Cervical Cancer Diagnosis and Management

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Questions and Answers

What clinical feature is associated with invasive cervical cancer?

  • Frequent urination
  • Increased menstrual flow
  • Unexpected vaginal bleeding (correct)
  • Unexplained weight loss

What is a characteristic feature of tumors causing a barrel cervix?

  • Cervical length increases
  • Widening of cervical diameter beyond 4cm (correct)
  • Surface ulceration
  • Calcifications within the tissue

Which diagnostic technique involves identifying atypical cells?

  • Direct immunofluorescence
  • Co-testing (correct)
  • Molecular stains - Single stains
  • Histopathological examination

What type of metastasis risk correlates with cervical cancer tumors of 3mm?

<p>10% (C)</p> Signup and view all the answers

What indicates that cancer has extended into the parametrial soft tissues?

<p>Affixing of the uterus to pelvic structures (D)</p> Signup and view all the answers

What color indicates maturity in squamous cells?

<p>Red to pink (B)</p> Signup and view all the answers

Which feature is characteristic of High-Grade Squamous Intraepithelial Lesions (HSIL)?

<p>Progressive atypia in all layers (C)</p> Signup and view all the answers

What does diffuse positivity with p16 indicate in cervical lesions?

<p>Surrogate marker for high risk HPV (C)</p> Signup and view all the answers

Which of the following tests is essential for diagnosing HPV cervical infection?

<p>PAP smear test (C)</p> Signup and view all the answers

What does dual-stain testing identify in Pap test samples?

<p>Presence of two proteins: p16 and Ki-67 (A)</p> Signup and view all the answers

Which statement about the HPV test is correct?

<p>It uses PCR to amplify viral DNA fragments. (C)</p> Signup and view all the answers

What marker is used to identify cell activity in cervical lesions?

<p>Ki-67 (C)</p> Signup and view all the answers

What significance does koilocytotic atypia have in squamous cells?

<p>It suggests low-grade lesions. (D)</p> Signup and view all the answers

Which characteristic is typical of a hydatidiform mole?

<p>Presence of cystic swelling resembling a bunch of grapes (B)</p> Signup and view all the answers

What is a key histopathological feature of a complete hydatidiform mole?

<p>Enlargement of avascular chorionic villi (D)</p> Signup and view all the answers

Which of the following types of hydatidiform moles is known to be compatible with embryogenesis?

<p>Partial hydatidiform mole (D)</p> Signup and view all the answers

What does the term 'invasive hydatidiform mole' refer to?

<p>A mole that penetrates into the uterine walls (A)</p> Signup and view all the answers

Which is NOT a feature observed in molar pregnancies?

<p>Presence of calcified tumors (A)</p> Signup and view all the answers

In the evaluation of gestational trophoblastic disease, which diagnostic technique is often used?

<p>Ultrasound imaging (D)</p> Signup and view all the answers

Which of the following closely resembles the diagnostic features of a hydatidiform mole?

<p>Choriocarcinoma (C)</p> Signup and view all the answers

What is the primary reason for performing surgical curettage in cases of hydatidiform mole?

<p>To prevent further trophoblastic disease (C)</p> Signup and view all the answers

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Study Notes

Atypical Cells and Diagnosis

  • Co-testing for cervical cancer includes the identification of atypical cells.
  • Dual staining (p16 and Ki-67) is a novel approach using molecular stains to detect high-risk HPV.
  • p16 positivity serves as a surrogate marker for high-risk HPV presence.

Cervical Malignancy

  • Invasive cervical cancers present with unexpected vaginal bleeding, leukorrhea, painful coitus (dyspareunia), or dysuria.
  • Palpation reveals tumor encirclement of the cervix, leading to a barrel-shaped cervix and cervical diameter widening beyond 4 cm.
  • Tumors may invade parametrial soft tissues, leading to pelvic lymph node involvement and uterine fixation to surrounding structures.

Metastasis Risk

  • The risk of metastasis to the bladder is significant; tumors greater than 3 mm have a 10% chance.
  • Features include a barrel-shaped cervix with heterogeneous invasion into the parametrium.

Squamous Intraepithelial Lesions (SIL)

  • Spectrum of SIL includes:
    • Low-grade SIL (LSIL) with koilocytotic atypia.
    • High-grade SIL (HSIL) with progressive atypia in all epithelial layers.
    • HSIL with diffuse atypia and loss of maturation, indicating carcinoma in situ.

Hydatidiform Mole

  • Defined by voluminous, cystic swelling resembling grape-like structures.
  • Molar lesions categorized as:
    • Complete Moles: Not compatible with embryogenesis; seldom contain fetal parts.
    • Partial Moles: Compatible with embryogenesis; may contain fetal parts.
    • Invasive Moles: Complete moles that invade uterine walls.

Key Histopathological Findings

  • Increased trophoblast proliferation is noted in histopathological examination of hydatidiform moles.
  • Enlargement and avascularity of chorionic villi are significant findings, along with formation of cisterns.

Diagnostic Procedures

  • Pap tests and HPV tests are utilized for cervical cancer screening.
  • HPV test amplifies viral DNA via PCR, while Pap smear detects cellular abnormalities.
  • Surgical curettage may be performed for histopathological examination to remove foreign contents.

Self-Assessment in Histopathology

  • Comparative evaluation of breast cancer tissues highlights features of invasive ductal carcinoma and calcification present within specific samples.

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