Pathology
Female Genital Tract
Female genital tract pathology for MBBS and NEET-PG: cervical and endometrial carcinoma, fibroids, ovarian tumours, trophoblastic disease and endometriosis, mapped to NMC codes PA30.1 to PA30.9.
MedNext Academy | 3 min read
Female Genital Tract
Female genital tract pathology for MBBS and NEET-PG: cervical and endometrial carcinoma, fibroids, ovarian tumours, trophoblastic disease and endometriosis, mapped to NMC codes PA30.1 to PA30.9.
This chapter covers pathology of the female genital tract. It includes carcinoma of the cervix and its link with human papillomavirus, endometrial carcinoma and hyperplasia, leiomyoma and leiomyosarcoma, ovarian tumours, gestational trophoblastic disease, and endometriosis and adenomyosis.
High-yield: Female Genital Tract
- Cervical carcinoma is linked to persistent infection with high-risk human papillomavirus types 16 and 18.
- Cervical cancer arises at the transformation zone and progresses through dysplasia (CIN) to invasive squamous cell carcinoma.
- The Pap smear detects pre-invasive cervical lesions and has greatly reduced cervical cancer mortality.
- Endometrial carcinoma is linked to unopposed oestrogen, obesity, nulliparity and late menopause, and presents with postmenopausal bleeding.
- Endometrial hyperplasia with atypia is a precursor of endometrioid endometrial carcinoma.
- Leiomyoma (fibroid) is the most common benign uterine tumour and is oestrogen dependent.
- Leiomyosarcoma is a malignant smooth muscle tumour with high mitotic activity, necrosis and atypia.
- Ovarian tumours are classified as surface epithelial, germ cell and sex cord-stromal.
- Serous cystadenocarcinoma is the most common malignant ovarian tumour and may show psammoma bodies.
- A mature cystic teratoma (dermoid cyst) is the most common benign ovarian germ cell tumour and contains tissues from all three germ layers.
- CA-125 is the tumour marker used to monitor epithelial ovarian carcinoma.
- A complete hydatidiform mole is diploid and androgenetic, shows a snowstorm appearance and grossly raised beta-hCG.
- Choriocarcinoma is a highly malignant trophoblastic tumour that produces very high beta-hCG and metastasises early.
- Endometriosis is functioning endometrial tissue outside the uterus, causing chocolate cysts in the ovary and dysmenorrhoea.
Female genital tract essentials
- **Cervical cancer:** HPV 16 and 18; transformation zone; CIN to invasive squamous cell carcinoma.
- **Endometrial cancer:** Unopposed oestrogen; postmenopausal bleeding; hyperplasia precursor.
- **Ovarian tumours:** Epithelial (serous, CA-125), germ cell (dermoid), sex cord-stromal.
- **Trophoblastic:** Complete mole (snowstorm, high beta-hCG); choriocarcinoma (very high beta-hCG).
NMC competencies in this chapter
- **PA30.1:** Epidemiology, pathogenesis, screening and progression of carcinoma of the cervix
- **PA30.2:** Pathogenesis, pathology and spread of carcinoma of the endometrium
- **PA30.3:** Pathology of leiomyomas and leiomyosarcomas
- **PA30.4:** Classification, pathology and complications of ovarian tumours
- **PA30.5:** Pathology and complications of gestational trophoblastic neoplasms
- **PA30.6:** Aetiology and morphology of cervicitis
- **PA30.7:** Aetiology, hormonal dependence and morphology of endometriosis
- **PA30.8:** Aetiology and morphology of adenomyosis
- **PA30.9:** Hormonal dependence and morphology of endometrial hyperplasia
Frequently Asked Questions
What causes cervical cancer?
Persistent infection with high-risk human papillomavirus, especially types 16 and 18, which drives progression from cervical dysplasia to invasive carcinoma.
What is the most common malignant ovarian tumour?
Serous cystadenocarcinoma, a surface epithelial tumour that may contain psammoma bodies and is monitored with CA-125.
What causes endometrial carcinoma?
Prolonged unopposed oestrogen exposure, linked to obesity, nulliparity and late menopause, which presents with postmenopausal bleeding.
What is a complete hydatidiform mole?
A diploid, androgenetic gestational trophoblastic disease with a snowstorm ultrasound appearance and grossly raised beta-hCG.
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