FRCPath Part1 Course
Gynaecological Pathology MCQ 1 A 48-year-old woman presented with vaginal bleeding for the past 2 months. An endometrial biopsy is performed and showed endometrial hyperplasia. An abdominal ultrasound reveals a solid right ovarian mass. Which of the following neoplasms is this woman most likely to have? A. B. C. D. E.
Mature cystic teratoma Granulosa cell tumour Serous papillary adenocarcinoma Mucinous cystadenoma Sertoli-Leydig cell tumour
MCQ 2 Cervical smear from a 28-year-old woman showed severely dysplastic cells. A biopsy of the cervix showed cervical intraepithelial neoplasia III (CIN III). Infection with which of the following organisms is most likely to cause her disease? A. B. C. D. E.
Herpes simplex virus infection Epstein-Barr virus Candida albicans Human papillomavirus Trichomonas vaginalis
MCQ 3 A hysterectomy was performed due to menorrhagia. On gross examination a reddish-tan mass was found with a fleshy cut surface. Microscopically the mass was highly cellular, with spindle cells having hyperchromatic nuclei and 10 to 20 mitoses per high power field. Which of the following is the most likely diagnosis? A. B. C. D. E.
Endometrial polyp Endometrial adenocarcinoma Adenomyosis Leiomyoma Leiomyosarcoma
MCQ 4 A 31-year-old woman at 14 weeks gestation had vaginal bleeding for 2 weeks. Laboratory studies showed an HCG level of 650,000 U/L. A D&C was performed with evacuation. A month later her vaginal bleeding persisted and her serum beta-HCG was 35,000 U/L. Which of the following pathologic abnormalities is most likely to be present in this woman? A. Endometriosis B. Endometritis C. Invasive mole D. Tubal ectopic pregnancy E. Placental site trophoblastic tumor
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FRCPath Part1 Course MCQ 5 A small cystic slightly tender mass found in the right lateral wall of the vagina of a 30 year old woman. On microscopic examination the cyst was lined by cuboidal epithelium. Which of the following is the most likely aetiology for this lesion? A. B. C. D. E.
Diethylstilbestrol exposure Gartner duct cyst Foreign body reaction Metastatic adenocarcinoma Oral contraceptive use
MCQ 6 A 40 year old woman presented with a solid ovarian tumour. Histologically the tumour showed nests of transitional-like epithelium separated by fibrous stroma. The cells have grooved nuclei. Which of the following is the tissue of origin of this tumour? A. B. C. D. E.
Germ cells Stromal cells Surface epithelium Urothelium Walthard nests
MCQ 7 A 47 year old woman had a pelvic ultrasound scan that reveals the presence of a left ovarian cyst, 10cm in diameter. She had a moderately raised level of the tumour marker CA125. A CT scan confirms the presence of the ovarian cyst but does not show any other lesion. A laparotomy is performed and a hystero-salpingo-oophrectomy is carried out, together with omentectomy and peritoneal washing. Histopathological examination of the cyst shows what appears to be a borderline ovarian tumour of serous type. However, the omentum shows Psammoma bodies and small serous epithelial structures on the surface and embedded within the fat, the latter haphazardly arranged and surrounded by granulation tissue and an inflammatory infiltrate. Peritoneal washings contain papillary fragments of bland serous epithelium. Identify the correct designation of this tumour. A. B. C. D. E.
Borderline ovarian tumour of serous type with endosalpingiosis Borderline ovarian tumour of serous type with non-invasive desmoplastic implants Primary peritoneal adenocarcinoma of serous type with synchronous ovarian borderline tumour Srage 1 serous cystadenocarcinoma of ovary with benign serous implants Stage 3 serous cystadenocarcinoma of ovary with peritoneal spread
MCQ 7a A 36 year old lady is found to have a large left sided ovarian mass. She undergoes staging surgery and you receive an intact cysts with multiple papillary excresences to the internal surface. On microscopy, you diagnose a serous borderline tumour. Identify the most important prognostic factor A. Psammoma bodies
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FRCPath Part1 Course B. C. D. E.
Papillary architecture Cytological atypia Invasive implants Microinvasion
EMQ 8 Options 1. Extramammary Paget disease 2. Vaginal Adenosis 3. Microglandular hyperplasia 4. Tunnel cluster 5. Mesonephric remnants Questions A. Closely packed cystically dilated endocervical glands B. Clusters of malignant epithelial cells within the epidermis and its appendages C. Glandular epithelium replacing the native squamous epithelium of the mucosa. D. Occurs secondary to oral contraceptive use E. Small clusters of tubules or glands usually at the lateral aspect of the cervix.
EMQ 9 Options 1. Sertoli-Leydig cell tumour 2. Fibrothecomas 3. Gartner duct cysts 4. Ovarian serous adenocarcinoma 5. Placental site trophoblastic tumor Questions A. Can be oestrogen producing B. Can produce virilizing symptoms C. Found in the anterolateral vaginal wall D. The cells make human placental lactogen E. Psammoma body formation is common
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FRCPath Part1 Course EMQ 10 Options 1. Gliomatosis peritoneii 2. Endosalpingiosis 3. Walthard nests 4. Struma ovarii 5. Adenomatoid tumour Questions A. Benign glands lined by tubal type epithelium in the peritoneum B. Benign tumour of mesothelial origin C. Due to peritoneal dissemination from an ovarian teratoma D. Nests formed by transitional type epithelium E. predominantly mature thyroid tissue EMQ 11 Options 1. Mucinous borderline tumour of the ovary 2. Endometrioid adenocarcinoma 3. Non-invasive desmoplastic peritoneal implants 4. Krukenberg tumour 5. Granulosa cell tumour Questions A. Shows complex architecture with fusion of atypical glands, solid areas and neutrophilic infiltration B. Shows cytological atypia and proliferation without stromal invasion C. Sharply demarcated foci of atypical epithelium and granulation tissue with occasional single cells in stroma D. Signet ring carcinoma with a cellular stromal reaction E. Typically shows Call-Exner bodies EXTRA QUESTIONS A: t(14,18)(q32,q31) B: hMLH C: t(11,22)(q24,q12) D: APC E: KVLQT1 F: PiZZ G: BRCA1 H: Alk1 I: cKIT J: Rb K: WT1 L: NF1
Follicular lymphoma HNPCC Ewing’s sarcoma FAP Romano-Ward (Long QT) Alpha-1-antitrypsin Breast/ovary carcinoma Hereditary haemorrhagic teleangiectasia GIST Osteosarcoma Wilms tumour Neurofibroma
1. Follicular lymphoma 2. Alpha -1-antitrypsin 3. HNPCC 4. Osteosarcoma 5. Ovarian carcinoma
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FRCPath Part1 Course A: B: C: D: E: F:
CIN1 CIN3 Endometriosis SqCCa Tubal metaplasia HGCGIN
G: H: I: J: K: L:
LGCGIN HPV Invasive adenoca Radiation atypia Endocervicosis Condyloma acuminatum
Relate histology/cytologys below to the most fitting pathology above. 1. Smear containing clusters of cells with low grade dysplasia 2. Smear with background neutrophils and debris with sparse elongate atypical orangophilic cells 3. Core biopsy containing an exophytic squamous lesion with clear paranuclear haloes, binucleate nuclei and keratinised cells 4. Cone biopsy containing non-invasive glandular lesion with hyperchromatic stratified nuclei, abnormal mitoses and intestinal metaplasia. 5. Peritoneal biopsy containing glands with columnar epithelium, oval nuclei and no nucleoli. Associated stroma and brown pigment are seen.
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