What symptom may indicate carcinoma of the fallopian tube?
Profuse watery secretion appearing as vaginal discharge.
p.31
Diseases of the Endometrium
What are risk factors for developing endometrial carcinoma?
Obesity, diabetes, hypertension, and prolonged exposure to estrogen.
p.18
Cervical Intraepithelial Neoplasia (CIN)
What is microinvasive carcinoma of the cervix?
The earliest stage of invasive cancer where spread is less than 5 mm in depth.
p.63
Gestational Trophoblastic Disease
What are the characteristics of a partial mole?
Part of the placenta shows cystic change, and a malformed fetus may be present.
p.80
Breast Diseases and Tumours
What is tubular carcinoma?
A rare form of breast cancer showing well-differentiated tubular structures.
p.31
Diseases of the Endometrium
How is endometrial carcinoma diagnosed?
Through pelvic exams, ultrasounds, and endometrial biopsies.
p.65
Breast Diseases and Tumours
What type of gland is the breast classified as?
A greatly modified sweat gland.
p.31
Diseases of the Endometrium
What is endometrial carcinoma?
A type of cancer that originates in the lining of the uterus (endometrium).
p.12
Cervical Intraepithelial Neoplasia (CIN)
What is a local proliferation of endocervical mucosa that may protrude through the cervix?
It is a condition characterized by pedunculated growth.
p.28
Diseases of the Endometrium
What characterizes complex hyperplasia of the endometrium?
It is often focal, affecting glands but not stroma.
p.47
Ovarian Tumours and Cysts
What is a characteristic feature of mucinous cystadenomas?
They can reach a very large size and are typically multilocular.
p.27
Diseases of the Endometrium
What is the primary cause of simple hyperplasia?
Excess estrogen stimulation, particularly associated with anovulatory cycles.
p.41
Ovarian Tumours and Cysts
What is oophoritis?
Inflammation of the ovaries.
p.3
Lichen Sclerosus and Lichen Simplex Chronicus
What is a characteristic presentation of Lichen Sclerosus?
White plaques (leukoplakia).
p.65
Breast Diseases and Tumours
What is the primary function of the breast?
To produce and secrete milk during lactation.
p.68
Breast Diseases and Tumours
Why is epithelial hyperplasia significant?
Some forms are associated with an increased risk of breast cancer.
p.26
Diseases of the Endometrium
Which form of endometrial hyperplasia is most important and why?
Atypical hyperplasia, because it is associated with an increased risk of malignancy.
p.28
Diseases of the Endometrium
Is there an increased risk of malignancy with complex hyperplasia?
No, there is no increased risk of malignancy.
p.61
Diseases of the Endometrium
What is the most common cause of ectopic pregnancy?
Previous damage to the fallopian tube, often due to salpingitis.
p.27
Diseases of the Endometrium
What are some rare causes of simple hyperplasia?
Estrogen therapy or estrogen-secreting tumors.
p.52
Ovarian Tumours and Cysts
Which tumors are known to produce excess estrogen?
Granulosa cell tumors and thecomas.
p.42
Ovarian Tumours and Cysts
What condition is associated with bilateral, multiple small cysts?
Polycystic ovarian disease, which is linked to obesity, hirsutism, and oligomenorrhoea.
p.37
Diseases of the Fallopian Tube
What is acute salpingitis?
An inflammation of the fallopian tubes resulting from ascending infection from the endometrium.
p.54
Ovarian Tumours and Cysts
What are the oestrogenic effects of Thecoma?
1. Precocious puberty in children. 2. Hyperplasia of endometrium, which may be atypical and can lead to carcinoma.
p.49
Ovarian Tumours and Cysts
What is the benign equivalent of endometrioid tumours?
Endometrioid adenofibroma.
p.73
Breast Diseases and Tumours
What characterizes lobular carcinoma in situ?
It is usually multifocal and bilateral, with affected lobules distended by fairly uniform cells.
p.50
Ovarian Tumours and Cysts
What histological feature is characteristic of Brenner tumours?
Islands of transitional epithelium in a fibrous stroma.
p.30
Diseases of the Endometrium
What can happen due to the progressive elongation of the pedicle of an endometrial polyp?
Venous congestion and bleeding.
p.27
Diseases of the Endometrium
When does simple hyperplasia typically occur?
During the peri-menopausal period.
p.78
Breast Diseases and Tumours
What characterizes medullary carcinoma?
It is a highly cellular tumor with a florid lymphocytic infiltrate and a 'pushing margin'.
p.42
Ovarian Tumours and Cysts
What is a characteristic of single follicular cysts?
They may be several centimeters in diameter.
What are endometrial stromal sarcomas?
Rare tumors that can be classified as low grade or high grade.
p.70
Breast Diseases and Tumours
How does fibroadenoma typically present clinically?
As a small, firm, mobile lump.
p.76
Breast Diseases and Tumours
What is the commonest form of breast carcinoma?
Infiltrating ductal carcinoma.
p.28
Diseases of the Endometrium
What is the appearance of glands in complex hyperplasia?
The glands appear crowded but show no atypia.
p.69
Breast Diseases and Tumours
What is a radial scar in the context of breast diseases?
A small (up to 1 cm diameter), firm lesion with a central dense fibrous core and radiating fingers of fibrosis.
p.34
Diseases of the Myometrium
What is the size range of fibroids?
From tiny (mm) growths to several cm in diameter.
p.43
Ovarian Tumours and Cysts
Are the classifications of ovarian tumors completely satisfactory?
No, none is completely satisfactory.
p.44
Ovarian Tumours and Cysts
What are common types of ovarian tumors?
Benign tumors, malignant tumors, and functional cysts.
p.54
Ovarian Tumours and Cysts
During which decades of life is Thecoma mainly found?
The third, fourth, and fifth decades.
What is characteristic of condylomata acuminata?
Koilocytosis in the superficial keratinocytes.
p.17
Cervical Intraepithelial Neoplasia (CIN)
Where do most adenocarcinomas of the cervix arise?
Within the endocervical canal.
p.51
Ovarian Tumours and Cysts
How does ovarian cancer typically spread in its early stages?
By direct extension to the pelvic peritoneum.
What type of carcinoma is associated with the fallopian tube?
Papillary adenocarcinoma.
p.31
Diseases of the Endometrium
What are the treatment options for endometrial carcinoma?
Surgery, radiation therapy, chemotherapy, and hormone therapy.
p.68
Breast Diseases and Tumours
What does epithelial hyperplasia mean?
Proliferation of the epithelial component of the breast.
p.30
Diseases of the Endometrium
What condition can endometrial polyps be associated with?
General endometrial hyperplasia.
p.63
Gestational Trophoblastic Disease
What is a partial hydatidiform mole?
Occurs when an ovum is fertilized by two sperm, resulting in a triploid karyotype (69XXY or 69XXX).
p.34
Diseases of the Myometrium
What is a leiomyoma?
A circumscribed growth derived from uterine muscle.
p.23
Diseases of the Endometrium
What is the regurgitation theory in relation to endometrial diseases?
It suggests that menstrual blood flows backward through the fallopian tubes into the pelvic cavity.
p.42
Ovarian Tumours and Cysts
What is another name for polycystic ovarian disease?
Stein-Leventhal syndrome or polycystic ovary syndrome.
p.26
Diseases of the Endometrium
What are the three forms of endometrial hyperplasia?
Simple hyperplasia, complex hyperplasia, and atypical hyperplasia.
p.27
Diseases of the Endometrium
What is simple hyperplasia of the endometrium?
A condition that tends to occur in the peri-menopausal period due to excess estrogen stimulation.
p.42
Ovarian Tumours and Cysts
What are follicular cysts?
Cysts that may be single or multiple, with a maximum diameter of a normal Graafian follicle being 1.5–2 cm.
p.78
Breast Diseases and Tumours
What is mucinous carcinoma?
A type of breast cancer where malignant cells lie in pools of mucin.
p.34
Diseases of the Myometrium
Where can fibroids be found in the uterus?
In any part of the uterus.
p.59
Ovarian Tumours and Cysts
How common is the yolk sac tumor among malignant tumors of germ cell origin?
It ranks as the second most common.
p.55
Ovarian Tumours and Cysts
What type of tumour is a Sertoli-Leydig cell tumour?
It is a virilising tumour and is considered rare.
p.37
Diseases of the Fallopian Tube
What can cause acute salpingitis?
Chlamydia and infections following abortion or puerperal infection.
p.42
Ovarian Tumours and Cysts
What are theca lutein cysts?
Cysts from which the granulosa cells have disappeared, surrounded by luteinised thecal tissue.
p.73
Breast Diseases and Tumours
How can ductal carcinoma in situ (DCIS) be detected?
Through mammographic screening due to focal calcification or it may present as a palpable mass.
p.11
Diseases of the Cervix
What can cause acute cervicitis?
Gonorrhoea or cervical laceration at childbirth.
p.44
Ovarian Tumours and Cysts
What is the significance of early detection in ovarian cancer?
It improves treatment outcomes and survival rates.
p.45
Ovarian Tumours and Cysts
How do the sizes of serous cystadenomas compare to mucinous tumors?
Serous cystadenomas almost never reach the large size of mucinous tumors.
p.24
Diseases of the Endometrium
What is adenomyosis?
A condition where deep down growths of endometrium occur within the myometrium.
p.79
Breast Diseases and Tumours
What is tubular carcinoma?
A rare form of breast cancer showing well-differentiated tubular structures.
p.61
Diseases of the Endometrium
What is ectopic pregnancy?
Implantation of the fertilised ovum outside the uterine cavity, usually in the fallopian tube.
p.52
Ovarian Tumours and Cysts
What are the two broad groups of sex cord stromal tumors of the ovary?
1. Tumors producing excess estrogen (e.g., granulosa cell tumors, thecomas). 2. Tumors producing androgens and causing virilization (e.g., Sertoli-Leydig cell tumors, hilus cell tumors, lipid cell tumors).
p.54
Ovarian Tumours and Cysts
What type of tumor is a Thecoma?
A spindle-celled tumor that is benign and rarely recurs.
p.41
Ovarian Tumours and Cysts
What happens to the fimbrial end of the tube during oophoritis?
It becomes adherent to the ovary, leading to direct spread of infection.
p.80
Breast Diseases and Tumours
Are rare forms of breast cancer common?
No, they are more rare forms of breast cancer.
What is unique about MED12 mutations?
They appear to be virtually unique to uterine smooth muscle tumors.
p.17
Cervical Intraepithelial Neoplasia (CIN)
What is the primary cause of cervical cancer?
Infection with strains of HPV.
p.67
Breast Diseases and Tumours
What is the first characteristic of fibrocystic change?
Fibrosis, which involves progressive hyalinisation of the stroma.
p.54
Ovarian Tumours and Cysts
What syndrome may be associated with Fibromas?
Meigs syndrome, which involves pleural effusion.
p.67
Breast Diseases and Tumours
What causes cyst formation in fibrocystic change?
Obstruction of ducts leading to dilatation of the ducts and acini.
p.30
Diseases of the Endometrium
What is an endometrial polyp?
A localized proliferation of endometrial glands that becomes pedunculated.
p.60
Ovarian Tumours and Cysts
What type of differentiation do choriocarcinomas represent?
Extraembryonic differentiation of malignant germ cells.
p.79
Breast Diseases and Tumours
What characterizes medullary carcinoma?
It is a highly cellular tumor with a florid lymphocytic infiltrate and a 'pushing margin'.
p.63
Gestational Trophoblastic Disease
Is there a risk of choriocarcinoma with a partial mole?
No, there is no risk of choriocarcinoma.
p.80
Breast Diseases and Tumours
What characterizes medullary carcinoma?
A highly cellular tumor with a florid lymphocytic infiltrate and a 'pushing margin'.
p.49
Ovarian Tumours and Cysts
What type of tumours are endometrioid tumours?
Solid or cystic tumours that are histologically similar to those of the endometrium.
p.43
Ovarian Tumours and Cysts
What does the text mention about the classification of ovarian tumors?
It provides a simple working classification.
p.52
Ovarian Tumours and Cysts
What types of tumors are associated with androgen production and virilization?
Sertoli-Leydig cell tumors, hilus cell tumors, and lipid cell tumors.
p.13
Cervical Intraepithelial Neoplasia (CIN)
What is the transformation zone in relation to cervical intraepithelial neoplasia (CIN)?
It is the area where the squamo-columnar junction presents on the vaginal surface of the external os, particularly from puberty onwards and during pregnancy.
p.23
Diseases of the Endometrium
What does the extrauterine stem/progenitor cell theory imply?
It implies that stem or progenitor cells outside the uterus can contribute to the development of endometrial tissue.
p.58
Ovarian Tumours and Cysts
What type of tumours are immature teratomas classified as?
Predominantly solid and malignant.
p.39
Diseases of the Endometrium
What is an ectopic pregnancy?
A pregnancy that occurs outside the uterus, often in the fallopian tube.
p.51
Ovarian Tumours and Cysts
How does serous carcinoma spread in the peritoneal cavity?
It seeds widely and only later invades lymphatics.
p.55
Ovarian Tumours and Cysts
What are the effects of androgens secreted by Sertoli-Leydig cell tumours?
Atrophy of breasts and external genitalia, deepening of voice, temporal recession of hair, growth of facial and body hair, and enlargement of clitoris.
p.51
Ovarian Tumours and Cysts
How does the mucinous variety of ovarian carcinoma spread?
It rarely spreads by lymphatics.
p.31
Diseases of the Endometrium
What are common symptoms of endometrial carcinoma?
Abnormal vaginal bleeding, pelvic pain, and changes in menstrual cycles.
p.24
Diseases of the Endometrium
What accompanies the growth of endometrium in adenomyosis?
An overgrowth of muscle and connective tissue.
p.26
Diseases of the Endometrium
What occurs on the pathway to cancer in endometrial hyperplasia?
Progressive molecular genetic alterations.
p.1
Vulval Inflammation and Atrophy
What makes the skin in post-menopausal women easily abraded?
The thin epithelial covering.
p.78
Breast Diseases and Tumours
What is tubular carcinoma?
A rare form of breast cancer showing well-differentiated tubular structures.
p.69
Breast Diseases and Tumours
What are complex sclerosing lesions?
Similar but larger lesions detected by mammography.
p.34
Diseases of the Myometrium
How common are fibroids in terms of quantity?
They are frequently multiple.
p.29
Diseases of the Endometrium
Why is atypical hyperplasia significant?
It is considered pre-cancerous due to its relationship with the development of adenocarcinoma.
p.80
Breast Diseases and Tumours
What is unique about mucinous carcinoma?
Malignant cells lie in pools of mucin.
What are condylomata acuminata?
Papillomas due to infection by human papilloma virus (HPV) Types 6 or 11.
p.38
Diseases of the Fallopian Tube
What is tuberculous salpingitis?
A tuberculous infection of the female genital tract that almost always starts in the fallopian tube.
p.13
Cervical Intraepithelial Neoplasia (CIN)
Why is the transformation zone significant?
Because cervical squamous carcinoma and its precursor, CIN, begin there.
p.32
Diseases of the Endometrium
What is the most important factor contributing to endometrial carcinoma?
Prolonged estrogenic stimulation.
p.37
Diseases of the Fallopian Tube
What happens if acute salpingitis does not resolve?
Chronic salpingitis follows, often referred to as pelvic inflammatory disease.
p.46
Ovarian Tumours and Cysts
What is the commonest malignant tumour of the ovary?
Serous cystadenocarcinoma.
p.37
Diseases of the Fallopian Tube
Why is antibiotic therapy important in acute salpingitis?
To prevent progression to chronic salpingitis.
p.1
Vulval Inflammation and Atrophy
What causes vulval inflammation in post-menopausal women?
Atrophy of the skin with very thin epithelial covering.
p.29
Diseases of the Endometrium
What is atypical hyperplasia of the endometrium?
A condition characterized by focal hyperplasia and cytological atypia with common mitotic figures.
p.17
Cervical Intraepithelial Neoplasia (CIN)
What type of carcinoma is most common in cervical cancer?
Squamous carcinoma (90% of cases).
p.79
Breast Diseases and Tumours
What are the more rare forms of breast cancer?
Tubular carcinoma, medullary carcinoma, and mucinous carcinoma.
How do leiomyosarcomas differ from leiomyomas?
Leiomyosarcomas have complex, highly variable karyotypes that frequently include deletions.
p.77
Breast Diseases and Tumours
Can infiltrating lobular carcinoma be multifocal?
Yes, they may be multifocal.
p.39
Diseases of the Endometrium
What are common diseases of the fallopian tube?
Pelvic inflammatory disease, ectopic pregnancy, and tubal ligation complications.
p.77
Breast Diseases and Tumours
How do infiltrating lobular carcinoma cells infiltrate tissues microscopically?
As single files of malignant cells.
p.38
Diseases of the Fallopian Tube
What is the usual cause of tuberculous salpingitis?
It is usually due to blood spread from another site.
p.66
Breast Diseases and Tumours
What is an occasional complication of lactation?
Acute infection, presenting with pain and tenderness.
p.46
Ovarian Tumours and Cysts
What is a characteristic growth pattern of serous cystadenocarcinoma?
Exuberant papillomatous growths extending over the surface and obliterating the ovarian structure.
p.48
Ovarian Tumours and Cysts
How does mucinous cystadenocarcinoma typically arise?
As a malignant transformation of a benign cystadenoma.
p.53
Ovarian Tumours and Cysts
What is the size range of granulosa cell tumors?
From a few mm to large cystic structures.
p.67
Breast Diseases and Tumours
What is adenosis in the context of fibrocystic change?
An increase in the number and size of lobules.
p.53
Ovarian Tumours and Cysts
Where are smaller granulosa cell tumors commonly found?
Deep in the ovarian substance.
p.21
Diseases of the Endometrium
What type of infiltrate is found in chronic endometritis?
Lymphoplasmacytic infiltrate.
p.22
Diseases of the Endometrium
What is a common result of endometriosis during menstruation?
Haemorrhage into the local tissues.
What are leiomyosarcomas?
Uncommon malignant neoplasms thought to arise from the myometrium or endometrial stromal precursor cells.
p.41
Ovarian Tumours and Cysts
What usually causes oophoritis?
It is always secondary to disease of the fallopian tubes or peritoneum.
p.61
Diseases of the Endometrium
What has been observed regarding intrauterine contraceptive devices and ectopic pregnancy?
There has been an increased incidence of ectopic pregnancy in women fitted with these devices.
p.23
Diseases of the Endometrium
What is the metaplastic theory regarding endometrial diseases?
It suggests that endometrial cells can transform into different types of cells in response to various stimuli.
p.44
Ovarian Tumours and Cysts
What is a common symptom of ovarian diseases?
Abdominal pain or discomfort.
p.41
Ovarian Tumours and Cysts
What is tubo-ovarian inflammation associated with?
The presence of an intra-uterine contraceptive device.
p.67
Breast Diseases and Tumours
What is fibrocystic change in the breast?
A condition presenting as a lump or lumpiness in pre-menopausal women.
p.4
Vulval Intraepithelial Neoplasia (VIN)
What are the characteristics of Vulval Intraepithelial Neoplasia (VIN)?
It appears as white patches and shows varying degrees of dysplasia.
p.38
Diseases of the Fallopian Tube
Is tuberculous salpingitis ever secondary to another condition?
Yes, it can occasionally be secondary to tuberculous peritonitis.
p.4
Vulval Intraepithelial Neoplasia (VIN)
What is the significance of Vulval Intraepithelial Neoplasia?
It is considered pre-malignant.
p.75
Breast Diseases and Tumours
At what age is breast cancer uncommon?
Below the age of 30 years.
p.35
Diseases of the Endometrium
What is the myometrium?
The middle layer of the uterine wall, composed of smooth muscle.
p.66
Breast Diseases and Tumours
What may form in the breast as a result of acute infection?
Abscesses, which may lead to scarring.
p.57
Ovarian Tumours and Cysts
What types of tissues may be present in a mature cystic teratoma?
Sebaceous glands, nervous tissue, respiratory, intestinal epithelium, and thyroid tissue.
p.16
Infectious Diseases of the Vulva and Vagina
What are common symptoms of HPV?
Often asymptomatic, but can cause genital warts.
How may Paget disease be mistaken?
It may be mistaken for eczema.
How do malignant cells (Paget cells) spread in Paget disease?
They extend from DCIS within the ductal system via the lactiferous sinuses into nipple skin without crossing the basement membrane.
p.35
Diseases of the Endometrium
What symptoms can diseases of the myometrium cause?
Heavy menstrual bleeding, pelvic pain, and pressure symptoms.
p.14
Cervical Intraepithelial Neoplasia (CIN)
What is a common cause of Cervical Intraepithelial Neoplasia?
Persistent infection with high-risk human papillomavirus (HPV) types.
p.64
Gestational Trophoblastic Disease
Is treatment for choriocarcinoma usually successful?
Yes, treatment is now usually successful.
p.79
Breast Diseases and Tumours
What is unique about mucinous carcinoma?
Malignant cells lie in pools of mucin.
p.61
Diseases of the Endometrium
How does salpingitis contribute to ectopic pregnancy?
It leads to partial blockage of the fallopian tube.
p.78
Breast Diseases and Tumours
What are the more rare forms of breast cancer?
Tubular carcinoma, medullary carcinoma, and mucinous carcinoma.
p.17
Cervical Intraepithelial Neoplasia (CIN)
Where do most squamous carcinomas of the cervix arise?
At the squamo-columnar junction.
p.11
Diseases of the Cervix
What is cervicitis?
Inflammation of the cervix, which can be acute or chronic.
p.37
Diseases of the Fallopian Tube
What are the typical characteristics of acute salpingitis?
Bilateral inflammation primarily involving congested and oedematous tubal plicae with purulent exudate.
p.2
Infectious Diseases of the Vulva and Vagina
What is Lymphogranuloma venereum?
A chlamydial infection that starts as an ulcer on the vulva or in the vagina.
Where do duct papillomas most commonly develop in the breast?
In the lacteal sinuses at the nipple.
p.2
Infectious Diseases of the Vulva and Vagina
What is the initial presentation of Granuloma inguinale?
It begins as a papule on the vulva, perineum, or vagina.
p.53
Ovarian Tumours and Cysts
What type of cells compose a granulosa cell tumor?
Cells resembling the granulosa cells lining Graafian follicles.
p.14
Cervical Intraepithelial Neoplasia (CIN)
What does CIN stand for?
Cervical Intraepithelial Neoplasia.
p.58
Ovarian Tumours and Cysts
How has chemotherapy affected the prognosis of immature teratomas?
It has greatly improved the prognosis.
p.58
Ovarian Tumours and Cysts
What are solid tumours occasionally seen in immature teratomas?
Tumours consisting only of thyroid tissue (struma ovarii) or carcinoid tumour cells.
Why is the term 'phyllodes tumor' preferred?
Because most behave in a relatively benign fashion and are not cystic.
p.21
Diseases of the Endometrium
What histological feature is characteristic of tuberculous endometritis?
Epithelioid granulomas within the endometrium.
p.66
Breast Diseases and Tumours
What are the characteristics of traumatic fat necrosis?
Necrotic fat with lipid-rich macrophages, giant cells, and later fibrosis.
p.53
Ovarian Tumours and Cysts
What is useful in following the progress of granulosa cell tumors?
Measurement of serum inhibin, a glycoprotein produced by granulosa cells.
p.56
Ovarian Tumours and Cysts
How do Dysgerminomas respond to treatment?
They are radio-sensitive and respond to chemotherapy.
p.69
Breast Diseases and Tumours
What is the significance of the fibrous core in a radial scar?
It entraps and distorts glandular elements.
p.23
Diseases of the Endometrium
What does the benign metastases theory propose?
It proposes that endometrial cells can spread to other areas of the body through the bloodstream or lymphatic system.
What characterizes low-grade endometrial stromal sarcomas?
They infiltrate extensively through the lymphatics of the myometrium, have cytologically bland cells, and few mitoses.
p.59
Ovarian Tumours and Cysts
From what type of cells is the yolk sac tumor thought to be derived?
Malignant germ cells differentiating along the extraembryonic yolk sac lineage.
p.55
Ovarian Tumours and Cysts
What is characteristic about Sertoli-Leydig cell tumours on microscopy?
They usually appear as small yellow tumours within the ovary.
p.55
Ovarian Tumours and Cysts
What type of cells can be found in malignant Sertoli-Leydig cell tumours?
Poorly differentiated spindle cells with occasional tubule formations.
What challenge is associated with high-grade stromal sarcomas?
It may be difficult to separate these from uterine leiomyosarcomas.
p.39
Diseases of the Endometrium
What complications can arise from tubal ligation?
Ectopic pregnancy and potential for tubal obstruction.
p.13
Cervical Intraepithelial Neoplasia (CIN)
What can develop later in some cases of CIN?
Invasive squamous carcinoma.
At what age do most phyllodes tumors present?
In the sixth decade of life.
p.4
Vulval Intraepithelial Neoplasia (VIN)
What is the analogy used for grading Vulval Intraepithelial Neoplasia?
It is analogous to cervical intraepithelial neoplasia (CIN).
p.32
Diseases of the Endometrium
How does obesity contribute to endometrial carcinoma?
Increased conversion of androstenedione to estrone.
p.14
Cervical Intraepithelial Neoplasia (CIN)
What is the primary concern of Cervical Intraepithelial Neoplasia?
It is a precancerous condition of the cervix.
p.66
Breast Diseases and Tumours
Is chronic infection common in breast diseases?
No, chronic infection, such as tuberculosis, is very uncommon.
p.35
Diseases of the Endometrium
What are uterine fibroids?
Benign tumors made of muscle and fibrous tissue in the myometrium.
What is vaginal intraepithelial neoplasia associated with?
CIN (Cervical Intraepithelial Neoplasia) and VIN (Vulval Intraepithelial Neoplasia).
p.14
Cervical Intraepithelial Neoplasia (CIN)
How is Cervical Intraepithelial Neoplasia typically detected?
Through Pap smears and HPV testing.
p.64
Gestational Trophoblastic Disease
What is used to monitor progress and treatment of choriocarcinoma?
High blood and urine concentrations of chorionic gonadotropin (hCG).
p.62
Gestational Trophoblastic Disease
What is an invasive mole?
A complete mole in which the villi may penetrate the myometrium and invade blood vessels, potentially leading to pulmonary metastases.
p.49
Ovarian Tumours and Cysts
Are endometrioid tumours usually benign or malignant?
They are usually malignant.
What is the prognosis for low-grade endometrial stromal sarcomas?
About one-fifth of patients eventually die from the disease.
p.73
Breast Diseases and Tumours
What is ductal carcinoma in situ (DCIS)?
A condition where the cells lining the ducts show features of malignancy but have not invaded the stroma.
p.44
Ovarian Tumours and Cysts
What is Polycystic Ovary Syndrome (PCOS)?
A hormonal disorder causing enlarged ovaries with small cysts.
p.54
Ovarian Tumours and Cysts
How do Fibromas differ from Thecomas?
Fibromas are histologically similar but do not produce hormones.
p.58
Ovarian Tumours and Cysts
What types of tissues are typically found in immature teratomas?
Immature tissues, typically of primitive nerve tissue and mesenchymal tissue.
What are the two forms of duct papilloma?
Solitary papilloma and multiple papillomas.
p.2
Infectious Diseases of the Vulva and Vagina
What happens to Granuloma inguinale after it starts as a papule?
It ulcerates and can spread widely, causing extensive destruction of tissue.
p.75
Breast Diseases and Tumours
How does the risk of breast cancer change with age?
The risk steadily increases with age, especially after menopause.
What is the typical age range for women affected by carcinoma of the vulva?
Usually in the sixth and seventh decades of life.
p.11
Diseases of the Cervix
What complications can HPV cause?
Simple viral warts, cervical intraepithelial dysplasia, CIN, and invasive carcinoma.
p.56
Ovarian Tumours and Cysts
What is the typical appearance of a Dysgerminoma?
Greyish color and rubbery consistency.
p.22
Diseases of the Endometrium
What complications can develop from endometriosis?
Adhesions, often leading to infertility.
p.64
Gestational Trophoblastic Disease
How can lung metastases present in choriocarcinoma?
As a single large 'cannon-ball' hemorrhagic mass or multiple small emboli ('snow-storm' lung).
p.16
Cervical Intraepithelial Neoplasia (CIN)
What is the role of HPV in the development of cervical lesions?
It can cause changes in cervical cells leading to precancerous lesions.
p.56
Ovarian Tumours and Cysts
Where do Dysgerminomas commonly spread?
To para-aortic lymph nodes.
p.39
Diseases of the Endometrium
What is pelvic inflammatory disease (PID)?
An infection of the female reproductive organs that can affect the fallopian tubes.
What defines high-grade endometrial stromal sarcomas?
They are highly malignant spindle-celled tumors with poor prognosis.
p.11
Diseases of the Cervix
What are common causes of chronic cervicitis?
Candida, Trichomonas, and Chlamydia.
p.32
Diseases of the Endometrium
What are the causes of prolonged estrogenic stimulation leading to endometrial carcinoma?
Endogenous overproduction, exogenous estrogen therapy, and obesity.
p.39
Diseases of the Endometrium
How can fallopian tube diseases affect fertility?
They can cause blockages or damage, preventing sperm from reaching the egg.
p.51
Ovarian Tumours and Cysts
What are common causes of death in ovarian cancer patients?
Cachexia and interference with intestinal and renal function.
p.46
Ovarian Tumours and Cysts
How are serous cystadenocarcinomas classified?
As low grade or high grade.
p.53
Ovarian Tumours and Cysts
Are all granulosa cell tumors potentially malignant?
Yes, all granulosa cell tumors are potentially malignant.
p.14
Cervical Intraepithelial Neoplasia (CIN)
What is the significance of CIN 3?
CIN 3 is considered high-grade and has a higher risk of progressing to cervical cancer.
p.22
Diseases of the Endometrium
Is malignant change common in endometriosis?
No, it occurs rarely, leading to endometrioid adenocarcinoma.
p.62
Gestational Trophoblastic Disease
What is the usual outcome of a complete hydatidiform mole?
Abortion is the usual outcome.
p.56
Ovarian Tumours and Cysts
What do Dysgerminomas consist of microscopically?
Large clear round cells with large nuclei resembling germ cells.
p.62
Gestational Trophoblastic Disease
What is the usual treatment outcome for an invasive mole?
There is usually complete regression after hysterectomy.
p.13
Cervical Intraepithelial Neoplasia (CIN)
What changes may develop within the metaplastic epithelium of the transformation zone?
Dysplastic changes that are graded as CIN I, II, and III.
p.38
Diseases of the Fallopian Tube
What complications are associated with tuberculous salpingitis?
Complications expected of chronic salpingitis, with the added element of caseation.
p.4
Vulval Intraepithelial Neoplasia (VIN)
What can varying degrees of dysplasia in VIN lead to?
Carcinoma in situ in some cases.
How common are phyllodes tumors compared to fibroadenomas?
They are much less common.
p.35
Diseases of the Endometrium
What are common diseases affecting the myometrium?
Fibroids, adenomyosis, and myometrial tumors.
What type of discharge may occur with duct papillomas?
Discharge from the nipple that may be blood stained.
p.57
Ovarian Tumours and Cysts
What type of epithelium lines a mature cystic teratoma?
Stratified squamous epithelium.
p.75
Breast Diseases and Tumours
How do early menarche and late menopause affect breast cancer risk?
They increase the risk due to prolonged cyclical exposure to sex hormones.
p.66
Breast Diseases and Tumours
What complication can occur with silicone implants?
Leakage of silicone leading to fibrosis and granulomatous inflammation.
p.14
Cervical Intraepithelial Neoplasia (CIN)
What are the treatment options for CIN?
Options include monitoring, excisional procedures, or laser therapy.
p.17
Cervical Intraepithelial Neoplasia (CIN)
Why is vaccination against HPV offered to girls?
To prevent cervical cancer caused by HPV infection.
p.44
Ovarian Tumours and Cysts
What are some risk factors for ovarian cancer?
Family history, age, and genetic mutations (e.g., BRCA1/BRCA2).
p.11
Diseases of the Cervix
What is follicular cervicitis?
Chronic cervicitis associated with reactive lymphoid follicles due to Chlamydia.
p.4
Vulval Intraepithelial Neoplasia (VIN)
How are the changes in Vulval Intraepithelial Neoplasia graded?
They are graded as VIN I, II, and III.
p.32
Diseases of the Endometrium
What is an example of endogenous overproduction of estrogen?
Oestrogen-secreting ovarian tumours.
p.22
Diseases of the Endometrium
Where is endometriosis typically confined?
To the pelvis and the genital tract.
p.51
Ovarian Tumours and Cysts
What is CA125?
A glycoprotein whose serum levels are raised in about 50% of patients with ovarian carcinoma.
p.53
Ovarian Tumours and Cysts
At what ages can granulosa cell tumors occur?
5% in children, 50% in child-bearing years, and 40% post-menopausal.
p.53
Ovarian Tumours and Cysts
Can granulosa cell tumors recur after removal?
Yes, they may recur, sometimes many years after removal.
p.64
Gestational Trophoblastic Disease
What is a common consequence of choriocarcinoma invasion?
Hemorrhage and early lung metastases.
p.75
Breast Diseases and Tumours
How does breastfeeding affect breast cancer risk?
Breastfeeding reduces the risk.
p.35
Diseases of the Endometrium
What treatment options are available for myometrial diseases?
Medications, hormonal therapy, or surgical interventions.
p.73
Breast Diseases and Tumours
What can lobular carcinoma in situ develop into?
It can break through the basement membrane to become infiltrative carcinoma, either of lobular or ductal type.
p.66
Breast Diseases and Tumours
How can staphylococci be transmitted during lactation?
Through fissures or abrasions of the nipple.
How are multiple papillomas distributed in the breast?
Throughout the duct system.
p.67
Breast Diseases and Tumours
What is sclerosing adenosis?
A localized condition that may simulate carcinoma, characterized by proliferation of acini and stroma with fibrosis.
p.15
Cervical Intraepithelial Neoplasia (CIN)
What does CIN stand for?
Cervical Intraepithelial Neoplasia.
p.21
Diseases of the Endometrium
What are some causes of endometritis?
Pelvic inflammatory disease, retained products of conception, intrauterine device-related.
p.75
Breast Diseases and Tumours
What is Li-Fraumeni syndrome?
A genetic disease associated with breast cancer due to mutation of the p53 tumor suppressor gene.
p.21
Diseases of the Endometrium
Which bacteria are associated with pelvic inflammatory disease leading to endometritis?
Neisseria gonorrhoeae and Chlamydia trachomatis.
What effect do Paget cells have on the epithelial barrier?
They disrupt the normal epithelial barrier, allowing extracellular fluid to seep out onto the nipple surface.
How can Paget cells be detected?
By nipple biopsy or cytologic preparations of the exudate.
p.15
Cervical Intraepithelial Neoplasia (CIN)
How is CIN typically diagnosed?
Through Pap smears and follow-up biopsies.
What is Paget disease of the nipple?
A rare manifestation of breast cancer that presents as a unilateral erythematous eruption with a scale crust.
p.16
Cervical Intraepithelial Neoplasia (CIN)
What is the primary risk associated with HPV?
It can lead to cervical cancer.
p.57
Ovarian Tumours and Cysts
What is the structure of a mature cystic teratoma?
It is unilocular with an eminence from which hairs grow.
p.56
Ovarian Tumours and Cysts
What type of tumour is a Dysgerminoma?
A solid tumour, usually ovoid with a smooth capsule.
p.48
Ovarian Tumours and Cysts
What complications can arise due to interruption of blood flow in mucinous cystadenocarcinoma?
Congestion and often infarction.
p.15
Cervical Intraepithelial Neoplasia (CIN)
What is the primary concern of Cervical Intraepithelial Neoplasia?
It involves abnormal cell growth on the surface of the cervix.
p.35
Diseases of the Endometrium
What is adenomyosis?
A condition where endometrial tissue grows into the myometrium.
p.16
Infectious Diseases of the Vulva and Vagina
Can HPV be prevented?
Yes, through vaccination and safe sex practices.
p.21
Diseases of the Endometrium
When should a diagnostic biopsy for tuberculous endometritis be performed?
As late in the cycle as possible to allow granulomas to develop.
p.15
Cervical Intraepithelial Neoplasia (CIN)
What does CIN 2 indicate?
Moderate dysplasia with a higher risk of progression to cancer.
p.56
Ovarian Tumours and Cysts
How are the cells in Dysgerminomas arranged?
In alveoli separated by fine connective tissue infiltrated by lymphocytes.
p.22
Diseases of the Endometrium
What is endometriosis?
Deposits of endometrium outside the uterine cavity.
p.11
Diseases of the Cervix
Which viral infections can affect the cervix?
Herpes simplex virus (Type II) and HPV.
What is the risk associated with duct papillomas?
There is a small increased risk of cancer developing.
p.14
Cervical Intraepithelial Neoplasia (CIN)
What are the stages of CIN?
CIN is classified into three grades: CIN 1, CIN 2, and CIN 3.
p.56
Ovarian Tumours and Cysts
What is a notable characteristic of Dysgerminomas regarding laterality?
They can sometimes be bilateral.
What historical factor contributed to the occurrence of clear cell adenocarcinoma in adolescent girls?
Administration of diethylstilbestrol to the mother during early pregnancy.
What condition is associated with the development of clear cell adenocarcinoma?
Vaginal adenosis, a proliferation of glands within the vaginal wall.
p.15
Cervical Intraepithelial Neoplasia (CIN)
What is the common treatment for high-grade CIN?
Treatment may include excisional procedures like LEEP or cone biopsy.
p.64
Gestational Trophoblastic Disease
What is choriocarcinoma?
A malignant tumor of trophoblast of fetal origin.
p.62
Gestational Trophoblastic Disease
What is a hydatidiform mole?
A type of gestational trophoblast disease where an ovum lacking its nucleus is fertilized by one or two sperm, resulting in a pregnancy without a fetus.
p.75
Breast Diseases and Tumours
Which genes are commonly mutated in hereditary breast cancer?
BRCA1 on chromosome 17 and BRCA2 on chromosome 13.
p.64
Gestational Trophoblastic Disease
What types of trophoblast are involved in choriocarcinoma?
Pleomorphic cytotrophoblast and syncytiotrophoblast.
What complications can arise from squamous carcinoma of the vagina?
Fistula formation between the vagina and the bladder or rectum.
p.15
Cervical Intraepithelial Neoplasia (CIN)
What are the stages of CIN?
CIN is classified into three grades: CIN 1, CIN 2, and CIN 3.
p.62
Gestational Trophoblastic Disease
What is the genetic makeup of a complete hydatidiform mole?
Both sets of chromosomes are paternal, usually 46XX.
p.15
Cervical Intraepithelial Neoplasia (CIN)
What is the significance of CIN 1?
CIN 1 indicates mild dysplasia and often resolves on its own.
p.35
Diseases of the Endometrium
How are myometrial diseases typically diagnosed?
Through imaging techniques like ultrasound or MRI.
p.15
Cervical Intraepithelial Neoplasia (CIN)
What is the concern with CIN 3?
CIN 3 is considered severe dysplasia and is often a precursor to cervical cancer.
