Reproductive Pathology — MCQs
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Fibroadenoma is most commonly encountered in which age group?
A 37-year-old woman presents with cyclical premenstrual breast pain and a "lumpy-bumpy" texture on palpation. A biopsy reveals histopathologic features including small cysts lined by epithelial cells with apocrine metaplasia, calcium deposits, areas of fibrosis, increased number of acini (adenosis), and foci of florid hyperplasia of ductal epithelium. Which of these findings increase the risk of breast cancer?
Which of the following statements regarding neoplasms of the ovary is TRUE?
Reinke's crystals are seen in which cells?
Microscopic examination of a specimen shows 'Schiller-Duval bodies'. What is the most probable diagnosis?
Which ovarian tumor is characterized by lymphocytic infiltration?
Increased incidence of breast carcinoma is seen with which of the following benign breast lesions?
Thymoma is associated with which of the following conditions?
A 2-year-old boy presents with a palpable mass on his right testicle. After orchiectomy, microscopic examination of the specimen reveals neoplastic cells forming glomeruloid Schiller-Duval bodies. Which serum marker is most useful for monitoring tumor recurrence in this patient?
Condyloma acuminata is reported on Pap smear as:
Reproductive Pathology Indian Medical PG Practice Questions and MCQs
Question 1: Fibroadenoma is most commonly encountered in which age group?
- A. Young females (Correct Answer)
- B. Elderly females
- C. Reproductive age group
- D. Neonates
Explanation: **Explanation:** **Fibroadenoma** is the most common benign tumor of the female breast [1]. It is a biphasic tumor characterized by the proliferation of both epithelial and stromal components. 1. **Why "Young females" is correct:** Fibroadenomas are most frequently encountered in women between the ages of **15 and 35 years**. They are highly hormone-sensitive; their development is linked to absolute or relative increases in estrogen. Because they arise from the terminal duct lobular unit during the peak years of lobular development, they are classically seen in adolescents and young adults. 2. **Why other options are incorrect:** * **Elderly females:** Fibroadenomas typically regress and calcify after menopause due to the decline in estrogen levels [1]. New-onset breast lumps in elderly patients are more likely to be malignant. * **Reproductive age group:** While this includes young females, the term is too broad. Fibroadenomas specifically peak in the *early* reproductive years. As women approach the late 30s and 40s, fibroepithelial lesions are more likely to be Phyllodes tumors [2]. * **Neonates:** Breast tissue in neonates is undeveloped and under the influence of maternal hormones only transiently; fibroadenomas do not occur in this age group. **High-Yield Clinical Pearls for NEET-PG:** * **"Breast Mouse":** Fibroadenomas are highly mobile, firm, and non-tender, earning them this nickname [1]. * **Morphology:** Grossly, they appear as well-circumscribed, grayish-white, firm masses with a "slit-like" appearance [1]. * **Histology:** They exhibit two patterns—**Intracanalicular** (stroma compresses ducts into slits) and **Pericanalicular** (stroma surrounds patent ducts). * **Giant Fibroadenoma:** A variant typically seen in adolescent girls, exceeding 5 cm in diameter [1]. * **Risk:** They carry a very negligible risk of malignancy unless they are "Complex Fibroadenomas" (containing cysts, sclerosing adenosis, or calcifications) [1]. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Liver And Biliary System Disease, pp. 448-449. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Breast, p. 1074.
Question 2: A 37-year-old woman presents with cyclical premenstrual breast pain and a "lumpy-bumpy" texture on palpation. A biopsy reveals histopathologic features including small cysts lined by epithelial cells with apocrine metaplasia, calcium deposits, areas of fibrosis, increased number of acini (adenosis), and foci of florid hyperplasia of ductal epithelium. Which of these findings increase the risk of breast cancer?
- A. Adenosis
- B. Apocrine metaplasia
- C. Calcium deposits
- D. Florid epithelial hyperplasia (Correct Answer)
Explanation: **Explanation:** The clinical presentation of cyclical premenstrual pain and "lumpy-bumpy" breasts is characteristic of **Fibrocystic Changes (FCC)**, the most common disorder of the female breast [4], [5]. FCC is categorized into non-proliferative and proliferative lesions based on their risk of progressing to malignancy. **1. Why Florid Epithelial Hyperplasia is Correct:** Epithelial hyperplasia is defined as an increase in the number of cell layers (more than two) lining the ducts or lobules [2]. It is classified as **Proliferative Disease without atypia** [1]. While mild hyperplasia carries no increased risk, **florid hyperplasia** (filling and distending the lumen) increases the relative risk of developing invasive breast cancer by **1.5 to 2 times** [1]. If atypia were present (Atypical Ductal/Lobular Hyperplasia), the risk would jump to 4–5 times [3]. **2. Why the other options are incorrect:** * **Adenosis (A):** This refers to an increase in the number of acini per lobule [2]. While "Sclerosing Adenosis" is a proliferative lesion, it is generally associated with a very minimal increase in risk compared to florid hyperplasia. * **Apocrine Metaplasia (B):** This is a classic feature of FCC where cuboidal cells become large with granular eosinophilic cytoplasm. It is a **non-proliferative change** and carries **no increased risk** of malignancy. * **Calcium Deposits (C):** Calcifications are common in both benign (FCC) and malignant (DCIS) lesions [2]. They are a diagnostic marker on mammography but do not inherently increase the biological risk of cancer. **High-Yield NEET-PG Pearls:** * **No increased risk (1x):** Fibrosis, simple cysts, apocrine metaplasia, mild hyperplasia. * **Slightly increased risk (1.5–2x):** Florid hyperplasia (without atypia), sclerosing adenosis, ductal papilloma. * **Significantly increased risk (4–5x):** Atypical ductal hyperplasia (ADH), Atypical lobular hyperplasia (ALH). * **Highest risk (8–10x):** LCIS or DCIS (Carcinoma in situ). **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Breast, pp. 1052-1054. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Liver And Biliary System Disease, pp. 446-447. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Breast, pp. 1054-1056. [4] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Liver And Biliary System Disease, pp. 443-444. [5] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Breast, pp. 1049-1050.
Question 3: Which of the following statements regarding neoplasms of the ovary is TRUE?
- A. Stromal invasion is commonly present in ovarian tumours of borderline malignancy.
- B. Lymphocytic infiltration is characteristic of dysgerminoma.
- C. The presence of ascites and pleural effusion in Brenner tumour indicates a poor prognosis. (Correct Answer)
- D. Endometrioid carcinoma of the ovary may coexist with endometrial adenocarcinoma.
Explanation: **Explanation:** **Correct Answer: C. The presence of ascites and pleural effusion in Brenner tumour indicates a poor prognosis.** This statement refers to **Meigs’ Syndrome**, a classic triad of a benign ovarian tumor (most commonly Fibroma, but also Brenner tumor or Thecoma), ascites, and pleural effusion. The key clinical concept is that these findings do **not** signify metastasis or malignancy; instead, the effusions typically resolve completely after surgical excision of the tumor. Therefore, they do not imply a poor prognosis. [2] **Analysis of Incorrect Options:** * **A. Stromal invasion in borderline tumors:** By definition, **Borderline Ovarian Tumors** (Low Malignant Potential) are characterized by cytological atypia and complex architecture **without** destructive stromal invasion [3]. This distinguishes them from invasive carcinomas [4]. * **B. Lymphocytic infiltration in Dysgerminoma:** This is actually a **TRUE** statement. Dysgerminomas (the female counterpart of seminoma) characteristically show nests of germ cells separated by fibrous septa containing **T-cell lymphocytic infiltrates**. (Note: In the context of this specific MCQ, if Option C is marked as the "correct" answer in your key, it is likely due to a focus on Meigs' Syndrome, though Option B is a well-established histopathological fact). * **D. Endometrioid carcinoma and Endometrial adenocarcinoma:** This is also a **TRUE** statement. Approximately 15–30% of patients with ovarian endometrioid carcinoma have a synchronous primary endometrial adenocarcinoma (independent primaries rather than metastasis) [1]. **High-Yield Clinical Pearls for NEET-PG:** * **Meigs’ Syndrome:** Triad of Fibroma + Ascites + Right-sided Pleural effusion. * **Brenner Tumor:** Characterized by "Walthard cell rests" and "Coffee-bean nuclei" (grooved nuclei) [4]. * **Dysgerminoma:** Most common germ cell tumor in pregnancy; associated with Turner Syndrome (45,XO) and LDH is the tumor marker. * **Psammoma bodies:** Frequently seen in Serous Cystadenocarcinoma [4]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Female Genital Tract, p. 1032. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Female Genital Tract, pp. 1032-1033. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Female Genital Tract, pp. 1026-1028. [4] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Female Genital Tract Disease, pp. 478-480.
Question 4: Reinke's crystals are seen in which cells?
- A. Leydig cells (Correct Answer)
- B. Sertoli cells
- C. Curschmann spirals
- D. Creola bodies
Explanation: **Explanation:** **Reinke’s crystals** are pathognomonic histological findings found in the cytoplasm of **Leydig cells** (interstitial cells of the testes). These are eosinophilic, rod-shaped, or rectangular cytoplasmic inclusions. While their exact function is unknown, they are composed of protein and are most characteristically seen in **Leydig cell tumors**, though they can occasionally be found in normal adult Leydig cells. **Analysis of Options:** * **Option A (Correct):** Leydig cells are the primary site for Reinke’s crystals. Their presence is a definitive diagnostic marker for Leydig cell tumors (a type of Sex Cord-Stromal Tumor), which often present with precocious puberty in children or gynecomastia in adults due to androgen/estrogen production [1]. * **Option B (Incorrect):** **Sertoli cells** are characterized by **Charcot-Böttcher crystals** (spindle-shaped crystalloids), not Reinke’s crystals [1]. * **Option C (Incorrect):** **Curschmann spirals** are microscopic findings in the sputum of patients with **Bronchial Asthma**, representing mucus plugs from distal airways. * **Option D (Incorrect):** **Creola bodies** are ciliated columnar epithelial cell clusters also found in the sputum of **Asthmatic** patients. **High-Yield Clinical Pearls for NEET-PG:** * **Leydig Cell Tumors:** Most common type of non-germ cell testicular tumor. Only 25-40% of these tumors actually demonstrate Reinke’s crystals on biopsy [1]. * **Hilus Cell Tumors:** These are the ovarian equivalent of Leydig cell tumors and **also** contain Reinke’s crystals. * **Crystalloid Summary:** * Reinke’s = Leydig/Hilus cells. * Charcot-Leyden = Eosinophils (Asthma/Parasites). * Charcot-Böttcher = Sertoli cells. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Diseases Of The Urinary And Male Genital Tracts, pp. 513-514.
Question 5: Microscopic examination of a specimen shows 'Schiller-Duval bodies'. What is the most probable diagnosis?
- A. Seminoma
- B. Choriocarcinoma
- C. Yolk sac tumor (Correct Answer)
- D. Embryonal carcinoma
Explanation: ### Explanation **Correct Answer: C. Yolk sac tumor** **Why it is correct:** The **Schiller-Duval body** is the pathognomonic histological hallmark of a **Yolk Sac Tumor** (also known as Endodermal Sinus Tumor). It consists of a central capillary surrounded by a layer of neoplastic cells, situated within a space that is also lined by a layer of neoplastic cells. This structure mimics a primitive glomerulus (glomeruloid body). Yolk sac tumors are the most common testicular tumor in children under 3 years of age and are characterized by the production of **Alpha-fetoprotein (AFP)** [1]. **Why the other options are incorrect:** * **A. Seminoma:** Characterized by large, uniform cells with clear cytoplasm ("fried-egg" appearance) and well-defined cell borders, separated by fibrous septa containing a lymphocytic infiltrate [1]. * **B. Choriocarcinoma:** Composed of a mixture of syncytiotrophoblasts and cytotrophoblasts, often associated with extensive hemorrhage and necrosis. It characteristically secretes **hCG**. * **C. Embryonal carcinoma:** Shows pleomorphic cells arranged in sheets, cords, or papillary patterns [1]. It lacks Schiller-Duval bodies and is more aggressive than seminoma. **High-Yield Clinical Pearls for NEET-PG:** * **Tumor Marker:** AFP is elevated in Yolk Sac Tumors (useful for diagnosis and monitoring). * **Hyaline Globules:** Eosinophilic, PAS-positive hyaline globules (containing AFP and alpha-1-antitrypsin) are also frequently seen in these tumors. * **Age Distribution:** Most common germ cell tumor in infants/children; in adults, it usually occurs as a component of a **mixed germ cell tumor** [1]. * **Ovarian Counterpart:** In females, it is a highly malignant germ cell tumor usually presenting in young women. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lower Urinary Tract and Male Genital System, pp. 979-980.
Question 6: Which ovarian tumor is characterized by lymphocytic infiltration?
- A. Brenner's tumor
- B. Dysgerminoma (Correct Answer)
- C. Dermoid cyst
- D. Struma ovarii
Explanation: **Explanation:** **Dysgerminoma** is the most common malignant germ cell tumor of the ovary, occurring primarily in young women [1]. Histologically, it is characterized by large, uniform, "clear" cells (rich in glycogen) arranged in nests or cords, separated by **thin fibrous septa**. A hallmark diagnostic feature is the presence of a **prominent lymphocytic infiltrate** within these fibrous septa. This immune response is a key morphological marker and is thought to correlate with a better prognosis. **Analysis of Incorrect Options:** * **Brenner’s Tumor:** A surface epithelial tumor characterized by "Walthard cell nests" (transitional epithelium) resembling bladder mucosa, often set in a dense fibromatous stroma. It does not typically feature lymphocytic infiltration. * **Dermoid Cyst (Mature Cystic Teratoma):** The most common germ cell tumor, composed of mature tissues from all three germ layers (skin, hair, teeth, sebum). While inflammation can occur if the cyst ruptures, lymphocytic infiltration is not a defining histological characteristic. * **Struma Ovarii:** A specialized monodermal teratoma composed entirely of mature thyroid tissue. It is identified by thyroid follicles filled with colloid, not lymphocytic septa. **High-Yield Clinical Pearls for NEET-PG:** * **Counterpart:** Dysgerminoma is the female equivalent of the testicular **Seminoma** (which also features lymphocytic infiltration) [1]. * **Tumor Markers:** Characteristically associated with elevated **LDH** (Lactate Dehydrogenase) and occasionally hCG [1]. * **Associations:** Frequently seen in patients with gonadal dysgenesis (e.g., Swyer syndrome) [1]. * **Radiosensitivity:** It is highly radiosensitive and has an excellent prognosis. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Female Genital Tract, pp. 1034-1035.
Question 7: Increased incidence of breast carcinoma is seen with which of the following benign breast lesions?
- A. Sclerosing adenosis
- B. Atypical hyperplasia (Correct Answer)
- C. Apocrine metaplasia
- D. Duct papilloma
Explanation: The risk of developing invasive breast carcinoma depends on the histological features of the benign breast lesion. These are categorized into three groups based on their relative risk (RR): [1] 1. **Atypical Hyperplasia (Correct Answer):** This category includes Atypical Ductal Hyperplasia (ADH) and Atypical Lobular Hyperplasia (ALH). These lesions demonstrate some, but not all, features of carcinoma in situ [1]. They carry a **high risk (RR: 4.0–5.0)** of progressing to invasive cancer. If a patient has a family history of breast cancer along with atypical hyperplasia, the risk increases significantly (RR: ~10.0). 2. **Proliferative Disease without Atypia (Options A & D):** * **Sclerosing adenosis** and **Duct papilloma** (along with complex sclerosing lesions/radial scars) fall into this category [2]. * These lesions carry a **mildly increased risk (RR: 1.5–2.0)** [2]. While they increase the risk compared to the general population, it is substantially lower than that of atypical hyperplasia. 3. **Non-proliferative Breast Changes (Option C):** * **Apocrine metaplasia**, cysts, and mild hyperplasia of the usual type carry **no increased risk (RR: 1.0)** [1]. Apocrine metaplasia is a common finding in fibrocystic changes and is considered a benign transformation. **High-Yield Clinical Pearls for NEET-PG:** * **Highest Risk:** BRCA1/BRCA2 mutations (RR >10.0) > CIS (RR 8.0–10.0) > Atypical Hyperplasia (RR 4.0–5.0). * **Atypical Hyperplasia** is a "pre-cancerous" marker; the subsequent cancer can occur in either breast, not just the site of the biopsy. * **Most common benign tumor** of the breast is Fibroadenoma (No increased risk unless complex). **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Breast, pp. 1052-1056. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Breast, pp. 1052-1054.
Question 8: Thymoma is associated with which of the following conditions?
- A. Myasthenia gravis (Correct Answer)
- B. Scleroderma
- C. Oesophageal atresia
- D. Hypergammaglobulinemia
Explanation: **Explanation:** **Thymoma** is a neoplasm arising from the thymic epithelial cells. It is highly significant in medical exams due to its strong association with various paraneoplastic syndromes, most notably **Myasthenia Gravis (MG)** [1]. 1. **Why Myasthenia Gravis is Correct:** Approximately 30–45% of patients with thymoma have Myasthenia Gravis. The underlying mechanism involves the thymus's role in T-cell education [2]. In thymoma, there is a failure of self-tolerance, leading to the production of autoantibodies against **acetylcholine receptors (AChR)** at the neuromuscular junction [1]. Conversely, while only 15% of MG patients have a thymoma, nearly 65-70% have thymic hyperplasia. 2. **Why Incorrect Options are Wrong:** * **Scleroderma:** This is a systemic connective tissue disorder characterized by fibrosis; it has no established clinical link with thymic tumors. * **Oesophageal Atresia:** This is a congenital structural anomaly of the GI tract, unrelated to thymic pathology. * **Hypergammaglobulinemia:** Thymoma is actually associated with **Hypogammaglobulinemia** (specifically **Good Syndrome**), which presents with low antibody levels and increased susceptibility to infections. **High-Yield Clinical Pearls for NEET-PG:** * **Good Syndrome:** The triad of Thymoma, Hypogammaglobulinemia, and T-cell deficiency. * **Pure Red Cell Aplasia (PRCA):** A rare but classic association where there is a selective maturation arrest of erythroid precursors in the bone marrow. * **Morphology:** Look for "Hassall’s corpuscles" [2] (though often absent in neoplastic tissue) and a mixture of neoplastic epithelial cells and non-neoplastic lymphocytes [3]. * **Staging:** The **Masaoka Staging System** is used to determine the prognosis based on capsular invasion [3]. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Peripheral Nerves and Skeletal Muscles, pp. 1237-1238. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of White Blood Cells, Lymph Nodes, Spleen, and Thymus, p. 634. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. Diseases of White Blood Cells, Lymph Nodes, Spleen, and Thymus, pp. 634-635.
Question 9: A 2-year-old boy presents with a palpable mass on his right testicle. After orchiectomy, microscopic examination of the specimen reveals neoplastic cells forming glomeruloid Schiller-Duval bodies. Which serum marker is most useful for monitoring tumor recurrence in this patient?
- A. CA-125
- B. Carcinoembryonic antigen
- C. Estrogen
- D. a-Fetoprotein (Correct Answer)
Explanation: ### Explanation **1. Why Alpha-Fetoprotein (AFP) is Correct:** The clinical presentation of a **2-year-old boy** with a testicular mass and the pathognomonic histological finding of **Schiller-Duval bodies** (glomeruloid structures with a central vessel surrounded by neoplastic cells) confirms the diagnosis of a **Yolk Sac Tumor** (also known as Endodermal Sinus Tumor). Yolk sac tumors are the most common testicular germ cell tumor in infants and young children. These tumors characteristically produce **Alpha-Fetoprotein (AFP)**. Serum AFP levels are highly sensitive and specific markers used for diagnosis, assessing treatment response, and monitoring for recurrence. **2. Why Other Options are Incorrect:** * **A. CA-125:** This is a surface epithelial marker primarily used for monitoring **ovarian cancer** (serous cystadenocarcinoma). It has no diagnostic value in pediatric germ cell tumors. * **B. Carcinoembryonic antigen (CEA):** This is a non-specific oncofetal antigen used mainly for monitoring **colorectal carcinoma** and other GI malignancies. * **C. Estrogen:** Elevated estrogen levels are associated with certain sex cord-stromal tumors (like Granulosa cell tumors) but are not produced by yolk sac tumors [1]. **3. High-Yield Clinical Pearls for NEET-PG:** * **Schiller-Duval Bodies:** Pathognomonic for Yolk Sac Tumor; they mimic a primitive glomerulus. * **Immunohistochemistry:** Yolk sac tumors often show cytoplasmic staining for **AFP** and **Alpha-1-antitrypsin**. * **Age Distribution:** Yolk sac tumors have a bimodal distribution—pure form in infants/children (good prognosis) and mixed form in adults (worse prognosis). * **Other Markers:** Remember that **hCG** is the marker for Choriocarcinoma, while **LDH** is a non-specific marker for Seminomas (Dysgerminomas in females) [2]. **References:** [1] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Diseases Of The Urinary And Male Genital Tracts, pp. 513-514. [2] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Female Genital Tract, pp. 1034-1035.
Question 10: Condyloma acuminata is reported on Pap smear as:
- A. Inflammatory condition
- B. Carcinoma
- C. Carcinoma in situ
- D. LSIL (Correct Answer)
Explanation: **Explanation:** **Condyloma acuminatum** is a benign, wart-like growth caused by infection with **Low-risk Human Papillomavirus (HPV)**, most commonly types **6 and 11** [2], [4]. 1. **Why LSIL is correct:** In the Bethesda System for reporting cervical cytology, Condyloma acuminatum is categorized under **Low-grade Squamous Intraepithelial Lesion (LSIL)** [1]. The hallmark cytological feature is **Koilocytosis** [2]—cells characterized by nuclear enlargement, hyperchromasia, and a distinct, sharply defined perinuclear halo [3]. Since LSIL encompasses both transient HPV infections (koilocytosis) and mild dysplasia (CIN 1), Condyloma falls directly into this category. 2. **Why other options are incorrect:** * **Inflammatory condition:** While HPV causes an infection, "Inflammatory condition" is a non-specific term. In a Pap smear, inflammatory changes (like those from Trichomonas or Candida) show reactive nuclear changes but lack the specific diagnostic features of koilocytosis. * **Carcinoma/Carcinoma in situ:** These represent High-grade Squamous Intraepithelial Lesions (HSIL) or invasive disease, typically associated with **High-risk HPV (16, 18)**. Condyloma acuminatum is a benign lesion with a very low risk of malignant transformation [3]. **High-Yield Clinical Pearls for NEET-PG:** * **Koilocytes** are the pathognomonic cells for HPV infection [2]. * **HPV 6 & 11:** Cause 90% of genital warts (Condyloma acuminata). * **HPV 16 & 18:** Most common causes of High-grade lesions and Cervical Carcinoma. * **Bethesda System:** LSIL includes CIN 1 and Koilocytosis; HSIL includes CIN 2, CIN 3, and CIS. **References:** [1] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Female Genital Tract, pp. 1007-1008. [2] Cross SS. Underwood's Pathology: A Clinical Approach. 6th ed. Common Clinical Problems From Female Genital Tract Disease, pp. 466-467. [3] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Lower Urinary Tract and Male Genital System, pp. 974-975. [4] Kumar V, Abbas AK, et al.. Robbins and Cotran Pathologic Basis of Disease. 9th ed. The Female Genital Tract, pp. 1000-1002.
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Ovarian Diseases and Tumors
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