? | Patients over50
🗑
|
||||
| What is the most common form of cancer in men? | Carcinoma of the prostate
🗑
|
||||
| What is the pathogenesis of carcinoma of the prostate? | 1) Androgens
2) Heredity
3) Geographical factors
4) Diet
5) TMPRSS 2-ETS (in 40-50%)
🗑
|
||||
| How is carcinoma of the prostate diagnosed? | Hard peripheral glands palpated by digital PR exam
Elevated PSA
Osteoblastic regions on bone scan showing metastasis
🗑
|
Review the information in the table. When you are ready to quiz yourself you can hide individual columns or the entire table. Then you can click on the empty cells to reveal the answer. Try to recall what will be displayed before clicking the empty cell.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
To hide a column, click on the column name.
To hide the entire table, click on the "Hide All" button.
You may also shuffle the rows of the table by clicking on the "Shuffle" button.
Or sort by any of the columns using the down arrow next to any column heading.
If you know all the data on any row, you can temporarily remove it by tapping the trash can to the right of the row.
Embed Code - If you would like this activity on your web page, copy the script below and paste it into your web page.
Normal Size Small Size show me how
Normal Size Small Size show me how
Created by:
Ulaisl
Popular Medical sets