Ch 3b (pathology of uterus + endo) Flashcards
Where is a gartner duct cyst?
Simple cyst located in anterolateral wall of vagina
Who gets gartner duct cysts?
Reproductive aged women
What do gartner duct cysts look like?
Anechoic fluid filled mass with well defined boarders + good transmission
Where are Nabothian/inclusion cysts found?
Simple cyst in cervix at the opening of a nabothian duct
When are nabothian cysts often found?
After pregnancy
SF of nabothian cysts?
-fluid filled mass in cervical canal
-refractive edge shadowing
-measure 3-30 mm
M/c benign neoplasm of the cervix?
Cervical polyp
Cause of a cervical polyp?
Profuse bleeding or discharge
Where are cervical polyps located?
Attached to cervical wall by a pedicle, can grow to be several cm
SF of cervical polyp?
-Solid lesion with stalk
-Vascular feeding stalk seen with CD
(no colour in endo normally)
What is a cervical myoma?
Muscular benign solid mass in cervix
(similar to fibroid/leiomyoma)
Symptoms of a cervical myoma?
Most asymptomatic
SF of cervical myoma?
-distorts cervix
-appearance similar to corpus myoma/fibroid
What is endometrial hyperplasia?
Excessive growth of endo
Cause of endo hyperplasia?
High hormone levels (estrogen) cause endo thickening
Can endo hyperplasia develop into something more serious?
Yes, risk for endo cancer. Must monitor closely.
SF of endo hyperplasia?
-Thick + heterogeneous endo
-Small, anechoic cysts within endo
What pathology is the m/c cause of abnormal uterine bleeding?
Endo hyperplasia
Thickness measurements of endo with endo hyperplasia?
-14mm with premenopausal
-10mm when on tamoxifen
-8mm with postmenopausal
What is synechiae/asherman syndrome?
Scar tissue adhesions develop inside the endo due to trauma of the uterine lining
What kind of trauma causes asherman syndrome?
-C section
-Dilation + curettage (removal of tissue inside uterus)
Risks of asherman syndrome?
-Fertility problems
-Recurrent pregnancy loss
What specific type of u/s exam is best used to identify synechiae/asherman syndrome + why?
Sonohysterography b/c scar tissue/adhesions are isoechoic to the endo. The anechoic fluid helps visualize the scar tissue.
(look like an isoechoic line in endo)
What is uterine dehiscence?
-When the C section scar ruptures, especially if pregnant
-Endo + myometrium layers open but the outer perimetrium stays in tact
When does uterine dehiscence occur?
Rare complication of C section that can result in maternal + fetal morbidity
SF of uterine dehiscence?
-Scar seen on anterior section uterus at the internal os of cervix
-Scar appears abnoramlly thin + hypoechoic
-Bulges outwards
-M/c seen in pregnancy
(Image lower uterine segment with EV)
What is the m/c tumour of female pelvis?
Leiomyoma/fibroid (they are benign)
Cause of leiomyoma?
Unknown, although often arise after menarche and get worse after menopause (estrogen + tamoxifen may cause growth)
Location of leiomyoma?
Anywhere in uterus
What is a leiomyoma?
Benign tumour composed of smooth muscle cells + fibrous connective tissue
SF of leiomyoma?
-single or multiple
-variable in size
-calcific degeneration occurs m/c after menopause
-degeneration occurs when it outgrows blood supply
-clusters of bright reflectors with acoustic shadowing seen with calcific degeneration
List the 4 locations for a leiomyoma?
intramural: within myometrium
submucosal: below endo
subserosal: below serosa/perimetrium/outer uterus layer
pedunculated: outside uterus with stalk
Which location of fibroid is m/c to cause changes to menstrual cycle?
Submucosal fibroid b/c it is within/adjacent to the endo
Symptoms of heavy vaginal bleeding with fibroids get worse when they are located where in the uterus?
Worsen the closer the fibroid is to the endo cavity
Which location of a fibroid does not affect menstrual bleeding?
Subserosal fibroids, b/c below perimetrium/outer layer
(they can become large and don’t affect period)
Causes of pelvic abscess?
Infection of tubes, ovaries, appendix, bowel, peritoneum
(often occurs from a procedure, bacteria gets into the pelvic space)
Patient symptoms with a pelvic abscess?
-fever
-increased WBC
-tenderness/pain
-swelling at surgery site
SF of pelvic abscess?
Varies, often mix of cystic + solid mass. Lots of colour flow.
What is a pelvic hematoma?
Collection of blood due to trauma or a disease process within an organ/potential space
Cause of pelvic hematoma?
-ectopic pregnancy
-cyst rupture
-postoperative bleeding
-surgery
-trauma
SF of hematoma?
-well defined with clear borders
-complex or anechoic
-appearance depends on age of blood
-not a lot of colour flow
What is a pelvic lymphocele?
Pocket of lymph fluid resulting from trauma to lymph vessels in pelvis
SF of lymphocele?
-septated
-well defined
-complex mass