Small Group: Pathology of the Female Reproductive Tract

Question 1

Lichen sclerosis often presents with ___________ of the dermis.

Answer 1

homogenization (evidenced by a lack of nuclei)

Question 2

Lichen sclerosis can progress to ____________.

Answer 2

squamous cell carcinoma

Question 3

True or false: most vulvar squamous cell carcinomas are not related to HPV.

Answer 3

True. Only about 30% of vulvar SCC is related to HPV. In particular, keratinizing vulvar SCC is more associated with VIN.

Question 4

In a Pap test, what are the two normal cell types?

Answer 4

Squamous cells that are flat and large with small nuclei that appear usually alone

Glandular cells that appear in clumps with a higher N:C ratio than squamous cells; nuclei should be regular

Question 5

True or false: Pap tests can detect endometrial cancer.

Answer 5

False. It is not an adequate test for endometrial cancer.

Question 6

Once again, differentiate the types of endometrial cancer.

Answer 6

Type I: younger women; PTEN, kras, and wnt/catenin pathways common; less aggressive; low grade; GLANDULAR/DEEP

Type II: older women; p53; more aggressive; high grade; EPITHELIAL/SUPERFICIAL

Question 7

Yolk sac tumors in the ovaries are called ________________.

Answer 7

endodermal sinus tumors

Question 8

Which ovarian malignancies are most often bilateral?

Answer 8

Serous (65%) 
Clear cell (40%) 
Endometrioid (40%)

Question 9

What is the risk of ovarian and breast cancer in those with BRCA1 and BRCA2?

Answer 9

BRCA1: ovarian (20%-40%); breast (40%-90%)
BRCA2: ovarian (10%-20%); breast (40%-90%)

Question 10

Again, leiomyomas present with _________________ nuclei.

Answer 10

cigar-shaped