Pathology EMQ template.

Name:

Candidate number:

Theme:

OPTION LIST

A	Adenocarcinoma	I	Squamous-cell carcinoma
B	Chronic endometritis	J	Salpingitis isthmica nodosa
C	Dysgerminosa
D	Endometriosis
E	Krukenberg tumour
F	Leiomyoma
G	Mature cystic teratoma
H	Papillary serous cystadenocarcinoma

For each scenario below, choose the most appropriate answer from the list above. Each option may be used once, more than once or not at all.

1. A 35-year-old woman attends for a routine cervical smear which shows severely dyskaryotic cells and highly keratinised cells ‘suspicious of malignancy’. Colposcopy reveals a 2cm, polypoid mass on the ectocervix that bleeds on contact. Biopsy confirms an invasive malignant tumour.

2. A 20-year-old woman presents with a 3-month history of abdominal pain. Investigations show an 8cm cystic mass in the right ovary. The excised cyst is filled with sebaceous material and matted hair; areas of bone and a tooth are also visible.

3. A 32-year-old woman seeks the advice of a gynaecologist because of dysmenorrhoea and dyspareunia. She and her partner have been trying to have a baby for 3 years without success. Laparoscopy shows a left ovarian cyst and haemorrhagic foci in the pelvic peritoneum with associated scarring. Excision of the ovarian cyst shows chocolate-brown fluid and altered blood in the cyst lumen.

4. A 72-year-old nulliparous woman presents with post-menopausal bleeding. On examination, she is found to be overweight and hypertensive. Histological examination of endometrial curettings shows a malignant tumour composed of closely packed glands.

5. A 46-year-old woman presents with abdominal pain and irregular periods. Abdominal ultrasound shows an enlarged uterus with multiple masses. Naked eye examination of the hysterectomy specimen shows several well-circumscribed intramyometrial masses with a white whorled cut surface in keeping with ‘fibroids’.

ANSWERS

1. I

2. G

3. D

4. A

5. F