Cervical pathology 2

Question 1

Endometrial proliferation:

Endometrial hyperplasia

Answer 1

Excess estrogen stimulation
Increased risk for endometrial carcinoma

Presentation: postmenopausal vaginal bleeding

Question 2

Endometrial proliferation:

Endometrial hyperplasia risk factors

Answer 2

Anovulatory cycles,
hormone replacement therapy,
polycystic ovarian syndrome,
granulosa cell tumor

Question 3

Endometrial proliferation:

endometrial carcinoma

Answer 3

Most common gynecologic malignancy, peak at 55-65.

Presentation: vaginal bleeding.
Typically preceded by endometrial hyperplasia.

Myometrial invasion => poor prognosis

Question 4

Endometrial proliferation:

endometrial carcinoma risk factor

Answer 4

Prolonged use of estrogen without progestins
Obesity
Diabetes
HTN,
Nulliparity
Late menopause

Question 5

Myometrial tumors:

leiomyoma (fibroid)

Answer 5

Most common of all tumors in females
Often with multiple with well demarcated.
Increased incidence in blacks.
Benign smooth muscle tumor; malignant tranx rare.
Estrogen sensitive-> size increase with preg and decrease with menopause.
Peak at 20-40 years of age

Question 6

Myometrial tumors:

leiomyoma (fibroid) presentation

Answer 6

May be asymptomatic.
Causes abn uterine bleeding, or results in miscarriage.
Severe bleeding may lead to iron deficiency anemia.
Whorled pattern of smooth muscle bundle

DOES NOT progress to leiomyosarcoma

Question 7

Myometrial tumors:

leiomyosarcoma

Answer 7

Bulky, irregularly shaped tumor with areas of necrosis and hemorrhage.

Question 8

Myometrial tumors:

leiomyosarcoma prevalence

Answer 8

Increased incidence in black

Most commonly in middle aged

Question 9

Myometrial tumors:

leiomyosarcoma characteristics

Answer 9

Typically arises de novo (not from leiomyosarcoma).
High aggressive with tendency to recur
May protrude from cervix and bleed