Pathology(Female Reproductive)*

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Rare malignant tumor of the vagina w/c inc. in incidence in daughters of women who receive Diethylstilbestrol(DES)therapy during therapy;may also occur in the cervix;vaginal adenosis(mucosal columnar epithelial-lined crypts in areas normally lined by str: Clear Cell Adenocarcinoma
Neoplasm of the vagina occuring in children <5yrs;rare variant of rhabdomyosarcoma;presents as multiple polypoid masses resembling "bunch of grapes"projecting into the vagina protruding from the vulva: Sarcoma Botryoides
Maternal exposure to DES(diethylstilbestrol): Clear cell carcinoma of the vagina in daughters
Predisposes to male germ cell tumors even if surgically corrected: Cryptorchidism(undescended testes)
Toxemia w/ CNS involvement, including convulsions & coma in a pregnant woman: Eclampsia
Most common cause of hematosalpinx: Ectopic Pregnancy
-chronic pelvic inflammatory dse. may predispose to ectopic pregnancy
Leukorrhea & irregular bleeding in a postmenopausal woman: Endometrial Carcinoma
-risk factors include obesity, diabetes, hypertention, infertility, & endometrial hyperplasia
Leading cause of infertility, w/ menstrual irregularities, severe dysmenorrhea, & intrapelvic bleeding in a young woman: Endometriosis
-"Chocolate Cysts" or blood- and debris-filled cysts in ovaries may develop
Discrete, rubbery, movable mass in the inner lower quadrant of the breast of a young female: Fibroadenoma
-most common benign tumor of the female breast
Blue-domed cysts & dense fibrosis that produce palpable lumps & mammographic densities: Fibrocystic change of the breast
-epithelial cell lining around cysts shows apocrine metaplasia
Bleeding w/ passage of grape-like structures, increased hCG, & rapid incr. in uterine size: Hydatidiform Mole
-similar presentation w/o uterine enlargement=choriocarcinoma
Most common cause of scrotal enlargement: Hydrocele
-clear, serous fluid can be seen upon transillumination of scrotal sac
Tumor w/ tendency to affect both breast: Infiltrating lobular carcinoma
Nodule of rock hard consistency in the upper outer quadrant of the breast of a postmenopausal woman: Invasive(infiltrating)carcinoma of the breast
-histologically charact. by nests of tumor cells in a scirrhous, or scar-like, dense, hard stroma
Most common benign tumor in females: Leiomyoma
-benign tumor of the smooth muscle of the uterus
Germ cell tumor that may contain, teeth, cartilage, &/or glands: Mature Cystic Teratoma(dermoid cyst)
-tumor is derived from all three germ cell layers
Presents as urinary urgency, frequency, & nocturia in anolder male: Nodular hyperplasia of the prostate(benign prostatic hyperplasia)
-commonly arises in the periurethral & transition zones of the prostate causing compression of the urethra
Eczematoid lesion of the nipple, often w/ underlying ductal carcinoma: Paget dse. of the breast
Psammona bodies: Papillary serous cystadenocarcinoma of the ovary
-also in papillary carcinoma of the thyroid & meningioma
Young female w/ amenorrhea, infertility, obesity, & hirsutism: Polcystic ovary(Stein-Leventhal)Synd.
-may be caused by excess secretion of luteinizing hormone
Insidious onset of hypertension, edema, proteinuria, & headache after the 32nd week of pregnancy: Preeclampsia
Extragenital infections due to gonorrhea: Pharyngitis(orogenital sexual contact), Proctitis(anal intercourse),Purulent arthritis(monoarticular involving large joints),Ophthalmia neonatorum(acquired at delivery)
Neoplasm of the vulva w/c accounts for 10% of malignant tumors of the vulva: Malignant Melanoma
Chlamydial infection causing the most common sexually transmitted dse.;common cause of PID;often asymptomatic;caused by Chlamydia trachomatis: Chlamydial Cervicitis
Chlamydial infection caused by C.trachomatis(L1,L2,or L3 serotypes); manifest as a small papule or ulcer~ superficial ulcers,lymphnode enlargement;lead to rectal stricture due infl.rxn. & scarring: Lymphogranuloma venereum
Neoplasm of the vulva similar to Pagets dse. of the breast;assoc. w/ underlying adenocarcinoma of the apocrine glands: Pagets disease of the vulva
Neoplasm of the vagina due to extension of squamous cell carcinoma of the cervix: Squamous Cell Carcinoma
Disorder charact. by severe HPN occuring de novo during pregnancy(during 3rd trimester often in 1st pregnancy)or complicates pre-existing hypertensive dse. affecting the kidneys,liver & CNS: Toxemia of Pregnancy
-occurs in 2 forms:preeclampsia(mild form,HPN,albuninuria,edema)& eclampsia(severe form,HPN,albuminuria,edema, convulsions,DIC;fatal)
STD producing small vesicles & shallow ulcers that involve the cervix,vagina, clitoris,vulva,urethra,& perianal skin; presence of multinucleated giant cells w/ viral inclusions in cytologic smears: Herpes Simplex Virus(HSV)infection
-HSV type 2 accounts for genital herpes
STD caused by Treponema pallidum presenting as a firm,painless ulcer(chancre) or as condyloma lata(gray,flattened wart-like lesions);may cause fetal malformation during pregnancy: Syphilis
STD caused by Haemophelus ducreyi charact. by soft,painful ulcerated lesions(in contrast to syphilis w/c have firm painless ulcers);common in tropical areas: Chancroid
STD caused by Calymmatobacterium(Donovania)granulomatis charact. by Donovan bodies(organism filling histiocytes)appearing as papules~ ulcerate~progress by adjacent lesions~large genital or inguinal ulerations w/ lymphatic obstruction or genital distortio: Granuloma Inguinale
Most common benign tumor of the vulva w/c originates from the apocrine sweat glands presenting as labial nodule~ulcerate~bleed;cured by exicision: Papillary Hidradenoma
Benign squamous cell carcinoma caused by HPV(types 6&11)presenting as multiple wart-like lesions(venereal warts)in the vulvovaginal,perianal & cervical regions charact. hitologically by koilocytes(expanded epithelial cells w/perinuclear clearing: Condyloma Acuminatum
Most common malignant tumor of the vulva occuring often in older women; assoc. w/ HPV type 16,18,31,33(also assoc. w/ squamous cell carcinoma of the vagina & cervix);preceded by vulvar dystrophy: Squamous Cell Carcinoma
-preceded by premalignant changes graded as vulvar intraepithelial neoplasia(VIN)1-3
Most common form of vaginitis;caused by Candida albicans(normal flora of vagina);charact. by white,patch-like mucosal lesions,a thick white discharge,& vulvovaginal pruritus: Candidiasis(moniliasis)
-assoc. w/ DM,pregnancy,broad spectrum antibiotic therapy,oral contraceptive use,& immunosuppresion
Infectious disorder of the vagina transmitted by sexual contact w/ charact. "clue cells"(epithelial cells containing dot-like organisms in Papanicolaou smear);classified as nonspecific vaginitis: Gardnerella Vaginitis
-caused by Gardnerella vaginitis
Infect. disorder of the vagina assoc. w/ use of highly absorbent tampons; caused by Staphylococcus aureus(grows in the tampon);charact. by rash(folowed by desquamation),fever,vomiting,& diarrhea~renal failure,shock: Toxic Shock Synd.
PID transmitted sexually;can be asymptomatic but infectious;charact. by purulent acute inflammation of the urethra,paraurethral & Bartholin glands,& Skene ducts;may ascend to infect the endocervix,uterine canal & fallopian tubes: Gonorrhea
-caused by N.gonorrhea
Results from an obstruction of the Bartholin ducts;can be infected by Neisseria gonnorrhoeae or staphylococcus: Bartholin Cyst
Group of disorders of epithelial growth presenting w/ pruritus & leukoplakia w/c may have no malignant potential(Lichen sclerosus,hyperplastic dystrophy)or premalignant lesion(atypical hyperplastic dystrophy): Vulvular Dystrophy
-should be evaluated by biopsy
Second most common type of vaginitis; caused by Trichomonas vaginitis; transmitted by sexual contact: Trichomoniasis
Non-neoplastic disorder of the uterine cervix charact. by columnar epith. replacing squamous epith.;may be a manifestation by chronic cervicitis: Erosion
Non-neoplastic disorder affecting the endocervix caused by staphylococci, enterococci,Gardenella vaginalis, Trichomonas vaginalis,Candida albicans,Chlamydia trachomatis manifested by cervical discharge;often asymptomatic: Cervicitis
General charact.,cause,& classification of dysplasia & carcinoma in situ in the uterine cervix: Charact. by disordered epithelial growth often in the squamocolumnar junct. beginning at the basal layer extending outward;assoc. w/ HPV(type 16,18,31,33)infxn.;dysplasia~carcinoma in situ;classified as cervical intraepithelial neoplasia(CIN)1-3
Malignant disorder in the uterine cervix affecting middle-age groups;often squamous cell carcinoma; arises from pre-existing CIN at the squamocolumnar junction;evovles from dysplasia~carcinoma in situ~invasive carcinoma;dec. mortality w/ Papanicolaou cyt: Invasive Carcinoma
Epidemiologic factors & role of HPV in invasive carcinoma: Inc. incidence w/ history of early sexual activity,multiple sexual partners,economically deprived & cigarette smoking;HPV types 16,18,31,33 are most common cause(>90%) of malignant genital squamous cell tumors;dysplastic cells demonstrate koilocytosis
Assoc. w/ intrauterine trauma from instrumentaion,intrauterine contraceptive devices,complications of pregnancy(postpartum retention of placental fragments;caused by Staphylococcus aureus or Streptococcus species: Acute Endometritis
Charact. by presence & proliferation of ectopic endometrial tissue;most common in the pelvic area(ovary most common, next uterine ligaments,rectovaginal septum);clinically manifest w/ severe mentrual-related pain;results in infertility: Endometriosis
-non-neoplastic;responsive to hormonal variations of the menstrual cycle; charact. by bleeding into ectopic endometrium~blood filled"chocolate cysts"
Caused by retrograde dissemination of endometrial fragments through the fallopian tubes during menstruation w/ implantation on the ovary,peritoneal structures,or blood borne or lymphatic borne dissemination of endometrial fragments: Endometriosis
Charact. by islands of endometrium w/in the myometrium: Adenomyosis
Abno° proliferation of the endometrial glands caused by excess estrogen stimulation~anovulatory cycles, polycystic ovary dse.,estrogen secreting ovarian tumors,estrogen therapy;manifest as postmenopausal bleeding: Endometrial Hyperplasia
-may be a precursor for endometrial carcinoma depending on the degree of cellular atypia
Benign lesion occuring in women >40yr w/c may result in uterine bleeding: Endometrial Polyp
Most common uterine tumor & most common tumor in women;benign;estrogen sensitive in w/c it inc. in size during pregnancy & dec. during following menopause;manifest as menorrhagia(if subendometrial): Leiomyoma(fibroid)
-may be in the myometrium(intramural), subendometrial(submucous),subperitoneal(subserous)
A malignant tumor of the uterus that occurs infrequently;arises de novo & is almost never caused by a malignant transformation by leiomyoma: Leiomyosarcoma
Most common gynecologic malignancy;peak incidence in older age group;often presents as postmenopausal bleeding; preceded by endometrial hyperplasia; predisposed by prolonged estrogen stimulation(estrogen therapy,estrogen producing tumors): Endometrial Carcinoma
-predisposed by obesity,diabetes,HPN; assoc. w/nulliparity
PID of the fallopian tubes assoc. w/ infl. of the ovaries & other adjacent tissues due to N.gonnorrhea,anaerobic bact., C.trachomatis,streptococci; results in pyosalpinx(tube filled w/ puss),hydrosalpinx(tube filled w/ watery fluid),& tubo-ovaria: Salpingitis
Bleeding into the fallopian tube caused by ectopic pregnancy: Hematosalpinx
Most frequent benign tumor of the fallopian tube: Adenomatoid Tumor
Ovarian cyst due to distention of the unruptured graafian follicle;assoc. w/ hyperestrinsm & endometrial hyperplasia: Follicular Cyst
Ovarian cyst due to bleeding into a persistent mature corpus luteum w/c presents w/ mentrual irregularity & intraperitoneal hemorrhage: Corpus luteum cyst
Ovarian cyst due to gonadotropin stimulation;assoc. w/ choriocarcinoma & hydatidiform mole;multiple & bilateral; lined by luteinized theca cells: Theca-lutein Cyst
A bloody-containing cyst resulting from ovarian endometriosis w/ hemorrhage; ovary is most common site: Chocolate Cyst
Ovarian cyst in young women charact. by amenorrhea,infertility,obesity,& hirsutism due to excess LH & androgens; morphologically charact. by thickened ovarian capsule,multiple small follicular cyst & cortical stromal fibrosis: Polycystic Ovary(Stein-Leventhal)synd.
-assoc. w/ insulin resistance(DM, hyperinsulinemia)~inc. ovarian androgen prod.~inc. LH
Malignant tumor of the ovary w/c accounts for 50% of ovarian carcinomas; often bilateral: Serous Cystadenocarcinoma
-serous tumor
Benign cystic tumor of the ovary lined by cells similar to fallopian tube epithelium;accounts for 20% of all ovarian tumors;bilateral: Serous Cystadenoma
Benign mucinous tumor of the ovaries charact. by multilocular cyst lined by mucus-secreting columnar epith. & filled w/ mucinous material: Mucinous Cystadenoma
Malignant mucinous tumor of the ovaries due to rupture or metastasis in pseudomyxoma peritonei w/ multiple peritoneal tumor implants producing intraperitoneal mucinous material: Mucinous Cystadenocarcinoma
Malignant tumor of the ovaries resembling the endometrium: Endometrioid Tumor
Rare malignant tumor of the ovaries: Clear Cell Tumor
Rare benign tumor of the ovaries charact. by small islands of epithelial cells resembling bladder transitional epithelium interspersed w/in a fibrous stroma: Brenner Tumor
Tumors of surface cell origin w/c make up almost 3/4 of ovarian tumors;occurs in women >20yrs: Serous(cystadenoma,cystadenocarcinoma), Mucinous(cystadenoma, cystadenocarcinoma),Endometrial,Clear cell,& Brenner tumor
Tumors of germ cell origin w/c make up 1/4 of ovarian tumors & account for most ovarian tumors occuring in women <20yrs: Dysgerminoma,Endodermal sinus(yolk sac)tumor,Teratomas(immature,dermoid cyst or mature teratoma,monodermal teratoma),Ovarian choriocarcinoma
An attachment of the placenta to the lower uterine segment w/c may completely or partially cover the cervical os resulting in bleeding;may coexist w/ placenta accreta: Placenta Previa
Pregnancy occuring in the fallopian tubes(most common),ovary,abdominal cavity,cervix;predisposed by chronic salpingitis(often gonorrheal), endometriosis,postoperative adhesions~ hematosalpinx & tubal rupture: Ectopic Pregnancy
-most common cause of hematosalpinx
Ovarian tumor of sex cord-stromal origin w/c secretes androgen;assoc. w/ virilism(masculinization): Sertoli-Leydig Cell Tumor(androblastoma,arrhenoblastoma)
Metastatic tumors to the ovaries w/c are GIT,breast,& endometrial in origin;bilaterally replace the ovaries w/ mucin secreting "signet-ring cells": Krukenburg Tumors
-stomach is common site of origin
A premature separation of the placenta causing antepartum bleeding & fetal death;assoc. w/ disseminated intravascular coagulation(DIC): Abruptio Placentae(placental abruption)
An attachment of the placenta directly on the myometrium of the uterus in presence of a defective decidual layer due to endometrial infl. & old scars from past cesareans w/c manifest as impaired placental separation after delivery assoc. w/ massive h: Placenta Accreta
Malignant germ cell tumor of the ovaries w/c is homologous to testicular seminoma: Dysgerminoma
Ovarian tumor of germ cell origin w/c produces alpha-fetoprotein;homologous to endodermal sinus tumor of the testis: Endodermal sinus(yolk sac)tumor
Ovarian tumor of germ cell origin derived from 2-3 embryonic layers & have 3 distinct forms(immature,mature, monodermal): Teratomas
-immature(aggressive malignant),mature(dermoid cyst;most frequent benign ovarian tumor;lined by skin,hair follicles,bone,tooth,cart.,etc.), monodermal(contains 1 tissue elements; most common,struma ovarii)
Ovarian tumor of germ cell origin w/c secretes human chorionic gonadotropin(hCG);aggressive malignant tumor: Monodermal teratoma
Ovarian tumors of ovarian sex cord-stromal origin w/c affects all age groups;accounts a small % of ovarian neoplasms: Thecoma-fibroma(Fibroma,Thecoma), Granulosa Cell tumor,Sertoli-Leydig cell tumor(andronblastoma, arrhenoblastoma)
Solid ovarian tumor of sex cord-stromal origin consisting of spindle-shaped fibroblast assoc. w/ Meig's synd(ovarian fibroma,ascites,& hydrothorax): Fibroma
Ovarian tumor of sex cord-stromal origin w/c secerets estrogen & demonstrates round lipid-containing cells in addition to fibroblast: Thecoma
Estrogen secreting ovarian tumor of sex cord-stromal assoc. w/ endometrial hyperplasia or endometrial carcinoma & charact. by Call-Exner bodies(small follicles filled w/ eosinophilic secretion)causing precocious puberty: Granulosa Cell Tumor
Peripartal complication of pregnancy caused by a tear in the placenta memb. & rupture of maternal veins charact. by sudden peripartal respiratory difficulty~shock~death & masses of debris of epithelial squamous cells in the maternal pulmonary mic: Amniotic Fluid Embolism
-causes DIC;should not be confused w/ amniotic fluid aspiration synd.
Peripartal complications of pregnancy w/c is consequence of severe hypotension(blood lost most common);insidious onset over weeks-months following delivery;of ant. pituitary hypofunction: Postpartum Ant. Pituitary Necrosis(Sheehan Synd.)
Peripartal complication of pregnancy w/c follows premature rupture of membranes due to ascending infection from the vagina or cervix: Chorioamnionitis
A degenerative or neoplastic change of trophoblastic tissue manifested by enlarged,edematous placental villi in a loose stroma resembling bunch of grapes;marked by inc. in hCG(also occurs in normal or ectopic pregnancy, gestational choriocarcinoma,germ c: Hydatidiform Mole
-charact. by vaginal bleeding & rapid inc. in uterine size;can be mistaken for normal pregnancy;results in choriocarcinoma(2-3% of cases)
2 variants of hydatidiform mole: Complete hydatidiform mole(no embryo present;46,XX karyotype(paternal derivation-androgenesis); Partial hydatidiform mole(embryo present;due to fertilization of the ovum by 2 or more spermatozoa~69 chromosomes derived from 2 paternal & 1 maternal haploid set
An aggressive malignant neoplasm charact. by inc. hCG(important diagnostic sign),early hematogenous spread to lungs;preceded by hydatidiform mole(50%),abortion of ectopic pregnancy(20%),& normal-term pregnancy(20-30%): Gestational Choriocarcinoma
-more common than ovarian choriocarcinoma;responsive to chemotherapy
Most common disorder of the breast affecting women ages 25-50yrs charact. as a palpable breast mass w/ midcycle tenderness due to inc. activity or sensitivity to estrogen or dec. progesterone activity;bilateral: Fibrocystic Dse.
-nonproliferative forms(stromal fibrosis & cyst form.):no risk of breast cancer;Epithelial hyperplasia w/ atypia or sclerosing adenosis(inc. risk of cancer w/ hyperplastic epthelial atypia)
Morphological charact. of fibrocystic dse.,the most common disorder of the breast: Fibrosis,cyst(may be filled w/ fluid & appear blue through the cyst wall "blue dome cyst"),epithelial changes(flattened,apocrine metaplasia, hyperplastic w/ atypia),adenosis(proliferation of ducts & myoepithelial cells),sclerosing adenosis(adenosis w/ fibrosis)
Most common breast tumor in women <25yrs old;benign;presents as a firm, rubbery,painless,well-circumscribed lesion;well demarcated from adjacent breast tissue: Fibroadenoma
-subclassified into:Intracanalicular(stroma compresses & distorts glands into slitlike spaces)& Pericanalicular(glands retain round shape)
A large,bulky mass on the breast of variable malignancy w/ ulceration of overlying skin charact. by cystic spaces containing leaf-like projections from the cyst walls & myxoid contents: Phyllodes Tumor
Tumor of the breast presenting w/ serous of bloody discharge & a palpable mass;mistaken for malignancy: Adenoma of the nipple
A benign tumor of the major lactiferous ducts presenting as serous or bloody discharge;must be distinguished from carcinoma: Intraductal papilloma
2nd most common malignancy of women(carcinoma of lungs is 1st);most common cause of breast mass in postmenopausal women;occurs most often in upper outer quadrant~metastasize to axillary lymph nodes,lung,liver & bone;has several histologic types(invas: Carcinoma of the breast
-demonstrates estrogen & progesterone receptors in some tumors
Tumor of the breast w/c may demonstrate estrogen & progesterone receptors; presence correlates good prognosis & is a predictor of efficacy of antiestrogen therapy;not predisposed by oral contraceptive regiments: Carcinoma of the breast
-other prognostic factors(type & size of the tumor,extent of lymphnode involvement,DNA ploidy);hyperexpression of c-erbB2(HER-2/neu)is assoc. w/ poorer prognosis
Factors w/c inc. the risk of carcinoma of the breast: Age(inc. w/ inc. age),(+)family history,history of breast cancer in one breast,early menarche & late menapause(due to inc. duration of reproductive life & hormonal activity),obesity, nulliparity,1st pregnancy after age 30,high animal fat diet,proliferative fibrocystic dse. w/ atypical epthelial hyperplasia
Carcinoma of the breast w/ lymphatic involvement involvement of skin causing red,swollen,hot skin resembling an inflammatory process;poor prognosis: Inflammatory Carcinoma
Carcinoma of the breast hitologically charact. by pools of extracellular mucus surrounding clusters of tumor cells;gelatinous consistency;better prognosis than invasive ductal carcinoma: Mucinous(colloid)Carcinoma
Carcinoma of the breast histologically charact. by cellular w/ scant stroma; soft,fleshy consistency;lymphocytic infiltrate;better prognosis than invasive ductal carcinoma: Medullary Carcinoma
Carcinoma of the breast histologically charact. by eczematoid lesion of the nipple or areola charact. by large cells surrounded by a clear halo-like area,invade the epidermis;usually accompanied by ductal carcinoma: Paget Dse. of the breast
Carcinoma of the breast charact. by ducts filled w/ tumor cells~tumor cell necosis~cheesy like consistency: Intraductal Carcinoma in situ(comedocarcinoma)
Most common carcinoma of the breast charact. by tumor cells arranged in cords,islands,& glands embedded in a dense fibrous stroma;fibrous tissue results in firm consistency: Invasive Ductal Carcinoma(scirrhous carcinoma)

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Number of cards 108